Borderline Personality Disorder

[HypercriticalOaf]

I'm certain I have it.

I've been referred to the CMH team but could anyone here please discuss it with me?

I'm feeling quite alone (I am in a sense, though sabotaging many close relationships) and would really appreciate hearing anything from anyone who has or who has experience of Borderline Personality Disorder.

This forum has a section for BPD, as well as other related issues.

Mind leaflets are also good

There is good long-term therapy of various types available on the NHS in many areas, but the pathways to referral can be a bit hit and miss. Having a good GP is a start, at least. Psych referral def also a good thing - some are brilliant, some... notsomuch. Again, a thoughtful GP may be able to improve the odds of you getting the former rather than the latter.

Good luck with it. FWIW I suspect my dsis has BPD, but oscillates between wanting help and pushing me away. It's painful to watch from a distance, but there's not really much I can do without getting sucked into her cycles, which for the sake of my own mental health I have to avoid. I reckon being clear in your own mind that you want and need help is a promising starting point.

oscharoses, the criteria are intentionally vague, so that they can be applied to almost anyone.

For those who are concerned that they recognise themselves in it all - personality disorders are rare and they will usually be diagnosed by a professional (hopefully after lengthy investigation) because the person themselves will lack the insight in their condition.

thepeoplesprincess on 22-May at 23:06 said it very well.

Queen have you been scarred by a bad experience? There is a bit more to BPD than such a quick dismissal - even though it is indeed in some quarters seen as controversial. My main problem with it is that in particular Complex PTSD (caused by such things as long term child abuse) has some symptoms in common and sometimes HCP go too soon towards the BPD angle.

That's interesting madmouse. I do have (diagnosed) complex PTSD so there is a definite crossover of symptoms for me. I think part of the reason that BPD is being considered in my case, is that many of my symptoms actually appear to precede what was defined as the series of traumas which caused my PTSD (and that both can exist together).

There is of course the possibility that childhood trauma caused undiagnosed complex PTSD and that secondary traumas exacerbated my condition. I suppose much more will come to light if I can access the appropriate therapies.

Thank you Polly for your links, insight and encouragement.

Just seen you have PTSD as well, so might be worth looking at the main boards of the TWHJ forum to see if other topics there resonate with you as well.

It can be a very supportive place with some longstanding and thoughtful and knowledgeable contributors, many of whom are therapists in their own right. But there are some very damaged and dsyfunctional people on there as well, so use with care. Some of the material can be quite triggering, and threads do sometimes go a bit left-field.

xx

The other thing to check might be to see if your local mental health trust has a Consultant Psychiatrist in Psychotherapy - they will generally be in charge of the local provision of proper long-term psychotherapy (as opposed to the 6 sessions of CBT-type scenario). If that kind of service exists locally to you then getting the appropriate referral at an early stage can cut out the kind of messing around with inappropriate services that can occur if an under-informed professional thinkingly follows the usual 'stepped care' pathway.

I am in the beginning states of treatment for a personality disorder that they think is bpd. I am unsure tbh although don't disagree that I may have a PD.

I have been told that I will need two years of psychotherapy and I have had mental health issues on and off for the past 8 years and it is only this 'crisis' which has involved a lengthy hospital admission and quite serious self harm that they have started to investigate PD. I have been seen by a psychiatrist and my therapy is with a clinical psychologist. I have previously had nurse-led TA and IAPT led TA/CBT both of which helped me to gain a greater insight into myself but not 'fix' it.

I am quite switched off emotionally but my psychologist thinks I am shut off in quite a sensory way as well. We shall see.

I have been married for 4 years and have stable, non-dramatic long term friendships. I also don't engage in risky behaviour (other than SI) - no reckless money spending, no sleeping around, no gambling etc.

NEVER try to self-diagnose.

I think that anyone concerned that they have BPD or any MH condition should get a referral to an NHS Psychiatrist.

This is my experience of BPD:

When i was seriously Depressed in Spring 2009 i finally asked my GP for that referral.
I saw 2 SHO-level Psychiatrists but i admit to not being very honest with them about how i truly felt, how paranoid i actually was, how obsessive & i never once said i was suicidal. I was scared to be honest with them in case i got sectioned.
I was sent for CBT to deal with the initial diagnoses of 'work-related stress & mild depression; but 16 appointments & 1 very frustrated therapist later i was referred to an NHS Consultant Psychologist linked with the Psychiatrist's team.
I started having appointments with the Cons Psychologist AND (finally) the Consultant Psychiatrist in late Spring 2010 & was given lots of tests to fill in.
I was still suicidal, self-harming, paranoid, & onto my 3rd (finally a bit more successful) Anti-Depressant (an SNRI).
I didn't know what the tests were for - i expected a diagnosis of Bipolar 2 maybe - because all i'd googled was 'types of Depression' & Bipolar 2 seemed to fit in slightly.

I was shocked to be told (in July 2010) that i had 'Borderline Personality Disorder' (aka 'Emotionally Unstable Personality Disorder'). Not quite so shocked to get a diagnosis of 'Chronic (Recurrent) Major Depressive Disorder' too.
I'd never heard of Borderline & spent months in denial questioning the diagnosis.
I had hour-long appointments with the Psychologist every 2 weeks for 18 months; she was frustrated too as she guessed i wasn't totally honest with her.

Plus I have Epilepsy & the meds (AEDs) i took for that were causing drowsiness & Memory Loss (basically Dementia-type side effects including muddled speech).

So at every session i would listen, take notes, then promptly forget where i put them or that i'd written them.

The Neurology team slowly took me off the horrible AEDs & slowly put me onto newer, safer AEDs. The drowsiness, tremor, constant hunger & 'Dementia'(!!!) side effects wore off thank god although i'm left with Memory Loss :(
The new Epilepsy meds are a revelation - i can think clearly again after over 7 years of feeling like i was 'swimming through treacle' or 'in a fog'. My eyes have lost the 'dreamy' look they had. The Epilepsy is not fully controlled due to the SNRI drug lowering my seizure threshold so i still get some Absence & Deja Vu seizures.

But the old meds also had a 'mood stabilising' effect. Unfortunately the BPD is much much worse now as i have more severe mood swings, suicidal thoughts, still self harm, get agitated & angry for no reason, switch in & out of paranoia, & transient psychosis :(

Not pleasant for me or my family (luckily i live alone though). I still have my job (but part time hours now); a family, colleagues & good friends who like me (because most of the time i'm horrible to myself not anyone else!).
I'm still obsessive & impulsive (overeating, undereating, overspending, meeting unsuitable men etc etc).

I am really really really sick of it all & keep wanting to give up on life but i know i'm lucky in a lot of ways so i just keep reminding myself of that.

The Psychologist is now aware of all my symptoms as i finally trusted her enough to start being honest with her.
She has referred me for DBT (Dialectical Behavioural Therapy) on the NHS - i've been assessed & accepted onto the (10 month!!!) waiting list. It's a therapy specifically for BPD patients - but you have to prove that you are 'bad enough' to need it; & that you are willing to work hard at the therapy to try & get well. I've heard DBT has a good success rate although my Psychologist isn't optimistic about my chance of recovery - she put it at 30% - that was when i was still badly affected by the old AEDs though.

My Psychiatrist feels i'm on enough medication unless the mood swings, paranoia & psychosis episodes get much worse. The truth is that most mood stabilisers & Anti-Psychotic drugs interract badly with the SNRI & with my Epilepsy meds; or they may lower my seizure threshold more.

I do accept my diagnosis but i do still question it when i get paranoid.

Now i'm on the DBT waiting list i only see the Psychologist once a month but see the Psychiatrist more often (8 weekly approx).
Also i can phone the Duty CPN or CMHT Crisis Team anytime i feel unwell - & i'm lucky to have an understanding & helpful GP Surgery.

But i wouldn't wish this all on anyone else - I'm just happy that i'm still alive so far & haven't slit my wrists during an irrational mood swing.
Because that's how it is.
Right now, this moment, I'm content, happy & want to stay this way for ever. But in 2 hours, 2 days, 2 weeks time? I don't know.

I've had a diagnosis of BPD for five years. Personally I don't agree with the diagnosis - I got a later diagnosis of Asperger Syndrome and I believe that explains my behaviour much better and makes more sense to me, especially as traditional therapy didn't work and I also have a DS on the spectrum. I've had long standing depression since my teens and I think the unrecognised AS was the core cause of that.

Women with AS are often misdiagnosed with BPD as some of the features overlap - black and white thinking, secondary depression and anxiety leading to self harm and damaging behaviour, loneliness due to poor social skills, lack of empathy due to poor theory of mind, sexual promiscuity due to low self esteem/misreading social signals. I think there are actually very few features of BPD which can't also be explained as part of AS as well and I think the diagnosis often just depends on what kind of training background your psych has. I think the flip side for men with AS is often a diagnosis of schizophrenia or NPD, as I've heard that men with AS are often misdiagnosed with those but are rarely diagnosed with BPD.

I didn't have the BPD diagnosis removed but it has quietly fallen by the wayside and all professionals involved in my care only mention the AS and depression now. I have only kept it as it makes sure my case ticks the boxes for 'complex issues' which means I get a better care package and better likelihood of retaining my higher rate DLA.

That must be hard to deal with orange - i'm pretty sure i don't have AS, because i have good social skills; i had to learn them really because my parents weren't sociable (Dad deaf, Mum had an abusive childhood). But once i lost my natural shyness i did make friends & keep them.
As for boyfriends - I think that the reason i have a bad track record there is because i used to get bored easily & always chose the good-looking bad boys - but it never lasted because i was actually quite a good girl! Now i'm older & have calmed down but unfortunately 'the good guys are taken' basically!! Or they don't go out socially; or they are too shy to talk to women without alcohol (but that's a whole other subject!!).
That's why i did (& still do) think i have an element of Bipolar - as i can get, basically, quite hypomanic. When i feel that way i get agitated & can't sleep, my thoughts are racing, i can't stop getting amazing ideas & writing etc etc. The Psychiatrist had been waiting for me to come off my old (mood stabilising) Epilepsy meds before seeing how things are with regard to possible Bipolar / mood swings; now that i'm on the new Epilepsy meds (I'm on 2 types & they have NO mood stabilising effects) he has started to see me more often & is considering medication for moods if things get worse.
As i said before though neither he or I are that keen on more meds & would rather wait for therapy - The DBT therapy for BPD does deal with ways to control moods through therapy.

The big problem is that my moods can switch with no recognisable cause, & my Psychologist is concerned about it because that does indicate more than BPD. I'm concerned at the lack of insight I get during mood swings - i don't want to end up dead because i'm feeling irrational & suicidal all of a sudden for no reason.
Orange - i'm awaiting a decision on DLA as i'm only allowed to work part-time by the DRs. But i do think that your AS must be a huge problem for you to cope with - i can see why it would make work etc difficult - & it's a shame that with the AS & depression diagnosis alone you can't get the higher rate.

I'm finding this thread really interesting, although it doesn't give me any clarity on what's going on in my head.

When I said I was waiting to see the psych about bpd (already seeing her for adhd and severe depression) I was literally sat in the waiting room. I had the appointment, but I'm still in two minds about it all.

When I'm "normal" and rational, I think bpd is just another label I'm trying to assign myself to make sense of my life, and be able to deal with the less pleasant side of it, that I'm using it as an avoidance technique to actually face up to taking responsibility for my behaviour.

But then I'll have another "psycho" episode where I tick every single bpd box and then some.

With the self diagnosis quizzes I never know how to answer, as the answer will totally depend on whether I'm answering as the "mask" (normal) the psycho or the self loathing self pitying creature that's left over.

I'm about to start my 3rd AD. Can't say I have high hopes. If it stops me killing myself in a moment of paranoia and idiocy, then I guess that's a start.

Arana - don't do self-diagnosis quizzes - just do those which are given to you by your Psychiatrist. If she gives you them to take home then decide on a set time that you will complete the tests (eg. 4pm); or fill them in at the clinic. Just give your answers honestly as to how you feel at the time you do them.

It will also help the Psychiatrist if you could:

Write down any worries & questions you have in bullet points on a separate sheet of paper (bullet points are good).

Keep a record of emotions / moods / thoughts / behaviour for a few days - to make it simple & easy: just write down 1 or 2 words that best describe your state of mind & for each hour.
In that record - also note down for each hour what you ate; what (if any) exercise, housework or activity you did (inc. sleep); when you took which meds; & who you were with.
This will help Drs to work out what may affect your state of mind.

Eg: Sat 02/06/12 1pm - 2pm: Hungry, low mood, unmotivated, wanted to self harm, ate 2 biscuits & apple; was alone; best friend phoned chatted 15 mins happy but worried she might hate me because she had to go.
11pm - 12am: in bed, agitated, doing crossword to calm down, sleepy.

In fact i am now going to try my own suggestion :)

Good luck anyway.

Hi
Based on my own experiences this is what I'd recommendt
-Go on amazon right now and order books on BPD by Marsha Linehan, the psychologist who developed Dialectical Behaviour Therapy as mentioned by other posters. DBT was unavailable in my area but I found working through it on my own invaluable. Even if DBT is available to you, I wouldn't wait. I'd get the books and start on my own. The best place to start is her "Skills Training Manual."

• Another book I found useful is "How to Stand up for Yourself" by Paul Hauck. -DBT is based on four basic areas of skills. These are mindfulness, interpersonal skills, emotional regulation and distress tolerance. For the first one check out the work of Thic Nat Han and Jon Kabat-Zinn, also see if there are meditation groups where you live. Even yoga is a step in the right direction. The second is mostly assertiveness, look into doing courses (I'm planning to get around to doing one soon). Most books in this area are crap though, with the exception of Paul Hauck. Emotional regulation really comes down to minding yourself ie excercise, sleep, diet etc. Linehan also recommends you do at least one thing a day from the Adult Pleasant Events schedule. Distress tolerance is explained in the book.
• Even though psychiatrists tend to put all their patients on meds, they're not always necessary or beneficial in the case of BPD. If they're suggested, quiz your doctor and don't take anything unless your brain tells you it's a good idea.
• Be positive. I now live as normal a life as most people. I no longer see myself as mentally ill.

lovetomatoes - i have work related studying to catch up on & finances to sort out right now, so will wait for my place at the clinic for DBT.
But i'm skeptical about therapy - so it's good to hear that you found it successful.
I know that part of staying well is down to making an effort to help myself (eg. keeping to a daily routine, eating well, exercise, enough sleep); also DBT apparently involves 'homework'.

That's all fine when i'm not depressed, agitated or hyper; but for me the depression in particular (especially before my period or at stressful times) is the thing which sabotages my efforts to stay well. It's just soul destroying & sucks the motivation & life out of me; i'm constantly fighting it all the time & i know that one day it might win.

I hate it so so much, i feel constantly guilty about being depressed, because of all the people out there who are physically ill. It feels like being selfish to talk about myself which is what therapy is for, that's why i don't know if i should do it.

wait for a consultation and psych assessment. IMO not advisable to guess a diagnosis, although I can appreciate things have been hard for you
bpd isn't a single diagnosis, it's a cluster and presents differently for each person
take a look at this

and good luck with cmht and psych, I hope you make good rapport and feel comfortable with team

Latara
I totally get what you mean when you say talking about yourself is selfish. I've been in and out of counselling loads of times and I've often felt isn't this ridiculously self-absorbed and should I not find something better to do with the money.
What I find though is that if I'm not going to counselling and a crisis happens that then I have to talk about it anyway. Meeting a friend for coffee and spending a whole hour talking about your problems and hardly asking how they are themselves is actually quite selfish. So I'm in therapy at the moment and that's my rationale; it's one hour a week where I get to indulge my need to talk about me. I talk about nothing else only my life and my issues. I hope then I can give a more balanced presentation to the "lay people" in my life.
My current counsellor is very good but I've had some turkeys in the past. They're only human at the end of the day. Many people, especially those with little experience of mentall illness, assume that counselling is wonderful. That it's the magic treatment that sets you on the road for recovery. But it's still only one hour in the week, or fortnight. It's a help but it's what we do ourselves that really makes the difference.
I recognised your description of what it takes to keep well; excercise, sleep, routine etc. Again, some people assume that this is all you need. It sounds very joyless and a Puritanical appraoch to life. Routine, sleep and excercise can be punishment or pleasure. Enjoy being organised, enjoy your night's sleep and enjoy being fitter than all those couch-potatoes.

Routine, sleep and excercise will never be enough though because we need human relationships to make us happy as well.