Inside a Borderline Mind
“ Everything looked and sounded unreal. Nothing was what it is. That’s what I wanted - to be alone With myself in another world, where truth is untrue and life can hide from itself.”
—‘Long Days Journey Into the Night’ Author: Eugene O’Neill
Three Factor Model of DSM-IV
DSM Categorization Borderline Personality
According to the Diagnostic Manual of the American Psychological Association there are 9 categories, 5 of which must be present in order to receive a diagnosis of Borderline Personality.
At first glance the criteria may seem unrelated; however, each criterion is intricately connected to one another. They interact with each other, where one criteria is triggered and triggers the rise of another. In “I Hate You Don‘t Leave Me” (Author: Jerold J. Kreisman, MD, and Hal Straus) it is referenced as to being like pistons working in a combustion engine.
The following are the 9 categories per the DSM-4.
- Frantic efforts to avoid real or imagined abandonment.
- Unstable and intense interpersonal relationship.
- Lack of a clear identity.
- Impulsiveness in potentially self-damaging behaviors.
- Substance Abuse
- Sexual Promiscuity
- Reckless Driving
- Binge Eating
- Binge Drinking
5. Recurrent suicidal threats or gestures
- Self-Mutilating Behaviora
6. Severe mood shifts and extreme reactivity to situational stress.
7. Chronic feelings of emptiness.
8. Frequent and inappropriate displays of anger.
9. Transient, stress related feelings of paranoia or unreality.
Life is like living on an emotional roller coaster at Six Flags Magic Mountain; with no destination for the person with Borderline (BPD). For family and friends dealing with someone with BPD may be frustrating, confusing, overwhelming, and sometimes hopeless.
As confusing for family and friends when dealing with it; it’s no easier for the person suffering. It is as confusing to them as it is to you.
When I was first diagnosed 12 years ago I was traumatized. I tried to confide in my parents and my sister and I found that they wouldn’t accept it. I was told “you just want attention,” or “you just want to justify my bad behavior.”
i was ashamed and I hid my diagnosis for 12 years. No one should feel ashamed.
How it Feels To Be Borderline
Clinical features of borderline personality disorder
- Borderline Personality Disorder (BPD): Approach by Dialectic-Behavioral Therapy (DBT
José Luis Triviño Mental Health: Global Challenges Journal 1 (1), 76-77, 2018 To carry out an approach of the current state of behavioral dialectic therapies focused on borderline personality disorder
- Please Don’t Leave Me—Separation Anxiety and Related Traits in Borderline Personality Disorder
Purpose of Review In light of the apparent symptomatic resemblance of separation anxiety disorder (SAD) symptoms on the one hand and abandonment fears, anxiousness, and separation insecurity central to borderline personality disorder (BPD) on the ot
- Google Scholar
What is Borderline Personality Disorder?
Borderline Personality Disorder (BPD) is 1 of 10 personality disorders. Axis 1 disorders are directly correlated to disorders due to chemical imbalances in the brain, treated by medication. Example of Axis 1 disorders: Depression, Bi-Polar, Schizophrenia.
Personality disorders are categorized on Axis 2. They tend to have more durable traits that gradually change and medications are not as effective. With depression you can control and virtually eliminate symptoms when prescribed and taken correctly. With BPD it May lessen the symptom such as anxiety medication making it tolerable or controllable. It does not eliminate BPD symptoms.
Those with BPD May appear to be bi-polar. I was mid-diagnosed in 2005 and given high doses of Paxil, Xanax, and Depekote. I actually got 100 times worse as the mood stabilizers created a chemical imbalance I never had. It caused permanent CNS damage, i became a complete different person. It created amnesia of the person I was before the medication. I changed psychiatrists and after a more thorough evaluation diagnosed with BPD, PTSD, Insomnia, and ADHD. The side effects of the Depekote also creates more Avoidance and Dependent traits of BPD (Which I don’t have anymore).
Evaluations and proper follow up with your mental health care team is important to monitor that you have been diagnosed correctly. I highly recommend you keep track in a journal every symptoms, issue, behavior and the situational context. It’s helped my doctors immensely determining a more accurate Diagnosis. As of 2 months ago I was diagnosed with only BPD, ADHD, chronic PTSD, Insomnia.
Inside The Borderline Mind
Borderline a Personality Disorder
Fear of Abandonment
“All is caprice. They love without measure those whom will soon hate for no reason.”
- Thomas Sydenham
Detailed explanation of DSM-IV criteria
Frantic efforts to avoid abandonment real or imagined.
- Extreme fear of abandonment is one of the most common traits among Borderline individuals. They exhibit depression over their own perceived notion of abandonment of current relationship partnerships and friendships. When a Borderline feels they have been abandoned, they can have this intense rage at the world for that abandonment, real or imagined. During an episode triggered by a fear of abandonment, a Borderline May lose a sense of existing or feeling real. Borderlines experience a “metaphysical loneliness” where relief of loneliness is only achieved by the physical presence of others. When they experience this they may frequent bars or busy crowded places. During situations a Borderline is alone, it is common for them to look back on vacant reflections of themselves. Panic may occur during solitude from the panic they suffered during the abandonment.
I suffer from severe fear of abandonment. A common phrase we use is “no one stays, everyone leaves.” For me my mental health team identified that since my father was my main caregiver with severe attachment, and I had a fear being left with my mother, that his frequent Naval duties in the US Navy that took him on aircraft carriers for months on end consistently, I feared him leaving and felt abandoned coupled with intense fear to be with mom. Later married to military souses I had frequent Iraq deployments of 12-15 months they would be gone. Each time they left it was abandonment to me. It spiraled into divorces and rocky relationships because I’d panic they’d leave me one I got emotionally attached and I’d end up self-sabotaging.
Everyone is different and has different reasons they may have developed this fear. But that fear is very real to a Borderline. I know for myself, no matter how much I try to rationalize a behavior someone I’m with exhibits is normal or not concerning, I still panic and get a rush of a burning feeling of fear throughout my body. I will see it as a sign they will leave me. Example: I text a boyfriend in the morning and don’t get a text back for hours. That triggers my panic.
Unstable and Intense Interpersonal Relationships
Characterized by marked shifts in their attitude and behavior towards someone else in their life. They May shift from “idealization“ of another person to “devaluation” of that same person. Or they may show a “clingy dependence” and shift to “isolation avoidance”.
This next trait I’m not convinced is accurate (but who am I to argue with professionals) is that Borderlines exhibit “prominent patterns of manipulative behaviors.” I have been told I was this way between ages 16-35. I never had a direct intention or motivation to manipulate anyone. During episodes triggered I’d make desperate attempts however that included manipulative tendencies that I couldn’t control. After that episode I’d feel intense guilt for doing it because it was not a true motivation. I argue that manipulative behaviors need to be intentional and have a motivation of manipulative behavior in order to characterize it as a BPD trait.
Borderlines can not tolerate separation. So in relationships where it’s a long distance relationship is very difficult for a Borderline. They can become dependent, clingy, and fear intimacy. Its a battle between taken care of and fear of suffocation. Borderlines make unrealistic demands of others and distrust any kind of expression of someone’s attachment.
My favorite saying is “They will leave, No one stays.” I joined online support groups because I needed group therapy, but I refused in person group. I found majority have said that same thing. I’d love to detail all the reasons I have learned manifested into an intense fear of abandonment and psychoanalysis But that would take ten articles to do. Important aspect of BPD that should be noted is Fear of abandonment is a main trait of BPD and has is a valid fear for Borderlines and the behaviors manifested that create unstable relationships are a defense mechanism for a Borderline.
I believe it is very important for anyone in a Borderline‘s life to understand the disorder and know how to avoid triggers and handle the stress we cause linked to our BPD. I have researched a lot over the years and put into practice strategies for those around me so I can not live hiding my disorder, but to embrace it. In a following article I will share what has worked for me.
We Are Not Attention Seeking
“You Just Want Attention”
We don’t want attention. We don’t capitalize on our illness for attention seeking.
Marked and Persistent Identity Issues
- BPD is characterized by an ongoing identity disturbance that is manifested by unstable self-image and/or sense of self.
”Who she is and what she does determines her worth.”
Borderlines can not process and accept that someone genuinely cares, loves them, and rejects compliments as not genuine. We feel like we need to prove ourselves over and over. Borderlines base their self-esteem on impressing the people around them.
An interesting part of this, keeping in mind BPD involves identity issues, is Borderlines have a constant sense of “faking it.” Ask me to “just be yourself” I don’t know who that is. I “faked” an identity from childhood because my father was embarrassed about aspects of my personality and as “daddy’s little girl,” the oldest child, and the child he had high expectations for; I was terrified of disappointing him so I “faked it.” Faked it so well I had no idea who I really am. Than married to my first husband ”faked it” as what an NCO wife should be to a Marine/Army military service member. I still remember when the CO said I was the perfect military wife. “If we could issue a wife in a sea bag to every soldier, we’d issue a carbon copy of you.”
It May develop in childhood, as mine did, and through the years continue to occur creating multiple idebtities. This is not to be confused with multiple personalities (DID). Those, like me, never developed a desperate sense of self so continue “fake it” in a role someone else defines. This also is attributed to unrealistic attempts at reaching perfection. Borderlines later external situations and make drastic changes in lifestyles to achieve contentment on what others expect. Also they do this to try finding an inner contentment that never is fulfilled.
- change constantly
- change goals constantly
- change friends constantly
It makes sense if we suffer from identity issues, we will have a high chance of confusion around our sexual identity. So bisexuality and other lifestyles is common. I was confused growing up about my sexuality and finally about 10 years ago came out as bisexual. I still haven’t told my family.
Identity issues do create such internal stress for borderlines, as well as a combination of many other attributes of the disorder, that frequent threats or thoughts of suicide is common. Speaking from a borderline perspective and keeping in mind the research I have done; I want to stress that these thoughts of suicide (and this is mentioned in “I hate you, don’t leave me” on recommended reading list) and this is how it is for me; we don’t all want to die. Its a desperation to communicate pain and begging for others to realize we aren’t trying to get attention in our illness but need someone to help us and intervene.
Hallmark of BPD is self-mutilation. A really common form is “cutting.” I never told doctors I have done it because most do it really often. I have done it three times in my life. We do it to relieve the inner pain. However, I want to educate on self-multinational, it’s not just cutting. Driving drunk, driving intentionally when revoked, starting fights are all other forms.
Any self-inflicted pain is self-harm behavior with a motivation to numb the pain or escape their numbness. ”Pain becomes an important part of a Borderlines existenice.”
Instability due to reactivity of mood with severe episodic shifts to depression
I believe this part of BPD is why Bi-polar is commonly mid-diagnosed. Bipolar is a Chemical imbalance in the brain that causes major mood disorder. In BPD it is NOT a chemical imbalance.
Marked shifts of mood include:
I was first diagnosed in 2005 with Bipolar. The psychiatrist gave me a test for five minutes and I was diagnosed and put on a heavy cocktail of medication. Can you imagine what happens when you give Lithium to someone without a chemical imbalance? It was catastrophic. I had to beg another psychiatrist listen to me that something was wrong and I was not okay and beg to be re-evaluated. Turns out I had BPD.
Chronic Feelings of Emptiness/Anger/Paranoia
Chronic loneliness is another marked trait of someone with BPD. It is common that they seek out new relationships to escape it. Borderlines have a need to fill a void. When they feel empty they will desperately try to fill that void and that can lead to suicide attempts, anger outbursts, self-harming impulsive behaviors and drug use.
I spent half my adult life single in short lived explosive relationships. That chronic empty and lonely feeling goes deeper than a neurotypical would experience. Since I have BPD from extreme trauma, these moments are extremely hard for me. Binge drinking, cutting, caught in your memories of trauma, pain. It’s something that is hard for a Borderline to endure and we get trapped in our head and pain.
Anger is another marked trait of BPD. It isn’t as simple as what a neurotypical feels when angry. Borderlines have an intense anger that is felt more intense than an average individual. Often it’s inappropriately displayed and we lack control of that anger. Frequent displays of temper, constant anger, and reoccurring physical altercations are common.
These outbursts are unpredictable and scary, not only to the people around it but also to the Borderline. Borderlines have lack of control to stop, even when they know its irrational. The anger is disproportionate to the actual triggered anger. The trigger never makes sense in my case.
In early 2000’s I was married and came home one day and found out our car got out. In seconds I flew into a rage. Screaming nonsense that wasn’t related to what happened. my husband was so confused. I screamed I was going to jump out the second floor window. I ran up the stairs and he came after me. I locked myself in the bathroom and refused to open the door. He got so scared he punched a hole in the door to open it. He was afraid I was going to hurt myself.
Another incident that would detail the trait of anger. Last year I came home from work and my adult son hadn’t cleaned the house. I started screaming and throwing pizza boxes across the hall and I could feel the out of nowhere rage. My son was screaming back I was making no sense. I knew I was being irrational but couldn’t stop. I threw a knife across the room. When I did that I panicked and walked out going to the bar.
Important to note: we don’t know why we rage all of a sudden and often we can’t control it or stop. I’m high functioning, so I have more control of it than most. I still can’t stop when I rage. It’s why I try to stay away from situations that will turn physical. I won’t stop. I can’t stop.
Paranoid Thoughts/Severe Disassociation
Borderlines experience psychosis. The most common is:
- Feelings of unreality
- paranoid delusions
Also, it’s common they experience disassociation from usual perceptions. Things around them don’t feel real. May experience “internal splitting” where different aspects of their personality emerge in different situations (I have six different ones finally identified.) We have have distorted perceptions that can involve any of our five senses.
Psychosis and Disassocitative episodes emerge in stressful situations or in unstructured surroundings. Usually these episode are short in duration.
I experienced such severe disassociation that I don’t remember 90% of my childhood, 75% of my life. Only just recently was that noticed by a mental health professional after, for first time, I gave them my journals to read from age 10. I developed it as a defense mechanism as young as age 5. I can also disassociate on purpose to go numb and not feel the rush of intense emotions that I know will send me into a downward spiral into an episode that lasts months. To describe how it feels is difficult to describe. Everything feels unreal, you feel floaty, like you aren’t a part of your body. My vision gets blurry and it feels like I’m being pulled backwards and I go numb. I feel nothing. My boyfriend knows right away when it happens, my eyes just go blank and he says I look like I zoned out. I won’t hear anything, sounds disappear. Mine normally don’t last long anymore 10 min to 2 hours. But I have done it for days before.