Borderline Personality Disorder

[HereWeGoAgain]

I've seen this condition/diagnosis mentioned here several times so I Googled it and did some reading. Holy cow! Our difficult child is like the textbook case. No P-Doctor or MD she's seen (dozens) has ever mentioned it before, to my knowledge.

These are the nine criteria from the APA's Diagnostic and Statistical Manual (DSM-IV), and how much I'd say each one applies to J on a scale of 1 to 10. According to the criteria, five or more must be strongly present for the diagnosis. I'm not a mental health professional (I've dealt with enough of them and read enough to almost qualify, though! LOL) but if J isn't borderline I don't know who would be.

1. Frantic efforts to avoid real or imagined abandonment. [Not including suicidal or self-mutilating behavior covered in Criterion 5] Not exactly sure what qualifies as "frantic", but staging crises to provoke rescue is quite common, so: 7.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. Bingo! 10.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self. Bingo, again. The new J is announced on a regular basis. 10.
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, promiscuous sex, eating disorders, substance abuse, reckless driving, binge eating). [Again, not including suicidal or self-mutilating behavior covered in Criterion 5] How about wild impulsivity in every single one of those areas? Once again, 10.
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. Yep. This really is a scale of 10, even if the meter is pegged virtually every time. 10.
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days) Yawn. That's going to be another 10.
7. Chronic feelings of emptiness. What can I say? 10.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). Hmmm. More irritability, anxiety, and passive aggressiveness than actual hitting. Let's give this one a 6.
9. Transient, stress-related paranoid ideation or severe dissociative symptoms. Does this mean checking out of reality for a while? It's happened on more than one occasion, but not all that frequently. Let's say 6.

So, we've got about as strongly present as it's possible to be on six of the nine, and present if not strongly on the other three; or to put it another way, 79 of a possible 90, or 88%.

Most everyone agrees that there is a fairly close association with childhood or adolescent traumatic separations/abandonment, history of sexual abuse, disrupted family life, and poor communication in the family. Save for sexual abuse, our J has experienced all of the above: abandoned by her father at 8, mom remarried at 9, seperated from friends and extended family at 10, poor communication with step-dad (me).

Commonly Borderline (BPD) manifests itself in early adulthood (or "by" early adulthood.) In J's case there were signs around 13 or 14 years and full-blown by 16-17.

Also, Borderline Personality Disorder is frequently accompanied by diagnosed bipolar disease and/or depression. J has been diagnosed with both.

There is a genetic component to Borderline (BPD). In J's case her mom has mild bipolar and anxiety. Her mom was adopted at birth so nothing is known about the biological family on that side, but the mere fact that her mom was adopted is suggestive. There is a history of substance abuse on her father's side.

With borderline, apparently, group therapy and proper balance of mood-levelling medications is the best course. One-on-one therapy is not the best option, according to several sources, because of the unstable relationship pattern. In other words, she'll either be inappropriately close to the therapist or blame the therapist for all her problems, maybe both in the same day.

This is progress, I think. It helps to understand the background and morphology of what's happening with J.

(The name "Borderline Personality Disorder" is confusing in that everyone uses acronyms and this one, Borderline (BPD), could also be taken for Bi-Polar Disease.)

 

[DammitJanet]

Hello...your resident borderline checking in to greet you! LOL.

I meet quite a lot of the criteria for borderline too except I have outgrown the manipulative behavior. Either that or Im too darn tired to continue it at my age.

I agree with most of what you have said in your post except the part about one on one therapy. A good relationship with a therapist can do wonders if that therapist is skilled in dealing with borderlines. Some arent and some dont like treating borderlines because they can suck the life out of a therapist.

The best group therapy for borderline is called DBT and it is done in both a group setting and individual at the same time. It is rather intense.

Im going to give you some resources which include some places for parents of borderlines.

http://www.mhsanctuary.com/borderline/resnet.htm

 

[HereWeGoAgain]

Thank you Janet, I'll check it out.

 

[rejectedmom]

A friend of min's daughter has this diagnosis and she went to Grooup and indivitual also on medications. She is doing great! I hope you have finally found your answer! -RM

 

[DammitJanet]

If you have any questions about this disorder, feel free to ask me. You will find that I am really open about talking about both bipolar and borderline in my life. I tend to be an open book and dont mind answering questions if they will help someone.

 

[AliceLee]

HWGA and DammitJanet,

I have read some about Borderline Personality Disorder, too, and thought it was a real possibility that my daughter has this. She has never threatened or attempted suicide (to my knowledge), but she has self-mutilated on quite a few occasions. Many of the other behaviors fit her to a T.

Also, my daughter has a fairly good relationship with her dad. To my knowledge, she never experienced any sexual abuse as a child...but who knows...something could have happened at a friend's house or at one of the babysitter's houses.

Unfortunately, my difficult child has not been open to getting psychiatric help. I think she's gonna have to hit bottom before she'll consider it. Any suggestions on reaching out to her, Janet?

OH, and I think I read somewhere that most people with this disorder do eventually outgrow it by their late 20's!!! If they live that long, I guess.

 

[DammitJanet]

Im 45 and I havent outgrown it...lol. I do think some of the behaviors mellow or change. Like I said, I am nowhere near as manipulative as when younger.

I didnt get diagnosed or receive help until I was in my late 30s so there is always hope.

Check out that site I posted earlier. There are a ton of resources for families.

 

[Hound dog]

Janet has excellent advice with Borderline (BPD). :smile: She's helped me tons.

I think the hardest thing I deal with is that when N is not stable, or having what I like to call a "borderline moment", is that her perception of situations and or the world around her are so distorted. And it can be all but impossible to get her to see this for herself.

It's not always that she is actually trying to be unreasonable, manipulative, or irrational. During these times she really does believe she is the rational one and everyone else just doesn't get it. Pile BiPolar (BP) on top of this and just wait for the explosion!

One of the things I've been seeing with the current stability is that she often will come to me and actually ask me if her behavior for a given situation is appropriate. Or she'll ask easy child. We both try to be really objective in our responses. I think it has helped her. I've been watching her of late being able to be assertive without going over the line. (big step for her) Being able to express her feelings without raging either offensively or defensively.

But she also knows this can change with just a single missed medication dose. We've seen it happen. Might be getting close to another medication increase as now it happens just when she's a bit late taking them. This is why I do worry about her once she decides to move out.

Thankfully she told easy child she isn't planning to move out for at least another year.

 

[DammitJanet]

Lisa makes a very good point about perceptions. Its very easy for the borderline to have odd perceptions of the world around them.

I call this seeing the world thru our filter. Everyone does see the world through a filter of your own experiences but for the borderline we have a skewed filter and sometimes we dont quite see it the way it really is. People may be meaning things in one way and we interpret them in a whole other way. That can get us in heap big trouble. That can be why relationships are so hard for us.

I have a whole lot of trouble with people. I cant figure out motives. I dont like game playing. I tend to say what I mean and mean what I say.

 

[jbrain]

Hi,
I am in 2 online support groups for parents of kids with borderline personality disorder. I now don't think difficult child 1 actually has the disorder but she fit all the criteria when she was younger. She has been diagnosed with Borderline (BPD) traits. These 2 groups have been immensely helpful (as has this one of course)! One thing, there is a lot of bad information out there still--like there always has to be some sort of abuse, the parents are the cause, it is a hopeless disorder, etc.

Dialectical behavioral therapy is the recommended therapy for Borderline (BPD) and I actually think it is helpful for anyone! It is based on the idea of "radical acceptance"--accepting a person for who they are right now, accepting their feelings, not judging them, yet encouraging change. When my dtr was in her Residential Treatment Center (RTC) her therapist used dbt and it really helped--she was able to correct some of her "thinking errors"--I was amazed at how she interpreted things I had said and done many years ago, things I didn't even remember or were so insignificant to me. She had built them into huge mountains and interpreted them to mean that I didn't care about her. I see that I also have been susceptible to this kind of thinking. If my husband is extra quiet I might figure he is mad at me and start reacting to him from that viewpoint. If I just ask him why he is extra quiet instead of assuming I have done something to anger him I may find out he is mulling over something that needs to be done at his job--nothing to do with me! I have found that I tend to interpret people's facial expressions and moods as having something to do with me--it is all about me--when it may have nothing to do with me.

Another princple of DBT is "benign interpretation" or something like that--it means to put the most benign interpretation on others' words and actions instead of assuming the worst. It makes me think of my son--when he was a teen if I walked in a room where he was he would immediately get defensive and say, "what?" He assumed I was mad at him all the time and that my walking into the room was all about him.

Gotta go for now--
Jane

 

[ediwiz]

My daughter was unofficially diagonosed with Borderline at 12. We were told that she was too young to officially be given that diagnosis. She started showing symptoms at 2. We were told that we had a "strong willed" child. LOL By 9 she was confounding us. Her rages could no longer be contained in a hold, timeouts never worked and I resorted to having my (then) teenage son stand behind me when I would escort difficult child upstairs to her room so that when she tried to headbutt me down the stairs I wouldn't get hurt. We couldn't go out, school and I knew each other intimately due to the "lovely" reports that difficult child would tell people about her home life. CPS would go through a cursery evaluation and apologize for having to put us through it. difficult child was not physically or sexually abused, was given every opportunity that the easy child's were given. She is our natural child. She had her own room, although eventually I did remove most of the furniture due to destructive behavior. She would tell people that we lived in a ghetto... LOL We lived in an old house near some apartments with some very nice and some very not so nice people. My husband had gotten a new job and the house we were living in sold, so I had about 3 weeks to find something, pack and move.

At 14 she was officially diagnosed with Borderline (BPD) (Borderline). She spent almost a year in an Residential Treatment Center (RTC). It was great, they taught her about physical boundaries, which she had no concept of. They also worked with her on social cues, again, she was totally clueless. Unfortunately they only started working with her on other types of boundaries before the SW told us either she gets transitioned out or we would have to TPR. Found out later that was a load of doo-doo. :rolleyes:

At 18 I had her re-evaluated by a neuro-psychiatric. She confirmed the diagnosis and told me that when I look up Borderline (BPD) difficult child's picture is there, then apologized to me for having to live with a Borderline (BPD) who was also a teenager. I was relieved that someone actually understood what difficult child was like to live with. difficult child refuses to do DBT, we started when she was 12, but her therapist fired her for non-compliance. He's a friend and difficult child loved him, but he warned her that if she did not work the program, he would stop seeing her. She didn't buy it until it was too late. He stuck to his guns. Her current therapist has tried to work with her on DBT, but difficult child is still resistant.

Latest difficult child thing was shaving her head and telling people that she had stage 3 cancer and was receiving chemo. Arghhh! :grrr: Of course she told us that she had lost a bet. Luckily for us difficult child has decided that she is gay so I don't have to worry about her getting pregnant anytime soon. difficult child goes to a private all girls college and does quite well. I still get phone calls at 3 am with all the drama. I'm her mom, not her friends, I really don't care who is mad at whom and who is dating.

We have been told that she will never out grow this. She will be able to learn to manage it better if she chooses to. We were also told that we did everything right and we did not "cause" her to have Borderline (BPD) (well except the genetic part). We were told that her brain is "wired differently". Duh, could have told them that when she was 2 and was going through the terrific two's. (I have video LOL) :rofl:

Sherry

 

[Sue C]

I have been wondering, too, if Melissa has Borderline (BPD) or is BiPolar (BP). But if she does not seek the help, there is nothing I can do. Sad.

Sue

 

[jbrain]

Hi Sue,
from your postings I have also wondered if Melissa has Borderline (BPD)--she sounds so much like the kids in my parents' groups. She may not want help but you could read up on it--might help you in dealing with her.
Hugs,
Jane

 

[DammitJanet]

Sue...I have often thought to myself that melissa could have it. Read up on a few things especially the book Walking on Eggshells. That is an excellent resource for the significant others in the persons life. I dont like it from the borderlines perspective but hey...lol.

 

[Sue C]

Janet -- I went online and put in a request for my library to get the book. All I could find was "Stop Walking on Eggshells" by Paul Mason. As that the correct book? The description sounded like it would be.

Thanks so much!
Sue

 

[CrazyinVA]

My Oldest has been unofficially diagnosed as Borderline .. unofficial because she never follows through with treatment. She will acknowledge taht she is bipolar, but again, refuses to do anything about it. When she hits the next bottom (there are so many), she will admit herself to psychiatric again, probably.

Stop Walking on Eggshells is a great book, I have read and re-read it. I think one of the keys to dealing with a borderline (adult) child is keeping very clear boundaries in place. Oldest will twist things around if I am not very clear on what I say and do.

I wish Oldest would get help and acknowledge her issues, but I don't have much that it will happen, at least, not anytime soon. It's so hard to watch how she is living her life, the lies she tells, the friends she manipulates and uses up, especially men. I love her dearly but it's frustrating and awkward, especially when a mutual friend will try to talk to me about her behavior. Sometimes I feel like a traitor when I simply say, "Well, that's my [Oldest.] I love her dearly but she's crazy." But it's come to be the simplest answer, and people tend not to push further after that.

 

[HereWeGoAgain]

Hi all, I bought a copy of SWOE, my wife is reading it and I am on the waiting list (at the rate wife plows thru printed material, I should have it in a day or two). wife is going to talk to her p-doctor (who has also been difficult child's therapist in the past) about Borderline (BPD) at next appointment., Monday I believe. difficult child doesn't have a p-doctor at the moment. wife's p-doctor is not going to take difficult child back as a patient due to past non-compliance issues. difficult child has an MD who may be able to do a referral but wants to get thyroid hormone levels straightened out right now. I forgot to mention before that difficult child has hypothyroidism in addition to everything else. She has managed to keep up with the synthetic thyroid medication by hook or crook until she went into detox and the doctor there arrogantly refused to listen to her telling him she needed it. Her levels got dangerously low before the MD re-prescribed.

As I mentioned on another thread, the Borderline (BPD) symptoms and the drugs and organic disease (hypothyroidism, seizures) are all mixed up together in a witch's brew, all reinforcing each other, it's very hard to figure out what may have started this roller coaster going. The first I heard of Borderline (BPD) was reading about it here and I had a bit of a "eureka" moment, but (of course) it's maybe not that simple. But I definitely know that however it came to pass, she meets the criteria now.

 

[KFld]

That is an awesome book you read. I actually bought that and sent it to my difficult child last year because wingnut is definatley borderline. He read it and though it was great too. Then she found it and called me screaming and ranting and raving, which is the last time I have ever spoken to her :smile:

 

[Sue C]

I have the book from the library right now and my husband actually wants to read it after me!!!!! He is taking great interest in this disorder and how we can deal with it. Yea for husband!

I keep nodding my head as I read the book--I feel quite positive that Melissa has Borderline (BPD) from what I've read so far. I don't think she'll go for help, but if the book can help husband and me understand her better and how to react, this could be a lifesaver.

If the rest of the book is as good as the first part that I've gotten through, I think it may be worth buying to reread and have on hand.

Sue

 

[DammitJanet]

Sometimes I Act Crazy: Living with Borderline Personality Disorder by Jerold J. Kreisman and Hal Straus (Paperback - April 14, 2006) and the first book, I Hate you Dont Leave Me by the same authors are two other good books.

Dont walk on eggshells has a workbook to go along with it.

You can get all these books on amazon either used or new.