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Trying to work out if I have borderline personality disorder.


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I am actually diagnosed with it, based on the outcome of taking a personality assessment inventory and an hour-long assessment from a psychologist. This evaluation happened because I had applied for disability benefits from the state of Washington (known as Disability Lifeline, another name I've forgotten, and currently called "Aged, Blind, and Disabled" - it's an interim thing while I go through the interminable process of getting SSI.

 

After that appointment, I was diagnosed with major depressive disorder (due to extensive suicidal ideation and symptoms of atypical depression), PTSD (due to a history of trauma from parental abuse, bullying at school, and having been in an abusive relationship) and BPD. 

 

Some of the conclusions the psychologist came to regarding the diagnosis were a bit off the mark. For example, I did go through a period of several relationships after I left the abusive relationship. This was over a period of five years (from 1995 to 2000) and what happened in each case was I didn't really know how to be in a relationship. I am terrible at staying in touch, returning or initiating signals of affection, and generally speaking I don't really get lonely for people or miss them with a few exceptions. These weren't intense brief relationships these were relationships that failed because I just couldn't hold up my end of interaction. There were a couple I stopped talking to people because they wanted me to talk to their parents and I became very anxious and stopped talking rather than deal with that.

 

I do have a history of self-destructive impulses (impulsive spending, binge eating, binge drinking) that have caused me a lot of trouble (mostly the spending). I also have a long history of suicidal ideation, and the suicidal ideation is itself ego syntonic (as in, it's something that seems to be a part of my personality and by itself doesn't distress me - there are things about it that are distressing, however). 

 

When I brought this up to my mother, she didn't think the diagnosis was accurate. When I asked people I interact with online, they did not think it was accurate. Both therapists I've seen have told me they do not think I have it. My case manager (who has also worked as a therapist) does not think I have it. And finally, the psychiatric nurse and the psychiatrist I saw for further evaluations for my therapy and medication needs who diagnosed me with ADHD and autism spectrum disorder (Asperger's Syndrome) did not support the BPD diagnosis.

 

However, I find it difficult to let it go. Every so often something happens or I do something or I react to something in a way that makes me question whether I really don't have it. One thing most of these people have in common is that they tend to view BPD as a more sinister thing, like it's about being consciously manipulative, about treating people badly, about being attention seeking. I don't think I am these things. I prefer to be alone and dislike attention. I try to be as straightforward as possible, and I am blunt - sometimes to the point of causing offense or causing people to think I'm angry. I am very much against treating people badly, but I can't guarantee that I never treat people badly. It's not something I do deliberately.

 

My research about it indicated that it was more about emotional pain, about trying to control the chaos (interpersonal and possibly otherwise) in one's life, and losing control of it in whole or part at times.

 

When I got the diagnosis, it actually made me panic a bit. I was worried that due to the stigma associated with the diagnosis that I would have difficulty getting the therapy and treatment I did need. I won't say that I didn't reject the diagnosis - I did - but I didn't believe it was true. If I had, I wouldn't have rejected it, but the anxiety about being shut out of therapy due to the diagnosis. 

 

Looking at The Militant Baker's post about BPD symptoms I see that:

 

Wide mood swings: I have alexithymia and I am not very competent at identifying my emotions. I will say that my mood is quite reactive to events, both positively and negatively. Such that an unexpected change in plans or environment can make me extremely angry or upset and whenever I read news that the state legislature is debating cutting Aged, Blind, and Disabled benefits again (when I signed up, it paid a maximum of $335/month to anyone who qualified - now it's only $197 and only to people applying for SSI or SSDI), or when something happens that makes it seem my income and benefits might stop, I tend to have rather intense depression. So, maybe, I guess?

 

Intense episodes of anxiety or depression: I do have these. I'm diagnosed with MDD with atypical features because of the depression. Anxiety - I've gone through periods of non-stop anxiety attacks and panic attacks. Sometimes these have been triggered by additional expectations and pressure placed on me and sometimes due to being reminded of past trauma. It doesn't happen nearly as much now as it used to, and it's been three years (to the month) since the last time I went to the ER due to a panic attack.

 

Inappropriate anger: I don't know. Anger I experience seems appropriate. I don't get overtly angry very often as it is, although I think sometimes I am angry and don't even know it unless I pay attention to how I am behaving. The few times I've noticed this I usually just go to bed or get away from people because being around people tends to make it worse.

 

I can identify instances of inappropriate anger - such as accusing a man at a storage facility of trying to steal my possessions because I was locked out of the storage lot while I was in the middle of removing everything. I knew and still know that the problem was that I waited until the last minute to get my stuff out of storage and miscalculated on how much time I still had left. I have had other instances like this but I do not know if there are enough situations like this to really count because to me most of my anger does seem justified when I feel or express it.

 

Destructive behavior: I have attempted suicide, multiple times. A few times as a teenager, several times as an adult. I managed to stop them by keeping in mind that even though I frequently want to die, I frequently don't want to die, and that my mood will change. Even so, suicidal ideation is fairly routine for me (on a daily basis - for the past few years it lightened up considerably but it is back again). Sometimes it is directly a result of depression, and sometimes just the thought of killing myself seems very comforting. I'm not likely to attempt in these situations, however. I do think that at some point in the future an attempt is likely due to being at the confluence of several issues that are frustrating and difficult for me. I try to be mindful so I can possibly hospitalize myself if I realize that I am likely to make an attempt. However, the ideation tends to have that feeling of inevitability to it.

 

Harmful or impulsive behaviors: I mentioned earlier about binge eating, binge drinking, and impulsive spending. I remember on one occasion managing to spend several thousand dollars in a very short period of time with very little of substance to show for it.

 

Frantic fear of abandonment: This is definitely the case. I remember flirting with someone online a few years ago, and one day they didn't chat with me and I actually started to literally freak out over the thought of them deciding they didn't really like me or that I had done something to alienate them. I found it very very hard to let go of this until they talked to me again - of course it was for one whole day.

 

There was another more recent instance and in this case it wasn't even a relationship - just meeting someone online with whom I had a lot in common, and who stopped responding to my PMs and made her blog private, and I spent the weekend going through similar anxiety. It turned out that she did this for reasons that had nothing to do with me.

 

In each case, I have not confronted anyone or accused anyone or tried to force them to talk to me. I just spent the time feeling a lot of anxiety over not knowing whether there was rejection or not. Times I have been explicitly rejected were not nearly so difficult for me. 

 

I have other less severe examples, like living with family and receiving support from family, it seemed often that my needs were prioritized last if at all while others' were prioritized ahead of everything else all the time. I am not sure if this was accurate or not, or if it was frustration from situations where I did need assistance like transportation or clothing or whatever that at the time I could not provide myself and could not get that assistance.

 

Feeling of hate and self-loathing: Not so much currently. Until a few years ago when I faced the fact that I was clearly mentally ill and self-destructive I did spend a lot of time ruminating on past mistakes and berating myself for making so many of them. The awareness that while I am still responsible for these things, but having explanations for them (like mental illness, being autistic, etc) has made this significantly easier to deal with. But the rumination and self-hatred lasted for a good 15 years after I left the abusive relationship, and built up as I made more attempts to find and keep jobs or go to school.

 

There's other stuff about feeling empty or having an unstable sense of self. I don't really know what the first one means, although I do know that I have found it rather gratifying to be able to include my diagnoses in my perceptions of my identity. Being able to say I was autistic for example was a huge thing. And I will admit that some of my thoughts around BPD are hitting this same chord.

 

I've also read about mirroring people - trying to make one's self over into someone you think they might like. I have done this on a few occasions, but mostly I don't really idealize people so much that I want to be like them. I do consciously imitate other people in order to seem more "typical." Like, copying phrases and mannerisms from other people to get through the awkwardness of social situations because I really do not have any real instinct for what I should be doing - so I have learned to fake it.

 

This isn't a request for anyone to diagnose me. I know that's not possible. I am trying to process this. I am not sure I will ever come to a firm answer about this because of the uncertainty, and that many of the things described above might very well fit into other diagnoses I also have. Or maybe some of those are wrong and this one is correct. The subjectivity is frustrating.

 

I don't feel any shame about the possibility that I may have it. I feel frustration at the lack of certainty.

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If all these different professionals think you do NOT have BPD, and it is agreed that you are somewhere on the asp/autism spectrum then isn't that enough?  Taking a test and a one hour assessment is very little time and attention compared to the other people who have treated you.

 

Also, one can have traits of a PD and not meet diagnostic criteria.

Edited by bpladybug
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True that I can have features and not have it.

 

I've seen the psychologist twice more and she continues to frame things in terms of BPD, and claims I have good eye contact and such.

 

And it should be enough. I can't really explain why it suddenly isn't, or why I haven't been able to let go of it.

 

I do appreciate your response. Your point about who has more time around me is helpful to hear back. In the past, I've had others try to rationalize why those professionals would tell me I don't have BPD while they insisted I really did have it, which probably contributes to my lack of certainty.

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"My case manager (who has also worked as a therapist) does not think I have it. And finally, the psychiatric nurse and the psychiatrist I saw for further evaluations for my therapy and medication needs who diagnosed me with ADHD and autism spectrum disorder (Asperger's Syndrome) did not support the BPD diagnosis."

 

 

Have you brought up the psychologists diagnosis with the case manager? And your own fears?

It is safe to say that no matter what you have - you've been down a tough road, and there's also going to be a long road to recovery.

It could be worth checking to find out if there's a therapeutic group available to you for people who have bpd and traits of it - because you have identified yourself those traits. something to discuss with your case manager.

 

i'm really happy that you've found the boards, that you're exploring, and that you have supports.

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I've discussed it with both therapists I've had and with my case manager. With my current therapist, I bring it up every few months to see if she's noticed anything.

 

Some of what I wrote in the post above I haven't told anyone. Not out of any desire not to, but because the way my brain works, I need to actively collate the information and sort of "rehearse" to remember to bring it up. Otherwise, I just tend to get all circuitous and spend 20 minutes explaining why I was watching a particular TV show at a particular time, or some other random thing. It's sort of like being able to do something in one context, but being unable to do it in another context and having to learn it all over again.

 

I also think that some of the early reactions I got made me less willing to actually explore this more thoroughly. I felt that people were building this idea of me in their heads as an evil schemer seeking to create drama everywhere - and discussing it often when I wasn't around - and I was just trying to figure out who I really was. Not very supportive and quite stressful.

 

Thank you for the response. It's quite helpful.

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One of my pdocs diagnosed me with "traits of Borderline Personality disorder" and when I asked him why, he said it had to do with my low self-esteem, and didn't really explain it  to me very well.  I didn't see him again because I go to a psych resident's clinic, and my pdoc changes yearly.  When I saw my new pdoc, I asked him about it, and he siad it had to do with my history of suicide attempts ( which happened when I was 13, and I am 35 now) and thoughts of self-harm that I haven't acted on since I was a kid. 

 

The whole diagnosis has been frustrating to me because I was told flat out that I don't have BPD, but now my pdoc seems to be blowing me off as if I have BPD.  For example, when I told him I was having thoughts of self-harm, he asked, "Well, isn't that baseline for you?" and wouldn't talk about it further or discuss any sort of treatment.  It really upsets me the way professionals blow off people with BPD as if everything they do is for attention, and now I feel as if I have been thrown into that pool wihtout even having the full diagnosis. 

 

Anyway, I don't know if you have BPD or not.  It does sound like you have stuff to work on, and the best advice i have received has been to not focuson a diagnosis so much as getting treatment that helps.  Which is hard for me to follow when it comes to BPD bcause there is a stigma attached to BPD and it sucks. 

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Yeah, and the work is not easy.

 

I got into an argument with my case manager about BPD stigma. I told her that I didn't think people with BPD were attempting suicide to manipulate people and get attention, and she insisted that "No, really, that's what they're doing." So I pointed out the high success rate and she made some comment about how they probably didn't intend to succeed.

 

I agree about not focusing on a diagnosis and focusing on symptoms. I need a therapist who can actually keep me on point because I really do tend toward circumstantial or tangential speech, and my current therapist tends to let me go because she finds what I say interesting. When I went back to therapy this (second) time I even pointed that out and said it would make therapy harder if I couldn't stay on point.

 

And then I wonder if I'm blaming the therapist for something I need to work on, but I don't even know how to work on it. So frustrating.

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Yeah, and the work is not easy.

 

I got into an argument with my case manager about BPD stigma. I told her that I didn't think people with BPD were attempting suicide to manipulate people and get attention, and she insisted that "No, really, that's what they're doing." So I pointed out the high success rate and she made some comment about how they probably didn't intend to succeed.

 

I agree about not focusing on a diagnosis and focusing on symptoms. I need a therapist who can actually keep me on point because I really do tend toward circumstantial or tangential speech, and my current therapist tends to let me go because she finds what I say interesting. When I went back to therapy this (second) time I even pointed that out and said it would make therapy harder if I couldn't stay on point.

 

And then I wonder if I'm blaming the therapist for something I need to work on, but I don't even know how to work on it. So frustrating.

I have to say, your case manager sounds extremely ignorant for someone dealing with mental health issues! As if all BPD people are attempting suicide purely for attention and not necessarily meaning to succeed.  Just another disgusting attitude from someone who should know better and BPD has enough stigma attached to it without this bullshit!

 

I (personally, I am NOT suggesting you do this) would get a new case manager, but that is just me and I am not advocating that! As for the therapist, if that isn't working out for you, by all means, get a new therapist.  The point of therapy is that it works for you and you have a communication with  the therapist, not just a one sided conversation, whichever side that may be.  If you feel the therapist isn't right for you, perhaps you need to raise some concerns over your therapy with them.  If they are not very accepting of your opinions, then maybe they are wrong for you. 

 

I wish you the best of "luck" (for want of a better term) and hopefully there will be some more answers to your dilemma here! :)

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Yeah, it's not the first time I've stopped discussing things with her or my therapist because what they said to me was so wrong I couldn't even figure out how to address it.

 

I don't see her as often as my therapist. Mostly she helps me with some other issues (like getting to a store to buy things I need). 

 

You have a good point about getting a new therapist. After the last appointment, I've been thinking of it anyway. One of those "I couldn't respond so I let it go." I have a response now, but I'm not sure if it'd be worthwhile to try to explain it. I definitely need to figure something out because the ideation's intensifying.

 

I appreciate the response. Thank you. :)

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kristenk is so right.         We place far too much importance in the diagnosis that is given by various health professionals.   Not a single MI or PD can be traced to a neuro-physiological or biochemical marker in our brains.    We may be fairly sure that the chemistry and/or the wireing in our brains is fairly f****d up but there are no objective or definitive tests that can proove it.

 

So professionals label us according to some decidedly arbitrary bundle of symptoms and then delude us and probably even themselves into believing that these labels are accurate and lasting.  

 

We put great trust in the people who attempt to help us relieve our anguish or at least fit in to a hostile world.  If those professionals do not treat us with respect and kindness then they betray the trust that we have put in them.

 

Don't allow the label to define you  ... and find mental health professionals who support you!

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Much appreciated. 

 

This is part of why I wonder, because i actually like having the labels - I am not sure I explained that well in my first post. Having these labels is like having an anchor for me, helps me understand who I am because of the things associated with those labels that I know are a part of me. That may just be a rationalization, I admit. I don't know. I have had trouble with knowing who I am, and when I tried to be who I thought was supposed to be, that failed spectacularly and dragged me down for years. That was more not understanding that I was actually different from others, so when I saw others could do things that were hard for me, I assumed that it was because there was some flaw inherent to me - something morally or ethically off  - and thus I didn't have the strength to "just do" the things that I found difficult. The diagnoses contextualize those difficulties, and give me conceptual categories in which to place and describe these difficulties. 

 

You are correct about not letting the labels define me or trying to make myself fit a diagnostic profile just because I have the diagnosis. This isn't what I want to do. I mean I won't lie and say the temptation isn't there, but it would be useless for me if I tried to base these things on lies or rationalizations. I am tired in a lot of ways of being me because of all the things I deal with. I would rather find ways to cope with them and improve.

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Yep ... frightening, exhausting, confusing and rejecting  ... you have beautifully summed up the reality of living with chronic MI.

 

I think that clinging to diagnostic catagories and labels gives us at least the hope that there may be an 'objective' way to analyse the problems we face and the possibility of 'specific' treatments   ...  but that hope is largely delusional. 

And the more intellect you bring to this task the deeper the hole that you dig in the mud.  

The best we can hope for is to do enough trial and error  work with meds and therapy to find the best combination for our particular brand of crazy.                                                                                                                                                                                                     Trust yourself more and seek therapists and pdocs who respect you.         Living with MI of any type requires unbelievable strength and courage ...  the fact that you have survived until now is proof of your bravery.   You are very hard on yourself and you need to be much more forgiving  ...  finding the space to do this may be your most important task.

Edited by glasssss999
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  • 4 weeks later...

I was diagnosed with BPD and I am kinda in the same boat as you. I don't attention seek nor manipulate people around me. There is so much more of explaining that I don't think I have BPD, my Pdoc just diagnosed me with it because I mentioned abusive relationships.

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Yea one pdoc tried diagnosing me as BPD too which I successfully refuted and avoided the diagnosis! I am not clingy or needy, never feel like self harm, don't really have a abandonment issue. About the only thing I have in common with BPD is the mood swings which are generally more wider then BPD. I informed him many years ago I was diagnosed with bipolar but did not feel that was a good fit, but I agree I have more in common with that then BPD. He agreed and suggested I may have a lighter version iof bipolar and for now he won't give me a diagnosis right away which I appreciate. The point is all pdocs have to go by is what we tell them or observe. It takes time to diagnosis some one with BPD or BP. Any diagnosis made in the first or second session imho is bogus.

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I am still indecisive on this, but for the most part I let it be. Some things I identify with, many I don't. I am glad that I am able to at least talk about it here. 

 

I occasionally cycle rapidly through deep depression (as in a matter of hours) and back out again. I think I am in one of those right now. I am not sure this is evidence for BPD since, per Dr. Tony Attwood, it is something that happens to autistic people.

 

Katzendame,

 

I occasionally see references to a socialiy isolating version of BPD that turns things inward, but every time I have seen someone reference it, I have never been able to get or find an expanded explanation. So, it is possible that is applicable to me, and I think it is not characterized by attention seeking or manipulation, but I really don't know.

 

When I posted this thread, I should acknowledge I was experiencing persistent suicidal ideation and trying to find a reason why it is something that I find consistent with my personality, rather than dissonant.

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  • 4 months later...

Bringing this back up:

In chat earlier Isabelle St. Pierre mentioned "quiet borderline" to me, so I asked the google and it gave me some interesting links:

 

http://www.downwardspiralintothevortex.com/2012/05/quiet-borderline-borderline-waif.html

 

http://www.borderline-personality-disorder.com/mental-health/what-is-a-quiet-borderline/

 

This is very much how I am, although it refers to loneliness and loneliness is not something I feel, or recall feeling. But turning everything inward to self-destructiveness, and experiencing my emotions primarily when I am alone is the case. When my emotions start to show I tend to get away from people and have a quiet meltdown on my own.

 

Between this and another conversation I had (that I am still processing) it seems like there was a lot of stuff going on that I didn't even realize were symptoms or odd/unusual. 

 

Anyway, whether I have it or not (and I am leaning toward accepting that I probably have it), this forum has been extremely helpful.

Edited by Bellatrix
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