[wisedude]

Hi.

Please let me say, that there are limited, accepted treatment options for the disorder, and I think therapy may certainly be helpful to some, so I am not discourage it in ANY WAY.

But with all or most other mental disorders, people believe in the physical side of it and "medication".

I am not discounting that there are significant psychological factors relating to managing the disorder, but I am of the VERY strong opinion that over the next several years, it will be apparent that medication is the way to go, at least in conjunction with therapy.

I am involved with some people with very severe BPD, and I have had a previous diagnosis of it years back.

I am trying to convince them to try some medication, but they don't want to face the fact they have a problem in the first place!

I just want to say that I ABSOLUTELY believe that BPD, especially when severe, has a physical basis in the human brain and it is not functioning the same as other brains.

[IGotThis]

I think no matter if it's therapy or medication, the only way for them to get the help the need is to accept that "something" is wrong, even if they don't label it....

I think there are definitely merits I both therapy and medication... For me, a lot of my bpd traits are waaaay stronger and harder to deal with when I don't take my meds for my depression and anxiety that goes along with it... In this case, I have to accept that not only is there something wrong, but there are multiple things... That is hard to accept sometimes, which for me, makes it hard to accept that I need the meds, so I get caught up in not taking them when I should. Which leads to many other problems...

On the other hand, therapy has also been a wonderful thing for me, because even with the meds improving my mood somewhat, I still have to deal with a lot of crap that I just don't know how to on my own, without letting my bpd take complete control... Plus it's nice to just have that safe outlet...

[Maranara]

I personally believe that BPD for most of us is based on childhood trama. I'm not discounting your belief. Maybe the trama happens early enough in some of us that it leads to actual changes in the brain.

I believe that therapy isn't necessary for everyone, but that in order to deal with BPD, you need to be able to safely talk to someone, whether that be therapists, good friends, or people online. BPDs hold things in until they are ready to explode; it important to have an outlet somewhere.

As for medication, I personally believe that BPD patients can do without, but when it's really severe, some may need that "edge" taken off. I have been on meds but have chosen to go without and can most of the time. This is personal preference, however, and I know some have a much more difficult time than others.

In my opinion, the only real relief from BPD is though mindfulness and meditation. It's a way of slowing down the overthinking, the dwelling on the past or worrying about the future. It is not a "cure", but I think it can offer help to most if they are willing to put the time and effort in to it. It is not easy....sometimes it is downright difficult...but it's the only thing I have done that truly helps.

[wisedude]

I am really good with meds, would it be rude to ask you which ones have helped you? (don't answer if you don't feel comfortable).

I have read thousands of pages about this subject

There are some VERY promising new medications on the market (well in the USA) at the moment.

[wisedude]

Originally Posted by Maranara

I personally believe that BPD for most of us is based on childhood trama.

Absolutely that is the #1 cause- not disputing that.

But there is very convincing scientific evidence that this trauma has long term, even permanent effects on brain function.

I could go more into detail, but I won't at the moment

Trauma changes the functionality of your brain, and impairs your ability to handle stress, and control your emotions- at a physical brain level. Just like if your physically traumatized and hurt, it has physical effects on your body function.

[Maranara]

Originally Posted by wisedude

Absolutely that is the #1 cause- not disputing that.

But there is very convincing scientific evidence that this trauma has long term, even permanent effects on brain function.

I could go more into detail, but I won't at the moment

Trauma changes the functionality of your brain, and impairs your ability to handle stress, and control your emotions- at a physical brain level. Just like if your physically traumatized and hurt, it has physical effects on your body function.

....and I stated in my answer that this trama can cause the effects in brain function you mentioned. I have also done lots of research.

[wisedude]

Originally Posted by Maranara

....and I stated in my answer that this trama can cause the effects in brain function you mentioned. I have also done lots of research.

Sorry I am trying to start a conversation but have barely slept- I should go to sleep but don't feel like it!

I am sure you read a lot, not disputing that at all! (I am ADHD diagnosed, make dumb errors all the time, sorry)

I definitely think therapy and social environment (and social support) are big parts of it. Some of the people I love the most have BPD and I just want what's best for them, they have had AWFUL lives, and don't deserve the problems that have.

[unaluna]

Originally Posted by wisedude

Trauma changes the functionality of your brain, and impairs your ability to handle stress, and control your emotions- at a physical brain level. Just like if your physically traumatized and hurt, it has physical effects on your body function.

Right - so if you hurt your hand, you go for physical therapy to retrain it and regain function. You move it, you exercise it. The exercise for your brain is... what?

Originally Posted by wisedude

I am not discounting that there are significant psychological factors relating to managing the disorder, but I am of the VERY strong opinion that over the next several years, it will be apparent that medication is the way to go, at least in conjunction with therapy.

This statement assumes that there is actually a singular way to go with this disorder. That is where the flaw in your statement is. That any two BPD sufferers are the same is stereotyping and as everyone is an individual, there is no single way to treat them either.

I am of the strong belief that medications, can be passed up and not used at all. I am of the strong belief that every single one of us has the capability to heal ourselves if we have the right resources. That being said, not all of us are as resourceful in self help so that's where therapy and even meds can come into play. Again, individuals are different. Some of us may be the type of self starters and helpers that we can actualy learn the things we need to do, on our own, have the capacity and determination to pull of things that some others may not be able to do without a lot of help,.

It seems to me that you're lumping the group into one big pile and saying that medication would work best for every one of us, hence my tendency to argue otherwise.

I am over 12 months without medications or therapy and in almost all ways am doing a lot better than back when I was a numbed zombie on Depakote the 10+ previous years.

[wisedude]

s4ndm4n2006,

I am not surprised you were zombied by that medicine, I would never touch it. I personally think that should be for bipolar. Definitely a harsh and sedating med.

But here is my story.

I was diagnosed many, many times with BPD up until about 10 years ago. I have scars all over my body from self harm.

I had tried all the various antidepressants, mood stabilizers, various anti-psychotics and others. None of them helped.

But then I tried a medicine with a special property that is not very common. It called a 5-HT7 antagonist, well that's the property that was different from the 30 or so medicines I have tried before.

This medicine has massively helped me. The doctors say that I don't meet the criteria anymore, but one time 4 years ago I ran out and ended up smashing up my unit and self harming, been back on it, and fine every since.

Then I read information that said people exposed- especially to traumatic childhood experiences0- had increased amount of 5-HT7 receptors in various parts of the brain which are scientifically implicated in the disorder.

Two areas in particular the Prefrontal Cortex, and Anterior Cingulate Cortex.

These areas are implicated in emotional regulation, the ability to do tasks without interference from stressful thoughts, and general self regulation of impulsive type and similar behavior.

The 5-HT7 receptors in people who have had traumatic childhoods are supposed to be expressed in the above brain areas in much larger amounts than other people. These receptors basically suck up the neuronal activity or "energy" of these brain areas causing them to not function properly, as though they have a flat battery.

Sure enough for me, it seems to work. There is a lot of research that implicated 5-HT7 antagonism in those two brain areas which are implicated as being functionally different in BPD.

The problem is normal Serotonin Reuptake Inhibitors are just as likely to ACTIVATE (as opposed to deactivate) 5-HT7 receptors, so normal standard anti-depressants do not help or may make it worst.

I have come to learn that there are a lot of new receptor systems being understood to be important to regulation of stress and emotion, and generally mood state, and indeed impulsivity, and I have formed the believe that some new drugs which have come to market, well I am very interested that they might be helpful for some people with BPD.

I am sorry to try and simplify and put everyone in the same basket, but people there are also some general similarities between many people with BPD- hence the category, and I am hopeful that new medications- which are quite a lot more advanced than previous- will offer some hope to people with BPD.

However being loved, and having strong social support and a good therapist will ALWAYS be critical also. And I know a lot of people work VERY hard to improve their BPD.

[venusss]

Meds can help SYMPTOMS, but not the actual causes.

What was said about brain training. Lots of things are about skills. Just like there is not reading or writting pill, there is no mindfulness and relanionship skills pill. It has to be learned. And just how some have harder time to learn how to read and write, some have harder time with the social... imho borderline is more like dyslexia then... some chemical imbalance (that never been proved in depression or bipolar). See, learning disorders can be helped with some stimulants and smart pills... but no way you can skip the hard work.

Originally Posted by wisedude

s4ndm4n2006,

I am not surprised you were zombied by that medicine, I would never touch it. I personally think that should be for bipolar. Definitely a harsh and sedating med.

But here is my story.

I was diagnosed many, many times with BPD up until about 10 years ago. I have scars all over my body from self harm.

I had tried all the various antidepressants, mood stabilizers, various anti-psychotics and others. None of them helped.

But then I tried a medicine with a special property that is not very common. It called a 5-HT7 antagonist, well that's the property that was different from the 30 or so medicines I have tried before.

This medicine has massively helped me. The doctors say that I don't meet the criteria anymore, but one time 4 years ago I ran out and ended up smashing up my unit and self harming, been back on it, and fine every since.

Then I read information that said people exposed- especially to traumatic childhood experiences0- had increased amount of 5-HT7 receptors in various parts of the brain which are scientifically implicated in the disorder.

Two areas in particular the Prefrontal Cortex, and Anterior Cingulate Cortex.

These areas are implicated in emotional regulation, the ability to do tasks without interference from stressful thoughts, and general self regulation of impulsive type and similar behavior.

The 5-HT7 receptors in people who have had traumatic childhoods are supposed to be expressed in the above brain areas in much larger amounts than other people. These receptors basically suck up the neuronal activity or "energy" of these brain areas causing them to not function properly, as though they have a flat battery.

Sure enough for me, it seems to work. There is a lot of research that implicated 5-HT7 antagonism in those two brain areas which are implicated as being functionally different in BPD.

The problem is normal Serotonin Reuptake Inhibitors are just as likely to ACTIVATE (as opposed to deactivate) 5-HT7 receptors, so normal standard anti-depressants do not help or may make it worst.

I have come to learn that there are a lot of new receptor systems being understood to be important to regulation of stress and emotion, and generally mood state, and indeed impulsivity, and I have formed the believe that some new drugs which have come to market, well I am very interested that they might be helpful for some people with BPD.

I am sorry to try and simplify and put everyone in the same basket, but people there are also some general similarities between many people with BPD- hence the category, and I am hopeful that new medications- which are quite a lot more advanced than previous- will offer some hope to people with BPD.

However being loved, and having strong social support and a good therapist will ALWAYS be critical also. And I know a lot of people work VERY hard to improve their BPD.

I have bipolar also, so hence the use of depakote.

Your explanation does explain your perspective, and I appreciate your taking the time to say all of that.

I understand and know of the different aspects of BPD, I know the causes of depression (chemically speaking) and with regards to seratonin etc. I also am not saying that meds do not or cannot help with the symptoms of many disorders, bpd not excluded. They can and do work for many people.

I am just one that over the years (again over 20 yrs in therapy, about 7 yrs bpd dx) I have come to the conclusion that this is my thorn in my side, my lot in life. I choose not to be medicated because at my root, I am not flawed any more than anyone else, but my challenges are related to emotions, fears among other things. This is just my challenge in life and I'd much rather do it with the real me, learn to cope and grow this way rather than treating the symptoms of what is my disorder.

Again this is my stance and my view on the subject and in no way a judgement on those that choose to go the other route with lots of expensive meds and therapy.

[wisedude]

I agree with what you are saying, I just feel people with BPD have been shortchanged a bit when it comes to medication.

There are lots of complicated issues that need to be mentally confronted and adjusted, no pill can change such complicated things, but I am hopeful better medicines for helping with the intensity of stress and emotion may be soon coming! I'll come back in 5 years and see if I am right, if I am not, then I have to do something to pay for my error

[wisedude]

Thanks for your views people.

It is a personal issue. I am still had to work on a lot on my life, I guess I found though a sort of "panadol" for my emotions. Luckily it wasn't alcohol or something awful!

Originally Posted by wisedude

I agree with what you are saying, I just feel people with BPD have been shortchanged a bit when it comes to medication.

There are lots of complicated issues that need to be mentally confronted and adjusted, no pill can change such complicated things, but I am hopeful better medicines for helping with the intensity of stress and emotion may be soon coming! I'll come back in 5 years and see if I am right, if I am not, then I have to do something to pay for my error

I knwo what you're saying here, but to the credit of doctors and scientists, I'd say that it's not so much that bpd sufferers have been short changed so much as it's been a disorder that's been hard to understand and the methods for dealing with it is still growing and changing.

[venusss]

as for new meds being created.... I wouldn't invest all my hopes in that...

http://www.nytimes.com/2013/08/20/he...ugs.html?_r=1&

[Maranara]

Originally Posted by wisedude

Sorry I am trying to start a conversation but have barely slept- I should go to sleep but don't feel like it!

I am sure you read a lot, not disputing that at all! (I am ADHD diagnosed, make dumb errors all the time, sorry)

I definitely think therapy and social environment (and social support) are big parts of it. Some of the people I love the most have BPD and I just want what's best for them, they have had AWFUL lives, and don't deserve the problems that have.

I apologize if I jumped at you a little too quickly. I have issues with invalidation (imagine that), particularly when it involves facts and figures and I can prove I am correct. I am also working on my self-assertiveness and I'm working on standing up to my abuser and others who have hurt me for pretty much the first time in my life. I didn't mean to draw conclusions or jump at you.

[wisedude]

Originally Posted by Maranara

I apologize if I jumped at you a little too quickly. I have issues with invalidation (imagine that), particularly when it involves facts and figures and I can prove I am correct. I am also working on my self-assertiveness and I'm working on standing up to my abuser and others who have hurt me for pretty much the first time in my life. I didn't mean to draw conclusions or jump at you.

I know I sensed the invalidation, it is something I feel myself.

Really good on you for working with your assertiveness, and standing up to people who mistreat you.

I don't know I have a simple formula for a brighter future for BPD:

(Strong social support) (Government/Therapy Support) (Psychological help/therapy/self improvement) and (better medications in the future).

That all still doesn't deal with the problem of people who do KNOW they have it, but don't want to face it. Two young women I know, very, very BPD, they know it on some level (been diagnosed), but they do not want to face it. And if you gently try to say anything- its a drastic insult to them! I love them though, they are good people.

I have suffered enough in my life to relate a lot to BPD, not sure if I do have it or not now, I know I have ADHD (and they can occur together). But I know these girls definitely have it, they have so much potential in life if they can get control of it.

[Maranara]

This is just a thought about your friends. I discovered my BPD early last year when I'd made a friend that I couldn't handle. We developed a warped co-dependent relationship and more than 20 years of "doing okay" overall, of coping most of the time, was flushed down the toilet.

I discovered BPD through him. He'd discovered it and sent me a link to the DSM. When I read the nine traits, there was absolutely no denying, but I was in total denial for over six months, until I found this site and started talking to others with the same basic issues.

I don't know how much they already know about BPD...sounds like a bit, but some thoughts.
1. Present them with a copy of the DSM and ask them what they think. Take "BPD" off of it as well as the suicide rate. That part kind of freaked me out when I first saw it....even though I was suicidal at the time!
2. Lead them to this site or sites similar to it. When they talk to others with the same issues, a light should start going off.

Don't give up on them. Most of us go through a period of denial. We can't accept that we're "not normal", and in my case, being "abnormal" was against the rules in my family. It was drilled in to me that there was nothing wrong for over 20 years. Keep it up with them but don't pressure too much either...that rebellion is strong as you probably already know. They WILL come around; it just may take a while.

[ScarletPimpernel]

According to a professional in the BPD health field that I recently communicated with, BPD can present in over 200 ways. Even with the DSM IV's and the DSM V's criteria, we all might not exactly fit into the mold. Some fit more criteria, some less. Some are more functional, some are less. Some express emotions inward, some express outward. Also, BPD typically occurs with other mental health issues: schizophrenia, BP, PTSD, Anxiety, Depression, ED's, etc.

Researchers are still trying to understand BPD better. There are common childhood characteristics: withdrawn, attachment to objects, neglect/abuse/trauma, etc. They are also finding that BPD might actually be genetic and find that other family members tend to have the disorder too:
Genetic Link to Borderline Personality Disorder | Psych Central News

Medication is useful...to treat symptoms that can be treated via medication. If you have a chemical imbalance, have other mental health issues besides BPD, have mood instability, etc., then yes medication might help you. If most your symptoms are based on reactivity, medication probably won't help you (but still might).

Therapy is a treatment because a lot of symptoms BPD's experience are based on reactivity. Therefore, if we can learn to recognize, adapt/adjust, and limit our reactivity, then our symptoms should slowly reduce over time.

But there are SO many avenues of treatment, and we each have to find what works best for us. There's different types of therapy, different meds, herbal treatments, meditation, treating physical problems, treating hormonal imbalances, hypnosis, etc.

What I prefer to focus on is making sure that I am as healthy and successful as I can be. My definition of that will not be the same as my friends/family/professionals or even fellow BPD suffers. My expectations have to reflect who I am, where I came from, where I want to go, and how I am able to achieve my own definition of fulfillment. So some might have goals of being a good parent, others goals might be holding down a job, and still others might be completing education. So long as we all can hold onto our hopes and dreams, does it really matter how we get there?

[Angel of Bedlam]

Originally Posted by wisedude

Hi.

Please let me say, that there are limited, accepted treatment options for the disorder, and I think therapy may certainly be helpful to some, so I am not discourage it in ANY WAY.

But with all or most other mental disorders, people believe in the physical side of it and "medication".

I am not discounting that there are significant psychological factors relating to managing the disorder, but I am of the VERY strong opinion that over the next several years, it will be apparent that medication is the way to go, at least in conjunction with therapy.

I am involved with some people with very severe BPD, and I have had a previous diagnosis of it years back.

I am trying to convince them to try some medication, but they don't want to face the fact they have a problem in the first place!

I just want to say that I ABSOLUTELY believe that BPD, especially when severe, has a physical basis in the human brain and it is not functioning the same as other brains.

Think of it like a cold. Meds in this case treat the symptoms of the cold. You'd take a cough syrup to help with a cough and runny nose and take ibuprofen to help with a fever, and in the same way, med management with BPD treats symptoms like anxiety, or depression, or mood stability. Therapy (in this case I'm referring to DBT), is the only proven way to "cure" DBT. They have actually found that undergoing DBT has led to new neurons growing within a BPD brain that weren't there prior to treatment (Google the case of Tami Green. In this analogy, therapy is like the antibiotic that's prescribed in the event of a bad cold. It does more than treat the cough or the sore throat, it gets rid of the bacteria so that the cold itself goes away.

I hope that helps understand the importance of the two.

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