[HaleyAnne]

After doing a lot of research, I suspect that a close family member has Borderline Personality Disorder. Everything I read says "Bingo". She spent a week in the hospital because she attempted suicide, and she was on 3 major drugs. Now is on 2 drugs plus therapy and is back to work, but I can tell she is nowhere close to where she should be. Given all of that: One of the signs of this BPD is cutting/self mutilation. She has 5 tattoos, and only 1 is barely visible. So I say "Why?" She says they really really hurt, but she continued to get 4 more that nobody can see. QUESTION: Is my hunch a stretch, or would tattoos be an indicator of cutting/self mutilation considering she has so many other BPD indicators? All comments welcome. Thanks.

As someone who has many tattoos but does not have BPD I would advise that you be very cautious about assuming that tattoos might be symptomatic of BPD. People have many, many reasons for getting tattoos. I see them as living art, not as self-mutilation.

[Trippin2.0]

Getting a BPD diagnosis takes much more than a suicide attempt and SI, because neither are exclusive to BPD.

Also, tattoos are not a form of SI, so all you actually have to go on is a Sui attempt, which could be straight up depression.

The other indicators you mention, I wonder about them, because this is such a personal diagnosis, its basis is on how we've (under)developed, our internal thought processes and how the ensuing behavioural reactions affects us and our relationships negatively.

So as a person with this dx, I wonder how someone (you) can make such an assumption (since you can't mindread) and what its actually based on...

[HaleyAnne]

Thank you both for replying! Please re-read my original. I said I had done a LOT of research and everything I read said "bingo". Believe me, a suicide attempt and tattoos (which the person admits were very painful) were not the 2 single things that alerted me to BPD--almost every red flag stunned me. But I will definitely take your cautions seriously. I have no plans to share my thoughts with anyone except here. It doesn't really matter what the fancy name is. The problem(s) still exist. Thanks again.

[SnakeCharmer]

HaleyAnne, back in the 1980s, when people were first getting enthusiastic about BPD, even pierced ears were seen as a symptom. This was really over-reaching.

There was a time when tattoos were considered highly anti-social and a symptoms of "something." But they've now reached of point of being an accepted cultural phenomenon. Yes, they hurt when they're applied, but if your family member was using it for self-harm, she'd be running to the tattoo parlor on a regular basis, in the middle of the night, whenever she wanted/needed to relieve tension. Five tattoos don't qualify these day. But back in the '80s, when people were looking too hard, even getting an unconventional haircut was called self-harm.

That doesn't negate all the other symptoms. Maybe she does have BPD, but that's really something for her and her therapist to figure out.

It's admirable that you want to know what's causing your family member so much pain. But I don't know if knowing the diagnosis will actually help you in any way. The important thing is that she's in therapy and is taking medication and is back to work. It sounds as if she's doing all she can to get better. Sometimes it's a long-haul.

People in therapy often get worse before they get better because it's so upsetting to them to explore the elements of their distress. Not to mention that it takes practice to try on new, more healthy, behaviors. Few people get it right the first few times.

I remember when one of my close family members first went to therapy. She started expressing herself ... about everything. It took her time to balance out and realize that telling everyone exactly what you thought of them as soon as you thought it was not the same thing as acting assertively.

So, I recommend patience. It may seem like she's not getting better fast enough. But, honestly, I do think, from my own experience and the experience of my friends, that these things can take time. The love and support of family can help a lot ... even if you don't fully understand what's going on. A pat on the back and an encouraging word can go a long way to helping someone who's experiencing mental distress feel accepted.

I wish you the best of luck.

[Hellion]

I really do not think tattoos are a sign of a psychological disorder, so I wouldn't worry about that bit though its intresting she'd insist on keeping them hidden a lot of people like to have them visible unless in a setting where its best to cover them....and from what I know getting tattoos does hurt but some people find it worth it my brothers got two so far. So probably best to leave that part alone.

Also BPD is not the only disorder that can contribute to attempting suicide or cutting/self mutilation...that can also have to do with depression and even PTSD among other things. Do you have any idea what her diagnoses is? like when she went to the hospital did they diagnose her with anything, or did she have a diagnoses previous to that?

Also though not to be rude, but how do you define 'where she should be' I mean i remember in psychology class the instucter was talking about how one problem is people with mental health issues beating themselves up over not being where they 'should' be but the trouble is where one should be is subjective....I normal person 'should' be able to cope with every day stress without major difficulties, someone with psychological problems shouldn't necessarily be able to do that for them maybe they 'should' just do their best to cope and continue getting help for their issue...but shouldn't be expected to reach the same bar as someone without psychological issues in every aspect of life because for some no matter how hard they try to work on the issues or make improvements they still aren't going to reach that state of normal functioning some people expect of them.

Sounds like she certainly has some sort of issue with the self harm and suicide attempt, but not sure jumping on BPD is the best idea. I mean people with that do suffer and do need help and compassion, though unfortunately even among mental health professionals there is a lot of stigma towards that disorder sad but true. But yeah you'd have to go into more detail as self harm and attempting suicide doesn't point to BPD per say.

[Trippin2.0]

Originally Posted by HaleyAnne

Please re-read my original

No need to, I don't suffer from reading or comprehension difficulties.

Re-read my reply, my concern with you coming to BPD as a conclusion was based on the fact that obtaining such a DX is a verrrry personal journey for a patient as the fault is in the root (invisible to outsiders) while the outcome is in the rotten fruits we bare (which affect the people around us)...

This DX is more like a personal journey toward self-awareness and change, than going into a Drs office where he rambles your diagnosis and prognosis and sends you on your merry way.

Getting a Bipolar diagnosis was much simpler than a BPD one as my Drs had to observe and learn A LOT about my thought processes and the havoc they wreak before even thinking about labelling me. In actual fact, I knew the label fit before they did exactly BECAUSE I am privy to my mind and how it works...

So unless you've been privy to her innermost thoughts and fears, and the extent they reach, I'm not sure how you have come to this conclusion.

Incase I have somehow been unclear, here is a list of the symptoms, which may I add, present in different combinations, are sometimes transient, and due to individuality are experienced and presented differently...

-Frantic efforts to avoid real or imagined abandonment

-Pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

-Identity disturbance, markedly and persistently unstable self-image or sense of self

-Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sex, eating disorders, binge eating, substance abuse

-Recurrent suicidal behavior, gestures, threats or self-injuring behavior such as cutting, interfering with the healing of scars (excoriation)

-Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety)

-Chronic feelings of emptiness, worthlessness

-Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

-Transient, stress-related paranoid ideation, delusions or severe dissociative symptoms

Again I wonder how you can check these off a list unless you've seen deep into the recesses of such a mind...

Ps. I'm not trying to start fires or fan flames, I'm just trying to clarify why I'm skeptical about your hunch. For all I know you are privy to the deep recesses of her mind.

At any rate, if she has this DX, it means your research is verrrry wrong regarding where you think she "should be" as she's right on schedule, because apparantly recovery takes between 5 and 10years!

[healingme4me]

Tattoos aren't listed in the criteria for self harm. Although I once had a friend who'd etched something in her chest and I went with her for a tat to cover it up. The self etch to me, self harm. Tattoo, not self inflicted injury,
Everyone classifies the pain(or not so painful) of a tat, different. If she chose to place them not on display, her choice. Lots of people don't show them off, daily.
I occasionally show off one, not the other. It is what it is.

If using the diagnostic criteria to ask if bpd, might get more positive response.

Learning effective communication skills to be supporting seems a better approach.

[monkeybrains21]

Wow Trippin I meet a number of those. Maybe I should bring that up with T and or Pdoc.

I have Complex Post Traumatic Stress Disorder and meet many of those criteria as well.

Some people do view tattoos as a form of self injury and/or mutilation, whereas others do not.

I also view my eating disorder and some of my other unhealthy behaviors as a form of self injury and/or mutilation as well.

Just my two cents and for what it's worth ...

Sincerely,
Pfrog!

[archipelago]

As people have pointed out, suicidal thinking/behavior and self-harm are not exclusive to BPD. Indeed, the new diagnostic manual proposes two as of yet undecided diagnoses for both suicidal behavior and self-injury that would be on their own without necessary connections to anything else. So it may not even be indicative of another disorder.

Diagnosis is very complicated. And BPD is a very complicated condition that has a range of things associated with it. People at in various states may present as if they have BPD, but actually in their typical state do not meet the criteria. That happens with people with chronic/complex PTSD and dissociative disorders too. People can have attachment issues that affect their behavior to produce BPD like symptoms, but they do not reach the level of a disorder per se.

But I'm curious. If she was in the hospital and also is on meds then doesn't she already have a diagnosis? Is it that you don't know or that you disagree? Having a diagnosis seems like it is something that is personal and also pertains to health issues so is private.

[marmaduke]

Not sure if tattoos qualify as self harm, I think they do if they are taken to extremes, like getting totally covered or having one on your face.
As for your family member having BPD I dunno. The biggest indicator of BPD is fear of abandonment an irrational assumption they are going to be deserted and extreme moods swings.
Does your family member fear abandonment?

No, even facial tattoos don't qualify as "self mutilation." Unless someone takes a tattoo gun and just grinds it into their skin, lol. Tattoos are artistic expression. Period.

[Trippin2.0]

Originally Posted by Pfrog

I have Complex Post Traumatic Stress Disorder and meet many of those criteria as well.

Sincerely,
Pfrog!

Originally Posted by archipelago

Diagnosis is very complicated. People at in various states may present as if they have BPD, but actually in their typical state do not meet the criteria. That happens with people with chronic/complex PTSD and dissociative disorders too. People can have attachment issues that affect their behavior to produce BPD like symptoms, but they do not reach the level of a disorder per se.

My point exactly

Thank you both for your individual input, this is what I meant by the process of diagnosis being personal and complex. You can't just go by a list of symptoms and match them to someone.

Its just not that simple...

[Perna]

Originally Posted by HaleyAnne

She spent a week in the hospital because she attempted suicide, and she was on 3 major drugs. Now is on 2 drugs plus therapy and is back to work, but I can tell she is nowhere close to where she should be.

That's a lot of drugs if she is Borderline; I would explore Bipolar also. Bipolar Disorder and Comorbid Borderline Personality Disorder | Breaking Bipolar

Have you spoken to her, asked her what's going on and indicated you are interested in her and her story?

[iditp20]

She would need a diagnosis for that from a professional.

As far as tattoos go, its a complete personal thing.

I have many tattoos, which I do get in exchange for my past self harm. Usually I will get them when I am depressed it is because it is a better alternative than cutting myself again, but you get the same relief.

Each person is different and does things for different reasons.

[HaleyAnne]

Thanks, SnakeCharmer. Your comments were extremely insightful and of great help!

[HaleyAnne]

Thanks, Hellion. I really appreciate what you said. True, cutting and suicide are not the only indicators of BPD, but my friend has a boatload of other symptoms! I can't think of anything she doesn't have! I don't think there has actually been a diagnosis--yet. As for "being where she should be", that was probably a very poor choice of words on my part. I should have simply indicated that she is struggling to barely keep her 'head above water'. Hopefully this will all improve in time. Again, many thanks!

[HaleyAnne]

Good thoughts, Trippin. I'm very grateful for everything you said. As for the checklist, my friend has all the issues except maybe one, some to extremes. Because you're saying that 'recovery' may take 5-10 years, I shall be much more sensitive and compassionate if she doesn't bounce back more quickly.