[Abby]

A psychiatrist has mentioned i may have a problem called borderline personality disorder. I didn't really know what this was so i've had a look around and although i can relate to some of the aspects, i can't to all of them. I don't know what to think - which is probably why i am writing this, trying to sort out my thoughts as i go along. Sure i have always known that i fear deeply rejection from anyone, and do frantically do masses to avoid that happening by usually doing all i can to please someone, and then i do become totally disappointed and angry when that person i invested in does not meet my expectations but i don't think this means i cannot maintain relationships. I have some great friends and i get on well with my family! From reading the website he gave me, i feel if i do have this illness it is my fault - my personality flaw

Here's the diagnostic criteria:

1. Frantic efforts to avoid real or imagined abandonment - well only as i have mentioned above

2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation - ok people can go quickly down in my estimations if they do something wrong or don't meet my expectations but i think that's normal - don't you?? Plus i have high expectations for myself - if anything i put myself under more pressure than i do others. I think i'm a very loyal person but there is a pt where everyone says 'no more' right??

3. Identity disturbance: markedly and persistently unstable self-image or sense of self - ok so yeh i have often said i don't know who i am - becoming dr Jekyll one minute and mr hyde the next etc...and not knowing what i want, what my values are, about my beliefs

4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating) - i know i don't do this, if i'm depressed maybe i'll treat myself but it is definitely not self-damaging!

5. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour - well ok...i do that.

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) - i guess i have said my biggest problem is not knowing how i feel one minute to the next in the past...but i'm confused to what affective instability and marked reactivity mean so who knows.

7. Chronic feelings of emptiness - yeh i feel this at times

8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights) - i don't fight with people, fighting really scares me, i can be passionate but i do not fight! - i do get angry sometimes completely at random but i put it inside me and do not know how to deal with it which is sometimes why i cut

9. Transient, stress-related paranoid ideation or severe dissociative symptoms - well sometimes i do feel disconnect from reality, like i am floating outside my body watching myself, or that 'myself' doesn't quite reach my fingertips...i have suggested this feels as though i'm ghost like and i want to connect the 2 parts of me

But still - i don't know what to think - i don't think i want this diagnosis it sounds scary!!

[Perna]

It's a way the "outside" world thinks and trys to organize what they "see" so they can deal with it more effectively/better. It's not actually "you" anymore than when you were in 4th grade, you were "only" a 4th grader or that that designation described you forever. Even in 4th grade you were better at some things (for me, English and History :-) and worse at others, etc. The borderline diagnosis is a bit like that, kind of says "well, we see some of these things and you might like to work on them to be a happier, more comfortable individual" and other parts aren't there.

Randomly pick one description, say #8 and look at your response, which was only your response this evening, not necessarily your response tomorrow or last week. You don't fight (but lots of guys might, if you think about it; you're like me though and internalize things instead of externalizing) but you do admit to being angry "at random" and that causes you to cut to try to help yourself deal with not knowing what to do with it. Well, therapy can help you learn what to do with it and how to recognize the "random" and stop it before it gets out of hand. Again, there's nothing "bad" or punitive about this description, it's just a means for those who would like to help to try to "understand" in a literal way. Think of it like a placement test you take; there's nothing wrong with where you place, it's just helpful because then they can see if you might do better in X place or Y. You haven't won or lost anything of "yours", it's external.

What is "fun" in therapy is to suddenly hold, at the same time, an understanding of how you feel versus how those outside of you "see" you. Someone without these issues only has what they have seen, kind of like a male OB/gyn :-) They talk like they know what having a baby is like or menopause, PMS, etc. but. . . :-)

Don't ever be afraid of yourself! And anything coming from "outside" like a diagnosis is not "you". You know you and have been dealing with her quite well all these years :-) Sure, you'd love to get some "tips" and help with dealing with the uncomfortable feelings and things that don't seem to make sense, finding someone to "help" understand and see how to beat your way out of a wet paper bag (that's what I felt like I couldn't do) but making "friends" with yourself and studying yourself and getting comfortable with you from the inside is what it's all about.

i did the calculation once upon a time but i can't remember the outcome. i'd be interested to know the answer if anyone is good with combinatorial mathematics.

there are... 9 different symptoms of BPD. in order to meet criteria you need to have i think it is 5 out of those 9 symptoms.

so you could have 5 symptoms
or you could have 6 symptoms
or you could have 7 symptoms
or you could have 8 symptoms
or you could have 9 symptoms.

there is one way in which you can have all 9 symptoms.
there are nine ways in which you can have 8 symptoms.
there are xxx ways in which you can have 7 symptoms.
there are yyy ways in which you can have 6 symptoms.
there are zzz ways in which you can have 5 symptoms.

so 1+9+xxx+yyy+zzz= how many different ways someone can meet criteria for borderline personality disorder.

can't remember. 54? 256? 512?

so... there can be considerable diversity in the symptoms exhibited by people who present with borderline personality disorder.

[Abby]

Thank you for replying - sorry it has taken me so long to get round to posting back! Sometimes i get into moods where i can't seem to form the sentences i want to say, i know the overall concept but for some reason my mind and fingers resist.

Thank you Perna, your words calmed me a lot. It made me realise that this diagnosis is not a life sentence but perhaps can give me an idea of how to get better when i start therapy. It means a lot that you took the time to write what you did, i was not expecting such a thoughtful reply!

Thank you Alexandra - you brought into perspective my need for absolute concrete adherence to the criteria! But i'm afraid the math is WAY to hard for me to do either!!

I really appreciated both of your comments.
Thank you for helping me.

[pachyderm]

What a nice and thoughtful and insightful (I think) response, Perna!