Head full of shit

"Lord it's so hot, and my heart's bleeding.
I ain't been with you and it's you I'm needing right now.
Just want the water, I just want an ocean,
an endless river to wash away all of my tears."
~ All Of My Tears, J. Spaceman

Feeling like total shit today. Woke up at 12. Went back to sleep at 1. Slept till 5. Took a shower in anticipation of going out. After showering, I cancelled my plans, now all I wanna do is sleep. Today is not a good day. I'm sick of this. Sick, sick, sick...

OK, now that you know...

Now that you know what BPD is and how it affects the lives of those who have it, let's get down to brass tacks. This blog is about me now, and how I've come to be how I am today. From childhood to now, and all the storminess and strife in between. But, not right now. I haven't showered in three days and I feel like I should actually leave the house for a little while today.

It's supposed to snow later tonight, which when it does, doesn't make me feel so bad that I'm unemployed. For some reason, it feels like a snow day, and in my head, I can then justify just sitting on my ass all day on my computer or watching TV or staring off into space wondering what the hell comes next.

I guess I'll start this way for now:

Current meds:
60mg Adderall XR (ADD)
60mg Cymbalta (Depression)
3mg Klonopin (Anxiety)
10mg Ambien (Insomnia)

I used to be on 6 different medications at one time once I was diagnosed with BPD. The biggest problem I had were my mood swings.

Now, it's just everything else. And they don't make a medication for that.

I must shower now.

They feel agony at the slightest touch or movement

"People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement."
~ Marsha Linehan, researcher

Traits Involving Relationships

» Unstable,chaotic intense relationships characterized by splitting.

» Frantic efforts to avoid real or imagined abandonment.

1. Splitting: the self and others are viewed as "all good" or "all bad." Someone with BPD said, "One day I would think my doctor was the best and I loved her, but if she challenged me in any way I hated her. There was no middle ground as in like. In my world, people were either the best or the worst. I couldn't understand the concept of middle ground."
2. Alternating clinging and distancing behaviors (I Hate You, Don't Leave Me). Sometimes you want to be close to someone. But when you get close it feels TOO close and you feel like you have to get some space. This happens often.
3. Great difficulty trusting people and themselves. Early trust may have been shattered by people who were close to you.
4. Sensitivity to criticism or rejection.
5. Feeling of "needing" someone else to survive.
6. Some people with BPD may have an unusually high degree of interpersonal sensitivity, insight and empathy.

What is BPD?

Borderline Personality Disorder (BPD) is a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior.
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior 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)
6. Chronic feelings of emptiness.
7. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
8. Transient, stress-related paranoid ideation or severe dissociative symptoms

The DSM IV goes on to say:

The essential feature of Borderline Personality Disorder is a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts.

Associated Features and Disorders

Individuals with Borderline Personality Disorder may have a pattern of undermining themselves at the moment a goal is about to be realized (e.g., dropping out of school just before graduation; regressing severely after a discussion of how well therapy is going; destroying a good relationship just when it is clear that the relationship could last). Some individuals develop psychotic-like symptoms (e.g., hallucinations, body-image distortions, ideas of reference, and hypnotic phenomena) during times of stress. Individuals with this disorder may feel more secure with transitional objects (i.e., a pet or inanimate possession) than in interpersonal relationships. Premature death from suicide may occur in individuals with this disorder, especially in those with co-occurring Mood Disorders or Substance-Related Disorders. Physical handicaps may result from self-inflicted abuse behaviors or failed suicide attempts. Recurrent job losses, interrupted education, and broken marriages are common. Physical and sexual abuse, neglect, hostile conflict, and early parental loss or separation are more common in the childhood histories of those with Borderline Personality Disorder. Common co-occurring Axis I disorders include Mood Disorders, Substance-Related Disorders, Eating Disorders (notably Bulimia), Posttraumatic Stress Disorder, and Attention-Deficit/Hyperactivity Disorder. Borderline Personality Disorder also frequently co-occurs with the other Personality Disorders.

Specific Culture, Age, and Gender Features

The pattern of behavior seen in Borderline Personality Disorder has been identified in many settings around the world. Adolescents and young adults with identity problems (especially when accompanied by substance abuse) may transiently display behaviors that misleadingly give the impression of Borderline Personality Disorder. Such situations are characterized by emotional instability, "existential" dilemmas, uncertainty, anxiety-provoking choices, conflicts about sexual orientation, and competing social pressures to decide on careers. Borderline Personality Disorder is diagnosed predominantly (about 75%) in females.

Prevalence

The prevalence of Borderline Personality Disorder is estimated to be about 2% of the general population, about 10% among individuals seen in outpatient mental health clinics, and about 20% among psychiatric inpatients. In ranges from 30% to 60% among clinical populations with Personality Disorders.

Course

There is considerable variability in the course of Borderline Personality Disorder. The most common pattern is one of chronic instability in early adulthood, with episodes of serious affective and impulsive dyscontrol and high levels of use of health and mental health resources. The impairment from the disorder and the risk of suicide are greatest in the young-adult years and gradually wane with advancing age. During their 30s and 40s, the majority of individuals with this disorder attain greater stability in their relationships and vocational functioning.

Familial Pattern

Borderline Personality Disorder is about five times more common among first-degree biological relatives of those with the disorder than in the general population. There is also an increased familial risk for Substance-Related Disorders, Antisocial Personality Disorder, and Mood Disorders.

Differential Diagnosis

Borderline Personality Disorder often co-occurs with Mood Disorders, and when criteria for both are met, both may be diagnosed. Because the cross-sectional presentation of Borderline Personality Disorder can be mimicked by an episode of Mood Disorder, the clinician should avoid giving an additional diagnosis of Borderline Personality Disorder based only on cross-sectional presentation without having documented that the pattern of behavior has an early onset and a long-standing course.

In the beginning...

I rarely, if ever, discuss the psychiatric issues I've had in my life. Those that know me well do realize I have bouts of depression. I've been diagnosed since I was about 13. But, since then, I've noticed something else going on. I'm not just depressed. I have stormy relationships with women and friends, 'black and white' thinking, chronic feelings of emptiness and failure, impulsive and reckless behavior, not being able to remember what you said or did in times of high stress, and probably most noticeable of all, severe shifts in mood and feeling.

I didn't know what was wrong with me until I was finally "officially" diagnosed with Borderline Personality Disorder recently. While it comes as somewhat a relief to know that I have something that actually has a name, the downside is, the disorder itself is not treatable with medication. The individual components (the depression, anxiety, mood swings) are treatable, but the rest of the destructive behaviors (stormy relationships, sensitivity to rejection or criticism, heavy need for affection and reassurance) are only treatable by intensive therapy. These behaviors have been developing in me since I was a child, and they provided some need, or protection, but right now, this disorder is destroying me. I hate what I have become.

It's hard when a relationship or friendship is destroyed based on my impulsive actions to explain, 'Oh, I have BPD, so that's why I did this.' That's unacceptable because one day, they're not going to come back. Ever. There's only so much abuse people will put up with. And that's a regret I'm going to have to live with. My therapist always says that regret is a wasted emotion. I don't think so. I think you need to regret things to learn from your mistakes, so you never have to regret anything ever again.

I'm talking about this here because Borderline Personality Disorder is a relatively controversial and underdiagnosed disorder. But it is very real, and can be very disruptive and destructive not only in the sufferers life, but for those around him. Maybe someone you know has it but doesn't even know it. According to the DSM-IV, these are nine basic criteria, five of which must be present to be diagnosed with BPD. If you see any of these in yourself, or in someone you love, urge them to get help. It is not very common, and is estimated to be found in 1 to 2% of the general U.S. population at any give time.

But what exactly is BPD?