What's Bpd Again?!

[lostsoul]

So, I was musing about BPD today and it dawned on me that I still don't really understand much about it, in fact, I don't really get it at all!!!!

Basically this is because I am starting to see our problems more in terms of chemistry problems than just symptoms. I am starting to think more about the causes of those symptoms than anything else.

Maybe that's not logical. I'll try to explain why I am doing this and then you can tell me why it's not logical!

Reading the article about neurotransmitters explained the chemistry behind certain symptoms. For example, serotonin explained depression, some OCD behaviour and micropsychosis as paranoia. Norepinephrine explained anxiety and panic attacks. Dopamine explained major psychosis, delusions and hallucinations. GABA explained mood swings, and also shared similar functions to norepinephrine.

So we have chemical bases for ALL the adjunct disorders that people with BPD commonly suffer from - depression, anxiety, mood swings and OCD traits. Just scrolling down the personal profile information it seems that almost everyone here, if not all, have at least one or two of these adjunct disorders.

So what's special about BPD? What makes it different than depression, anxiety, OCD and mood swings all lumped together?

Is BPD what you call what you get, when you share all those particular adjunct disorders, combined with a traumatic childhood?

It just seems as though something isn't adding up with BPD. There is an apparent 'other' cause or quality to it which I cannot find, name or suggest!

Almost by its very nature; it being a borderline disorder, it seems to be skirting around the edges of things, evading proper definition.

It goes hand in hand with childhood trauma, though not everyone who has BPD did suffer trauma. In other words, truama is not necessary in the development of BPD. Why? Does this indicate we could legitimately favour chemical causes over environmental ones?

Why can you still have BPD if you do not fit ALL the criteria? How is it that different people's experience of the SAME disorder can be so unique? Some have outrageous black and white thinking and some do not. Some have huge relationship problems, others do not. Some SI, some do not. Some get suicidal, some do not, and so on.

It seems like such a fluid, maleable definition, that I am losing a definition.

I am beginning to think that brain chemistry is a safer place to work, becuase there is no ambiguity as to whether a level is right, or wrong.

I am beginning to think that calling things names is very confusing and just obscures the underlying cause of it.

Yet I want to group it into something, to give it a name, almost instinctually. I feel a need to set it apart from depression, anxiety, OCD and mood swings. There is an otherness to it which I cannot even define. Perhaps it is just my need to be different, to be a harder case than just a depressive, just an OCD, just an anxiety, or a mood swing sufferer. Maybe because deep down i feel its foundations are much more complicated than the foundations of these 'other disorders'.

Any thoughts?

[LadyMacbeth]

I iwll have to think about this and I just posted a similar comment in "my mother having BPD" but I also posted an article on BPD and the environment that does explain a lot. I think you have just pinpointed why psychiatrists and therapists are so reluctant to label us as BPD. BPD is a personality disorder not a mental illness the traits that can tie in with the disorder our physiological such as anxiety disorder, OCD, psychosis, Bi-polar II, and depression. But you are right we all have different traits and symptoms. But I look like it how BPD is expressed as emotional hemophelia. We have not formed the correct coping mecanisms to control our emotions.

[lostsoul]

Yes I just read that post and thought hmmm... that's similar!

There seems to be some controversy as to whether BPD is a mental illness. This site certainly classes it as being one, 'within the remit that personality disorders are mental illnesses'.

I am not sure what implications this would have for BPD anyway. I am unsure of the definition of a mental illness, and on what grounds BPD might not be one. I think your arguement comes down to genetics, heritability and so on. But there is evidence that if one or more of your parents has BPD then you are more likely to have it too. This could however, i admit, be due to shared environment, and the learning of faulty behaviours, as much as it could be to do with genetics. I am unaware if any conclusions were drawn as to whether they found that environment or genetics was to blame here.

I like the idea of BPD being like emotional haemophilia. But again, where do emotions spring from? What is the cause of this?

I wrote something yesterday in the debate forum about thought being faulty rather than emotions. But there is not just the type of emotion that is displayed, it is also the INTENSITY. Yes, that is something I did not think about when I made that arguement. So faulty thinking is to blame, in part, but there is also intensity to consider - this is very interesting.

Where is the intensity of emotion derived from?

Is it thought? Or something else? Chemistry?

Anyway. Good thoughts Lady. Where is the article about environment?

[LadyMacbeth]

The article is in Borderline Personality Disorder under BPD and the environment. I am goingt o reread it again before I apply to your post. But I definetly agree with the debate about BPD being a mental illness or a disorder I was just reading info about it before receiving a call from a CBT therapist.

I enjoy giving my brain a workout it needs it!

[LadyMacbeth]

I actually read that the UK and USA have seperate criteria for BPD it would actually be interesting to anaylize that!

[lostsoul]

Yes thats interesting. Again, it doesn't help to clarify anything when two continents decide to define it differently.

I will have to check out what the differences are.

I am off to look at the article you posted now. Cheers for that.

x

[LadyMacbeth]

Ok I am excited. Just read the article again and it answers a lot of your questions and when you are back we can discuss it.

[kraaken]

Hi lostsoul,

I believe there is ongoing research being done into BPD. I have been reading "Cognitive Behavioural Therapy of Borderline Personality Disorder" by Marsha Linehan (1993; ISBN 0-89862-183-6) and in it she writes that there are different approaches to understanding what BPD is.

There is a table on page 12 which gives quite a lot of information (most of which I don't really understand!!) :

1. WHAT IS MEANT BY 'BORDERLINE'?

Psychoanalyticaly it may be "psychostructural level or psychodynamic conflict;

Biologically it may be a mild varient of one of the major disorders e.g.depression;

Eclecticly it may be a specific personality disorder;

Biosocially it may be a specific personality disorder;

Cognitively it may be a specific personality disorder.

2. DATA ON WHICH DIAGNOSIS IS BASED

Psychoanalytical: symptoms, inferred intrapsychic structures, transference;

Biological: clinical symptoms, familial-genetic history, treatment response;

Eclectic: combination of symptoms and behavioural observations, psychodynamics and psychological test data;

Biosocial: behavioural observation, structured interviews, behaviourally anchored test data;

Cognitive: as for biosocial.

3. ETIOLOGY OF DISORDER (where it came from/ how it arose):

Psychoanalytical: nurture, nature, fate;

Biological: nature;

Eclectic: unspecified;

Biosocial: nature, nurture;

Cognitive: nurture.

4. COMPOSITION OF BORDERLINE POPULATION:

Pyschoanalytic: homogeneous - intrapsychic sturcture; heterogeneous - descriptive symptoms;

Biological: all BPDs are not the same but there are groups of similar subtypes;

Eclectic: all BPDs are not the same

Biosocial: all BPDs are not the same

Cognitive: unspecified.

5. IMPORTANCE OF DIAGNOSTIC SUBTYPING:

Psychoanalytic: generally not regarded as important;

Biological: regarded as important;

Eclectic: somewhat important;

Biosocial: important;

Cognitive: unspecified.

6. RECOMMENDED TREATMENT (this information is from 1993)

Psychoanalytic: modified psychoanalysis, confrontive psychotherapy;

Biological: chemotherapy (=medication);

Eclectic: unspecified;

Biosocial: modified behaviour/cognitive behaviour therapy;

Cognitive: modified cognitive therapy.

I've underlined for etiology biological - nature, and cognitive - nurture above, because the cause of BPD determines the treatment that is thought to help. So here if there is a physical neurotransmitter cause for example in BPD you would expect that to be treated with medication, in the same way that SSRI antidepressants have been used to treat depression while depression is thought to result from a deficiency in the brain of serotonin.

However, if there is no biological (physical/chemical) basis for BPD, and it is a result of nurture (your upbringing and life story) then treatment would need to be some sort of cognitive therapy or psychoanalysis.

Because both of these forms of treatment, medication and psychoanalysis are used in most BPD sufferers, this shows that no-one really understands the Borderline Personality Disorder.

So in answer to 'what's BPD again?' I think from what Linehan writes, there are five different approaches to answering that question, and there are researchers working on each of the approaches: psychoanalytic, biological, eclectic, biosocial and cognitive.

(I had to refer to the dictionary for the meaning of 'eclectic', it means: "said of a set of beliefs, selecting material or ideas from a wiede range of sources or authorities")

Bye for now

K

[lostsoul]

Wow ok thats really interesting and illuminating happier now.

first of all. lady, the environment post was a great read.

it poses that there are two pathways to BPD which can be travelled seperately or which can be travelled together to reach the final destination: BPD!

these are biological vulnerability, and, psychotrauma in early environment

what i did not know was that psychotrauma can actually alter the limbic system permanently, so that our stress sensitivity to related trigger events is forever set on 'high'. the comparison with ptsd is formidable and convincing, and it makes good sense. early trauma also affected serotonin and norepinephrine and dopamine regulation systems. WOW. just WOW.

i can see better now why i seem primed for certain triggers. excellent. this really helps me to rationalise the fear and anxiety and mood states i get stuck in.

also the stuff about having a smaller hippocampus due to psychotrauma.

given all this, our brains have literally been changed, in size, in chemical make-up. our homeostatic levels are wrong, inherantly. this explains why coming off drugs to regulate the faulty systems often leads to relapse. i wonder if you can re-grow your hippocampus or amygdala?????

what remains though is that much more work needs to be done. it is one of the most complicated disorders yes? because of the dual pathways to developing it. i mean with bi-polar the theory is just genetic right? it comes from chemical imbalance, nice n straightforward. not easy to live with but at least you know why you have it.

i guess the conclusion i am coming to is that as i always suspected, my mum traumatised me and my brother over a period of about ten years and on a daily basis throughout that time. but she has it too, and it must have been tough. i know i have biological and environmental causes with my bpd. knowing about the biological predisposition, and knowing she had it too and that it was tough for her to bring us up, will hopefully help me to shelve the anger and resentment i often feel toward her.

i am sure she never meant to screw us up.

kraaken -

thanks for the information you posted. yes i am glad you looked up the eclectic word cos in this context its a bit aint it?

i dont think i undertsand half of it either.... hmmm. it is interesting that she has broken it down into those 5 components. definitely something to chew over and come back to!

thanks so much again to the pair of you.

lost

xx

[LadyMacbeth]

Yes, I got pretty excited reading that article I found it absolutely fascinating actually. Makes me just want to go to school and study mental disorders and mental illnesses and obtain a degree for it after.

This paragraph really caught my attention because like you said it helps understand where this poor self-image and anxiety stems from.

As PTS exposure is repeated and generalized, neurobiological changes (as specified in Perry's 1996 analysis) begin to take place. According to some of the findings reviewed earlier, changes in catelcolamine functioning and serotonin functioning may occur. At the same time a relationship control phobia develops in response to the PTS emitted by members of the child's family. Basic trust, thought to form within the first years of life (Erikson, 1950), is compromised. As relationships, through generalization (the generalization dimensions appear to be intimacy and authority), become viewed as threatening, the child also develops a negative image of him or herself. Chronic aversive treatment, especially at the hands of loved ones, condition a negative self-image that leaves the child feeling that he or she is "bad." The core self-image of "badness" progresses to one of self-hatred. These core beliefs condition the development of other distorted cognitive beliefs and errors in thinking (e.g., black and white thinking).

Yes, I found it really interesting that psychotrauma can alter the limbic sytem permanently. It actually may be helpful to make a list of events that have made us anxious as children and recall how we felt in that situation and then connect them with everyday life. The anxiety we are experiencing today usually does not a cause behind it it comes out of nowhere. Maybe if we can figure out how to connect early trauma with this present fear immobilizing us it could actually help us overcome our anxieties. With the help of therapy and drugs in the meantime. But, it takes a lot of hard work for us as well to understand where this is coming from.

For example one of my triggers is abandonment. I moved probably over 18 times in my life. I had to leave behind family and friends over and over again. Not to mention the fear of instability and insecurity that goes along with it. Also my mother moved out and went to live in another state. This represents a pattern iof instability in my life so of course its going to trigger anxiety in my adultlife. Now it will be interesting to connect each event of my childhood to my BPD traits. In order to recover it takes understanding and accepting things for what they are. I believe that this can be done we do have the ability to feel better about ourselves. It won't be easy but it can be done.

Claire-your brain is pretty sharp at 12:00am at night. Its only 7:15 pm here and I am already nodding off so if this makes so sense please do not mind me. But, I think either tonight or tom. morning I am going to track my own emotional growth. Its a project but I think it will help and I can also bring it up in therapy. I am going to research this more tom. when I am wide awake again.

I am glad you liked the article its a good one!

[lostsoul]

gawd my list would be so incredibly long. what a task.

some of them i already know about. some are more obscure and evade my inner eye. that's one of my eyes going inward, the left one. tee hee

see my brain is getting blunter by the minute. <--- me in half an hour, muted and expressionless. quickly followed by a higher state of unconsciousness, called sleep.

yes. tomorrow i will do the list. but i still want a new amygdala and hippocampus, and limbic system!

:P

[LadyMacbeth]

I think you may need a labotomy for that. Hope I spelled that right and I hope it is the right word.

[LadyMacbeth]

Yeah correct word wrong spelling lobotomy.

[lostsoul]

Yeah, a full lobotomy. Just take the whole brain out and then put in a cloned one with lots of good memories and intelligence and a great memory bank of jokes.

It doesn't even have to be like me! In fact the less me the better!

:P

[LadyMacbeth]

I am on the phone listening to my friend cry over a fight with her boyfriend and I started to read your post at the same time....bad idea...my tongue hurts from biting it so hard to keep from laughing.

[lostsoul]

:P

[Katherine]

according to DSM I always seem to come out as BPD, but not the IC European thingy!???

Cos I don't have the impulsive thing..its more abandonment and separation anxiety, dissociation, depression, occasional paranoia, emotional instability, panic attacks....

Any clues from you budding psychiatrists out there???

I strongly resoante with the neuroscience psychotherapy link, having studied attachment, embodiment and emotion last year. BPD in that sense is described as a RELATIONAL TRAUMA.

As a premature baby with 3 weeks separation from my mother after I was born, she didn't touch me or see me close up for that time, it is clear many of my attachment anxieties stem from there and I never developed an adequete emotional coping mechanism that comes through the mother's containment of the baby's emotional distress through close emotional and physical contact, through holding and understanding, through love and care.

--o yeah and all that other stuff I never had at home and school!

(Read D.W. Winnicott and Roz Carrol, also Schore and Cozolino---if you want links for Roz Carroll I can pm them to you. I had her as a tutor for 6 classes last year.)

As to repairing the amygdala etc, well, developing a relationship where one is seen and heard, responded to empathically, recieving emotional attunement NOW, that can help--as in therapy.

lorna

[LadyMacbeth]

Lorna,

You may just have PTSD with BPD traits w/o meeting the specific criteria.

[Katherine]

oooo sounds good to me!!!!!

cheers,

lorna

(can it be official!!!!!!)

[LadyMacbeth]

I diagnose you with PTSD...So if anyone asks you can tell em'....tell the psychiatrist that one! :lol:

[Katherine]

who's the psychiatrist???? *quizzical expression* (too lazy after 10 hour working day to pop up the similes!)

lorna

[kraaken]

Hi folks,

I was just wondering about childhood trauma. When I was 2 years old I fell on my head from the first storey of a building, a balcony. Does that count? Or is the trauma referred to in BPD more psychological? My mum said she smacked me once when I was a baby and I "went into shock" as she says. On the other hand my mum had a temper when my brother, sister, and I were kids and we used to hide from her when she went on the rampage. And she used to smack us if we ran away and she caught up with us. (My brother and sister are mentally sound though, it's just me having some problems).

Bye for now

K

[LadyMacbeth]

I am not sure if falling on your head may cause psychological trauma. Are you older than your siblings? Were you smacked more? Did your mum take out her anger more of you? Yes, that could have something to do with it.

[kraaken]

Thanks LadyMacbeth...

Apparently I wasn't smacked more, my mum said she smacked me less as I reacted worse to it compared to my brother and sister (I'm the youngest).

The other thing I was wondering about was the difficulty I had coping with going to boarding school when I was 8 years old. That was tough.

Bye for now

K

[LadyMacbeth]

Could be abandonment. Ummm...its also how you adapted to your environment. I guess. Have you spoken to a therapist? I can't wait until I can get into a Master's program so I can start studying psychology because then I will really have a grip on this stuff.