100 milligrams twice a day of "shut up and deal with it"
January 26, 2015 8:30 AM   Subscribe

"But here's the facts: Like most other psychiatric disorders, we are really unlikely to hurt another person. Even when we're really upset at someone, we're still convinced that it's entirely our fault, so we mostly take it out on ourselves. That's a big reason why we self-injure -- it's punishment as much as relief -- and why suicide attempts are as routine as daylight saving time for many of us."
5 Realities of Life for People With Borderline Personalities
posted by almostmanda (43 comments total) 24 users marked this as a favorite
 
I liked this one.
posted by michaelh at 8:47 AM on January 26, 2015


This article is dangerously inaccurate. There absolutely is treatment for borderline personality. Additionally, a significant percentage of people with borderline personality grow out of it as they age into their late 20s/early 30s (perhaps not coincidentally, this is when impulse control and other executive functions reach their highest level of maturity).
posted by internet fraud detective squad, station number 9 at 8:49 AM on January 26, 2015 [35 favorites]


It is especially important to be accurate about treatment prospects in an article about Borderline Personality Disorder. They are a group of people who typically experience feelings of helplessness and hopelessness. They also typically experience suicidal ideation. This particular pernicious myth could do real harm to some very vulnerable people.

I don't blame the author for getting it wrong. I do blame the people who see publishing an article like this with no expert oversight as acceptable. It's similar to an article saying that, say, skin cancer isn't treatable.
posted by internet fraud detective squad, station number 9 at 9:09 AM on January 26, 2015 [8 favorites]


It is especially important to be accurate about treatment prospects in an article about Borderline Personality Disorder.

So what are the most effective forms of treatment?
posted by yoink at 9:10 AM on January 26, 2015 [1 favorite]


My understanding is that cognitive behavioral therapy has shown a lot of promise in treating people with BPD but they are exceedingly demanding on the therapist so you need to severely limit the number of BPD patients an individual therapist works with.
posted by vuron at 9:11 AM on January 26, 2015


I'm on a state of California internet connection temporarily. The state runs everything through a filter company (WebSense) and I can't reach the linked article. The link returns a page that reads: "Blocked due to: Tasteless."

I guess "cracked.com" has crossed the borderline?
posted by CrowGoat at 9:13 AM on January 26, 2015


As much as love Cracked, yeah, they sometimes have some harmful information (The blindness community and I absolutely cringed at the one about braille.)
posted by Melismata at 9:16 AM on January 26, 2015 [1 favorite]


Dialectical Behavior(al) Therapy (DBT), which is a form of Cognitive Behavioral Therapy, has shown positive effects. Researchers have made a lot of progress on teasing out which components of DBT are vital to its success. It does require specific training, so accessing it isn't always simple.

Also important is that we have more knowledge about what doesn't work: inpatient hospitalization and turning people into walking pharmacies, ie constantly increasing the dosages of meds that don't work. This is an especially bad practice when these meds are benzodiazepines.

I should note that I'm not a professional, rather I'm an interested layperson.
posted by internet fraud detective squad, station number 9 at 9:23 AM on January 26, 2015 [8 favorites]


Cracked.com is interesting - I like the podcast, and I'm (sometimes) mildly amused by After Hours, but it's like mining: sometimes it's a diamond, but mostly it's schist.
posted by eclectist at 9:25 AM on January 26, 2015 [3 favorites]


Dialectical Behavior(al) Therapy (DBT), which is a form of Cognitive Behavioral Therapy, has shown positive effects. Researchers have made a lot of progress on teasing out which components of DBT are vital to its success. It does require specific training, so accessing it isn't always simple.

Dude, it says that right there in the article. Did you actually read it?
posted by Sys Rq at 9:26 AM on January 26, 2015 [4 favorites]


Talk therapy does help with BPD, if it includes some guidance into developing coping skills.

There is a problem that some people with BPD can be so needy for approval that an unscrupulous or lazy therapist can basically make easy money by nodding and agreeing with everything the patient says, and offering no help or guidance. This is anecdotal though, and I really hope it's not a common occurrence.
posted by idiopath at 9:28 AM on January 26, 2015 [2 favorites]


DBT is useful for a lot of people, not just those with BPD. And if you're motivated, there are some pretty good DBT self help resources out there.
posted by elsietheeel at 9:36 AM on January 26, 2015 [6 favorites]


I also got blocked when trying to access this article here on an North Carolina government computer. Sometimes at work I'll try to go to a legit site that discusses human sexuality or similar (I am an academic), and I get blocked with the message "Sex" or "Nudity". But when I tried to access this article, I got blocked with the message "Tasteless".

I was hoping that it was because it was a Cracked article being . . . well, a Cracked article, but perhaps it has something to do with the factual content?
posted by chainsofreedom at 9:43 AM on January 26, 2015


I think a major issue is that BPD is presented here as unique in being difficult to treat with medication, but in reality many psychiatric conditions are difficult to treat with medication. And this:
We're living in supposedly enlightened times in which no one blames the mentally ill for their condition. If you meet people with schizophrenia, you assume whatever they do is just the result of chemicals going rogue and fighting epic battles in their head meats. But then there is a category of illnesses that are deeply entwined with an individual's personality called -- wait for it -- personality disorders. These are a series of destructive behaviors and thought processes that are part disease, and part ... just the way you are.
is just not really true of schizophrenia, either. Plenty of people blame people with schizophrenia for not pulling their lives together better, including patients themselves. And antipsychotics don't fully work for a lot of people dealing with schizophrenia, either.

I mean, I get that there can be a feeling of "Those people have specific medications for their conditions, which makes their conditions seem more legit and treatable," but I think that's a false conclusion.
posted by jaguar at 9:47 AM on January 26, 2015 [5 favorites]


Yes, Sys Rq, I did read the article. The headline/section title claiming that there is no treatment is prominent, and worth responding to despite it being somewhat contradicted by the rest of the text.

Anyone who wants to discuss further is welcome to mefimail me; dominating the discussion in this thread is not my goal so I'm stepping out.
posted by internet fraud detective squad, station number 9 at 9:51 AM on January 26, 2015 [3 favorites]


The headline/section title claiming that there is no treatment is prominent, and worth responding to despite it being somewhat contradicted by the rest of the text.

I think "The subhead for the section on treatment is unfortunately misleading" might have been a better comment than "This article is dangerously inaccurate"—which is what you actually wrote. It seems that the article actually gives pretty much exactly the same advice that you give wrt treatment. It also adds the claim that it's hard to find a therapist trained in DBT. Is that accurate?
posted by yoink at 9:56 AM on January 26, 2015 [4 favorites]


FTA: "Do you remember the relationships you had in your early teens, when the hormones first started pumping and absolutely everything was HUGE and DRAMATIC?"

I've posted about my sister many times in the blue. She killed herself a year and a half ago (Oct 2013). I ended up not being as good a support as I could have been (to say the least). My mother stuck through, steadfastly, through all the pain, as only a mother can.

I can't tell you the number of times when I'd visit my folks and I'd hear my mom, loudly, on the phone, trying to interrupt and get through to her (H = her initial, for privacy sake): "H... H... Just... would you please, just... hold on... H... Listen. You're not thinking clearly. Just... Hold on... Slow down. Please..." and it was always drama drama drama. And it hurt to know that like 75% of my mom's conversation with her was always trying to get her to slow her brain down and think rationally/like an adult...

As a teenager, I never noticed much of an issue, and always wondered why mom sounded so frustrated with her. Of course, I was a teenager, so what did I know of emotional adultedness.

Then I had to deal with boundary issues with her when I had moved out on my own, calls at 7-8 am, when I was still sleeping or getting ready to go to work.

Eventually we had set boundaries, which she mostly abided by, but she couldn't just let the phone be hung up and dragged it on and on, and it was so draining. So I ended up not talking to her much, and then...

After my one sister died, this sister with BPD really did break, and after dealing with a lot of physical problems and addictions added in, and a struggle to obtain help for a decade, it took its toll on her and she ended up killing herself.

What I wanted to bring up, however, was when I think I really realized, and this was already when I was, probably a good 26 or 27 when it hit me, and it may have been a combination of her having a downslide in general to me maturing enough to see it... But I recall saying to my partner at the time that I thought she (my sister) was "mentally challenged". Now - I think I would have said "emotionally challenged" but that was the only phrase I knew then.

I felt like she was stuck being a teenager. And until you've experienced it you really don't understand. And when it's a teenager, you expect it, but you don't expect it from a person in their 40s.

I think, there are two things I regret in my life:

1) Going in to be with my cat when they put her to sleep.
2) Not being there more for my sister near the end of her life. She probably would have ended up killing herself anyways, and she would have been in misery, but she tried and I could have given her the benefit of the doubt while still setting boundaries. Instead, I set such a firm boundary that I didn't let my compassion seep through.

I can't say what other people should do or shouldn't, but for me, I thought the whole "break contact for your own sanity - don't force yourself to live in misery" was sage advice (and to a point it is) but if the other person shows improvement, if they are doing their best and you can tolerate a little of it, then don't be afraid to share the love you DO have. Just make sure that you set the boundaries that you need. Don't run, don't hide, don't shirk. Because ...

In the end, all they might have is you, or their mother, or their children. And if you cut them off, that's one less anchor they have to reality.

And again, if somebody needs to do that for their own sake, I cannot judge them for doing what they deem is necessary for their mental health. If my sister hadn't made any improvements at all, or attempts to do better, then perhaps that advice would have been right for me, but in the end, I sorta regret not sharing more love.

I don't dwell on it, but there are times, when confronted with the issue, that I do think of it, like now... Everybody has to make a choice with how they deal with BPD, both the person who has it, and the people in their lives... And everybody has different levels and abilities to cope, and sometimes they exist with other conditions that amplify the BPD aspects of the need for attention/love...

There is no sure answer, and I wish people with BPD and the people who love them could get group therapy, or at least, therapy together, cohesive, so everyone in the core group can work on the same page.
posted by symbioid at 10:00 AM on January 26, 2015 [42 favorites]


Several Therapies Show Success in Treatment of Personality Disorders has some good information about treating BPD, though the lack of a date on the article makes it annoying. I have known therapists who use the STEPPS program mentioned and found it successful.
posted by jaguar at 10:15 AM on January 26, 2015 [1 favorite]


There is no sure answer

Too, too true. For every sibling/child out there thinking "if only I'd done more" there's at least one other thinking "if only I'd just refused to get sucked into their maelstrom." Love is patient and love is kind but there are people out there for whom love is also an act of heroism which can't reasonably be demanded of everyone. You certainly don't sound like you did anything you should reproach yourself with.
posted by yoink at 10:16 AM on January 26, 2015 [8 favorites]


Also, when an outbreak consists of emotional violence (shouting, harsh words, insults, accusations, etc.) and the trigger is fear of abandonment (such that trying to get space will likely escalate the situation), love can be hard to differentiate from being victimized.
posted by idiopath at 10:19 AM on January 26, 2015 [11 favorites]


I thought this was interesting:

Some researchers, like Judith Herman, believe that BPD is a name given to a particular manifestation of post-traumatic stress disorder: in Trauma and Recovery, she theorizes that when PTSD takes a form that emphasizes heavily its elements of identity and relationship disturbance, it gets called BPD; when the somatic (body) elements are emphasized, it gets called hysteria, and when the dissociative/deformation of consciousness elements are the focus, it gets called DID/MPD. Others believe that the term "borderline personality" has been so misunderstood and misused that trying to refine it is pointless and suggest instead simply scrapping the term.
posted by larrybob at 10:54 AM on January 26, 2015 [4 favorites]


For every sibling/child out there thinking "if only I'd done more" there's at least one other thinking "if only I'd just refused to get sucked into their maelstrom."

And, not all that infrequently, these two people are the same person.
posted by Errant at 10:55 AM on January 26, 2015 [11 favorites]


I don't say this as a form of judgment, but it's actually not surprising to me that a person suffering from BPD would open a paragraph by saying "we're really unlikely to hurt another person" and then close that same paragraph by saying "suicide attempts are as routine as daylight saving time for many of us."
posted by drlith at 11:15 AM on January 26, 2015 [5 favorites]


It also discounts emotional abuse.
posted by idiopath at 11:19 AM on January 26, 2015 [13 favorites]


For every sibling/child out there thinking "if only I'd done more" there's at least one other thinking "if only I'd just refused to get sucked into their maelstrom."

And, not all that infrequently, these two people are the same person.


Add friend to that list.

Both my friend and from the reports I heard about her aunt makes me suspect BPD ran in her family. I spent most of my teenaged years trying to help, but in the end for my own safety I had to let go. I still think about her a lot. She was very much " I hate you don't leave me." When she was well she was amazing, but as we grew up ....

Drlith is right , she never physically hurt anyone but every act of self harm, suicide attempt and eating disordered day had an effect. It wasn't on purpose, though some of our friends think it was. she may as well have been stabbing me in the gut.

(Apologies for the bad typing, I'm on a tablet and it isn't playing nice!)
posted by Braeburn at 12:09 PM on January 26, 2015 [1 favorite]


It also discounts emotional abuse.

I may be too close to the topic to comment productively, but I will point out that while my spouse with BPD never only occasionally took a punch at me, she did spend months and months complaining to family and friends about abuse from me that never happened, how afraid she was of me, and her concerns for the children's safety. These accusations has no basis in reality whatsoever. (See "distortion campaigns.") But before I knew what was going on, our mutual friends had sided with her against me, and staged an intervention in which they took her and the kids to a "safe location" while I was at work, and then contacted my supervisors to regale them with sufficient enough tales of horror that they found reason to let me go, leaving me with no financial resources to fight a legal battle while they offered to help her pay for the best attorney in town. When I eventually got full-time work again, a year and half later, on the other side of the country, in a completely new field, it paid almost exactly half of what I was making before, so I would estimate the total financial cost to me just in lost income has been $300,000 over the last five years, and unless I magically get a job that pays what my old one did, that number's going to keep getting bigger. Throw in the debts I acquired during the whole fiasco and the whole thing gets really miserable. Let's just suffice it to say that marrying her wound up costing me an easy half million* and several years of some of the most gut-wrenching stress you can imagine.

But did she ever leave a bruise? No. Did I fear that she would take my life? No. So in my experience, people with BPD absolutely do not abuse others, for certain very, very, very strict definitions of abuse.

*And I'm not rich. I'm not going from $1 million in the back to only $500,000. I'm starting at "could have had $300k worth of home and savings by now, instead I'll be in debt forever.
posted by cute little Billy Henderson, age 4 at 12:45 PM on January 26, 2015 [21 favorites]


It also adds the claim that it's hard to find a therapist trained in DBT. Is that accurate?

Yes. BPD (yup, doesn't affect only women, though I've noticed that in the DBT clinic where I receive treatment I have yet to meet another person who presents as male, and I only know one other person with BPD who is a guy) can be highly treatment-resistant. Medication can ameliorate some symptoms--most notably antidepressants can help break the depression-BPD cycle if you have both disorders--but at the end of the day it's a lot of hard work.

Mindfulness is more or less the basis of the entire treatment, and I won't say it hasn't been helpful, and (DBT is big on saying 'and' and not 'but') it is tiring as all hell. A lot of the treatment means being constantly aware of yourself, your surroundings, your physical and emotional and mental state. It is draining. Imagine walking through your day, having to continually be aware of your emotions, and constantly questioning "Is this a rational response? Is it proportionate? Is it effective? How do I navigate through this situation?" when really all that's happened is someone giving you the side-eye on the bus.

It's really, really hard to convey to people how difficult the treatment is. When you are already prone to feelings of hopelessness and despair, it's so very, very hard to even see the point in engaging with the treatment. Not least because you realize that you have to be hypervigilant for the rest of your life. And that any failure starts pushing you right back into that cycle of self-judgement and shame. And then you try to break through that, but you fail or you partially succeed, so you just feel worse so why fucking bother.

I felt like she was stuck being a teenager. And until you've experienced it you really don't understand. And when it's a teenager, you expect it, but you don't expect it from a person in their 40s.

Yes. Yes that is exactly what it feels like. It is hell. Compounded by having an adult understanding, it's just a maelstrom of fear and anxiety and reckless impulsive behaviour and shame. And the effects drag on and on and on--it's been nearly four years since I lost the love of my life due to irrational fear of abandoment and that drags me down almost every day.

This (linked from the article) rings absolutely true, though I'd never made a link before between sensitivity to internal emotions and sensitivity to detecting emotions in others.

Some researchers, like Judith Herman, believe that BPD is a name given to a particular manifestation of post-traumatic stress disorder

It does seem intuitively obvious that the two disorders (BPD and PTSD) are linked, or at least have overlaps, and it's worth considering that not everyone (I don't have statistics) with BPD has traumatic events in their lives which may have triggered the disorder, even allowing for greater sensitivity leading to less-intense trauma having greater effects than would happen in other people.

Others believe that the term "borderline personality" has been so misunderstood and misused that trying to refine it is pointless and suggest instead simply scrapping the term.

I'm on board with that. Emotional Dysregulation Disorder is, I think, more or less the consensus arrived at within the group of professionals who want to rename it.
posted by feckless fecal fear mongering at 1:07 PM on January 26, 2015 [18 favorites]


...we mostly take it out on ourselves.

In my limited experience, that's true. It's also true that the line between "you" and "me" gets blurred, and "taking it out on myself" doesn't stop at the usual boundaries of the self. Other people get hurt when they take it out on themselves.
posted by clawsoon at 1:08 PM on January 26, 2015 [5 favorites]


Other people get hurt when they take it out on themselves.

A fact which, I promise you, we are acutely aware of.
posted by feckless fecal fear mongering at 1:09 PM on January 26, 2015 [4 favorites]


A fact which, I promise you, we are acutely aware of.

Which leads to more self-recrimination and more self-destructiveness. :-) I don't envy what people with BPD has to deal with, and I appreciate what you've said about how exhausting therapy can be. It reminds me of the constant effort described in The Journal of Best Practises for ameliorating a severe case of Asperger's. (...this case of which, as it happened, also involved dealing with a lot of anxiety.)
posted by clawsoon at 1:24 PM on January 26, 2015


cute little Billy Henderson, age 4:

Thank you for sharing your story.

I just had an experience that likely could have become yours, but it ended much sooner. Luckily the distortion campaign was limited to facebook, and its effectiveness was diminished by her reputation of doing this previously.
posted by idiopath at 1:40 PM on January 26, 2015


my ex, who i believe has BPD, did the same thing to me to a lesser degree

"stop walking on eggshells" is a very good book that opened my eyes to what was really going on - unfortunately, i didn't read it until after the divorce

she has an astonishing ability to manipulate and sweet-talk people - and then flies off the tracks when conflict happens - i went from being the best guy in the world to a loathsome snake

i don't want to say more
posted by pyramid termite at 3:06 PM on January 26, 2015 [4 favorites]


Um, conflating abuse and manipulation with a profoundly distressing disorder by way of "i believe has BPD" is really not doing anything to help those of us who have this problem.
posted by feckless fecal fear mongering at 3:15 PM on January 26, 2015 [4 favorites]


The incredible emotional "mind-reading" that many with BPD have isn't just limited to reading faces, though. I have a friend with BPD and we talk on the phone from time to time - in fact, I haven't seen her in person in over a decade. But her ability to pick up on things I'm thinking or feeling but haven't said in during a phone conversation and state them out loud is spooky (she herself says "witch-like")... it really does seem like mind-reading at times.
posted by Auden at 3:22 PM on January 26, 2015 [1 favorite]


One has to be aware of accidental cold-reading and forer-effecting going on, but I can definitely buy that BPD sufferers have a tendency to stronger-than-baseline emotional reading ability. The downside, of course, being that everyone has false-positives when reading the moods and microexpressions etc of other folks, and when the false positives are REALLY LOUD that can't help but feed right into that "disorder" portion of it.
posted by Drastic at 3:29 PM on January 26, 2015 [1 favorite]


I'm a man who's was diagnosed with BPD once upon a time in my early 20's. By a therapist who said in the next breath "It's basically a garbage can diagnosis". His honesty was actually quite refreshing in hindsight. And as mentioned up-thread, I did grow out of it to a certain extent as I developed better coping and compensating mechanisms.

That said, if you want to get a rough idea of what it's like inside my head when it's bad, read "Notes from Underground" by Dostoyevsky, particularly the first part, and picture it babbled at you rapid fire by someone who seems to be simultaneously desperate for something and trying very hard not to look at you directly. I quite like this animation about the topic.
posted by Grimgrin at 6:10 PM on January 26, 2015 [3 favorites]


The problem with renaming it "emotional dysregulation disorder" is that it kind of co-opts and defines itself by a single symptom that is related to a number of of other psychiatric diagnoses (ADHD, autism spectrum disorders, bipolar disorder, ODD, PTSD).

Not everyone who is dealing with emotional dysregulation has BPD. I have ADHD, depression, and anxiety; additionally I'm an Adult Child of an Alcoholic. My own emotional dysregulation has a huge affect on my life, but over the years a number of psychiatric professionals have told me point blank that I do not have BPD.

I also have no idea what they could call it instead, although I acknowledge that borderline personality disorder is inadequate AND inaccurate. The WHO's ICD-10 suggests "emotionally unstable personality disorder" but that doesn't seem quite right either.
posted by elsietheeel at 7:09 PM on January 26, 2015 [1 favorite]


From the article:
Science doesn't really know what to do with them. They're incredibly difficult to pin down and diagnose, since the symptoms are less "hearing voices" and more "I keep ruining my relationships."
That one hits close to home for me.

My former fiance and I broke our engagement in 2013 because of his treatment-resistant BPD. We were madly in love and I was even planning to leave the US and move to Germany to live with him, but in the end his disorder ruined our relationship (just as it had ruined every relationship he'd had before he met me). He tried every form of treatment available to him, including DBT, and nothing seemed to help. He also suffered severe side effects from all the medications that had been tried. Eventually he gave up trying altogether. To this day he suffers greatly from untreated BPD and struggles with self-harm, and I can do nothing to help him. We are still in touch, but we are no longer close.

This is the first time I've ever talked about it in public. He has a kind heart and he gave me his permission to write and publish our story someday, in the hopes that it might help other suffering people. I think it'll be years before I'm ready to tell that tale in full. But this post is a small first step in that direction.
posted by velvet winter at 8:41 PM on January 26, 2015 [18 favorites]


I wonder if it's a combination of the emotional dysregulation of BPD with other, nastier traits that aren't necessarily part of BPD that makes for the really bad outcomes. Does everyone with BPD occasionally start untruthful slander campaigns against exes or parents? Or is that kind of behaviour limited only to the subset of people with BPD who also happen to be comfortable with lying, and/or the subset of people with BPD who also happen to develop false memories?

I would be interested in knowing the answer to that question.
posted by clawsoon at 5:20 PM on January 27, 2015 [2 favorites]


clawsoon: I am admittedly not an expert, but my best guess is that it is related to the phenomenon of splitting. It clearly isn't something everyone with BPD does. In my own experience it seemed like her options, once it was established that we were in some sort of disagreement, was that I was evil and bad and deserved to be punished, or she was evil and bad and deserved to not exist. I understand that given those two as exclusive options, she would construct a self defensive narrative constructing the former "reality" out of any ingredients she could find in our interaction. And in this twisted logic, she needed to spread it to others in order to validate her own right to be alive, and to ensure I was punished without her taking any direct action that could be construed to make her the bad person.
posted by idiopath at 5:44 PM on January 27, 2015 [3 favorites]


And this same splitting and conviction that bad people need to be punished was, funny enough, the source of this conflict. I could never have needs or concerns that would be addressed, because either she was blameless (thus nothing needed to change and I needed to suck it up and deal with it), or she was wrong (thus she needs to kill herself because she is evil and wrong for hurting me).

So a simple request regarding keeping the kitchen clean would turn into a choose your own adventure: I could "admit" my complaint was groundless (she playfully scolds me for complainging about something that isn't really a problem) or she goes into a spiral of self hatred and despair because she is so bad and wrong and I need to talk her out of self harm or suicide.

Because she left some pots uncleaned after dinner.
posted by idiopath at 5:49 PM on January 27, 2015 [3 favorites]


Does everyone with BPD occasionally start untruthful slander campaigns against exes or parents?

No. The minority, I'd say--and no, I don't have statistics to back that up, so take it as you will.

BPD is often comorbid with other disorders. 60% of the time, if memory serves. Most of that is comorbid with either depression or bipolar. And some people subdivide BPD into various types, which includes a narcissistic type that unless I've misread, can come with manipulative behaviours of that nature. Jury's out, there, I think. From my experience, the majority of people with BPD are more likely to turn such campaigns against ourselves and not against others. YMMV.

I meant to write in my over-long comment before: treatment is difficult both for the client and for the provider, which is a lot of why it's difficult to find someone who's trained in BPD. On top of that, because it's such an easily dismissable illness, funding is low. Schizophrenia, for example, is easy by comparison to get funding for--and it's really not that easy to get funding for. But it's one of those diseases that has such profound effects, and is 'easy' to spot, that it gets more money. I hasten to point out that schizophreniform disorders are horrifically damaging and I begrudge no money that is given to research and treatment, so please don't take it that way.

What I'm saying is, schizophrenia (which I am using only as an example) is something that's pretty easy to point to and say "that is a person who is having serious problems, please help." BPD, as noted in the article, often gets brushed aside as "oh just get over it, you're just being crazypants." Which makes it harder to really address in a systematic way. More women are diagnosed with it, as well, which also brings in the problems of institutional sexism. Which also affects men, because men in general are less socialized to seek help for emotional problems. And all that just reinforces the idea that BPD is just crazy-bunny-boiler-woman-syndrome, which helps exactly nobody.

(I use schizophrenia as an example ONLY because, unless I've misread the stats, the incidence in the general population is pretty similar. It's a terrible and life-altering disease that needs lots more compassion, understanding, and funding.)

So the combination of difficulty and lack of funding leads to not a lot of people trained to help. Also, Linehan only published her treatment regimen (DBT) about twenty five years ago, so there's lag time there.

It's difficult. I find myself returning again and again to the teenager analogy: imagine a life where your rational brain grows up, but your emotional mind stays at about 15 or so. You get this really awful push-pull between this incredibly immature emotional state while at the same time being able to rationally see what you're doing--because that's one of the things maturity brings--and yet those emotions, because they're so powerful, so often stomp on what your rational mind is thinking.

It's tough. And it's so, so cyclical, especially when it comes to how we affect others; we explode because we can't or won't take time to step back and think about what we are doing, and those around us get hit by the emotional shrapnel. The fallout from that--not the least of which is soul-sucking guilt--hits us hard and drives the cycle again. And the whole time, our rational minds are saying "WHAT THE ACTUAL FUCK ARE YOU DOING?"

Or, worse... you have that emotional bone-deep need for love and acceptance, and to any outside observer you are absolutely getting those, but they cocked their eyebrow the wrong way or punctuated a text message this way and now they OBVIOUSLY don't love you and four years later you're sitting here crying bitter tears about how you fucked up the actually best relationship that ever, ever happened in your life. Cue cycle.

In some ways, it's kind of like that old saw about the angel on one shoulder and the devil on the other. Except the devil can reach into your brain and tweak until they get what they want. And, the devil is actually you. It's not some outside force you can blame. It's a terribly, terribly self-reinforcing disorder, and only depression (in my experience at least) is even remotely similar in how it feeds upon itself.
posted by feckless fecal fear mongering at 8:42 PM on January 27, 2015 [13 favorites]


You get this really awful push-pull between this incredibly immature emotional state while at the same time being able to rationally see what you're doing--because that's one of the things maturity brings--and yet those emotions, because they're so powerful, so often stomp on what your rational mind is thinking. . . . we explode because we can't or won't take time to step back and think about what we are doing, and those around us get hit by the emotional shrapnel. The fallout from that--not the least of which is soul-sucking guilt--hits us hard and drives the cycle again. And the whole time, our rational minds are saying "WHAT THE ACTUAL FUCK ARE YOU DOING?"

Quoted for truth.

It's a miserable feeling to know that you're your own worst enemy. That you keep trying and trying to fix things, and you KNOW what you're doing is wrong, but sometimes your immature emotional brain is SO much stronger and, more importantly, FASTER TO REACT than your mature rational brain so you've already had the emotional outburst/meltdown by the time your rational brain catches up and says "Oh hey, a thing happened. Let's ponder that for a moment before we respond."

And then sometimes emotional brain replies, "Huh? Oh that? That was two minutes ago. I'm over it now. Let's play video games!" But maybe that's more emotional dysregulation in ADHD. My ex could never understand how or why I'd be furiously angry one minute and joking the next. Like if you were going to go out of your way to express an emotion then you should commit to it until you discussed it with someone or at least mulled it over in your mind and rationalized it or something.
posted by elsietheeel at 11:51 AM on January 28, 2015 [4 favorites]


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