Fida Abbott: AUTHOR: Facing Someone with Borderline Personality Disorders?

Since my husband told me about these three words: Borderline Personality Disorders for someone that I'm facing right now, I have been interested to do the research about this kind of personality disorders which is I have thought about this signal since I was aware something not right with that person. I ever found a very good information article from daily local newspaper when I lived in Secane. It explained exactly 90% right about description of the person I pointed. it was a pity, I didn't collect its article and I forgot either about its title but the subject--emotional personalty disorder--was about similar with the three words my husband mentioned.

Below is the list of the result I found that I thought it contains information about the person I'm facing right now. I just copied and pasted them here with their resources links to make me easier when one day I need them to determine her personality deeply. They don't represent all her personalities but one or several information they have written just not far to describe about her personality.

From this experience that I have been facing more than 30 years, as an author I would like to include this case to my third next project: writing a novel with a character with Borderline Personality Disorder. This will be the most challenging writing project I would ever have and I'm very excited. I like CHALLENGE in my writing project. From this way, I can see the level of my writing ability to narrate, describe and explore such a challenging character in a novel. Can't wait? Just stay tuned for my upcoming novels.

For this purposed project, I should enrich my knowledge by also watching some movies mentioned in the bottom of my last search.

THE LIST OF MY SEARCHING RESULTS:

A child exhibiting one or more of the following characteristics to a marked degree for a long duration of time that adversely affects their education:^[1]^[2]

Difficulty to learn that cannot be explained by intellectual, sensory, or health factors.
Difficulty to build or maintain satisfactory interpersonal relationships with peers and teachers.
Inappropriate types of behavior (acting out against self or others) or feelings (express's the need to harm self or others, low self-worth, etc.) under normal circumstances.
A general pervasive mood of unhappiness or depression.
A tendency to develop physical symptoms or fears associated with personal or school problems.

http://www.ask.com/wiki/Emotional_and_behavioral_disorders?o=2800&qsrc=999 emotional disorder - any mental disorder not caused by detectable organic abnormalities of the brain and in which a major disturbance of emotions is predominant

affective disorder, emotional disturbance, major affective disorder

folie, mental disorder, mental disturbance, psychological disorder, disturbance - (psychiatry) a psychological disorder of thought or emotion; a more neutral term than mental illness

clinical depression, depressive disorder, depression - a state of depression and anhedonia so severe as to require clinical intervention

manic disorder, mania - a mood disorder; an affective disorder in which the victim tends to respond excessively and sometimes violently

bipolar disorder, manic depression, manic depressive illness, manic-depressive psychosis - a mental disorder characterized by episodes of mania and depression

http://www.thefreedictionary.com/emotional+disorder Transactional associations among maternal and paternal depressive symptoms and child problem behaviors and emotions were identified during the transition from toddlerhood to school age and during adolescence. Finally, gender differences were evident in the transactional associations between parental and child psychological symptoms.

Kostas A. Fanti,
Georgia Panayiotou,
and Savvas Fanti

Associating Parental to Child Psychological Symptoms: Investigating a Transactional Model of Development

Journal of Emotional and Behavioral Disorders September 2013 21: 193-210, first published on April 3, 2012 doi:10.1177/1063426611432171

Signs and symptoms

The most distinguishing symptoms of BPD are being highly sensitive to rejection and spending a lot of time thinking about and feeling afraid of possible abandonment.^[10] Overall, the features of BPD include unusually intense sensitivity in relationships with others, difficulty regulating emotions, and impulsivity. Other symptoms can include feeling unsure of one's personal identity and values, having paranoid thoughts when feeling stressed, and severe dissociation.^[10]

Emotions

While people with BPD also feel joy intensely, they are especially prone to dysphoria, or feelings of mental and emotional distress. Zanarini et al. recognize four categories of dysphoria that are typical of this condition: extreme emotions; destructiveness or self-destructiveness; feeling fragmented or lacking identity; and feelings of victimization.^[17] Within these categories, a BPD diagnosis is strongly associated with a combination of three specific states: 1) feeling betrayed, 2) "feeling like hurting myself", and 3) feeling completely out of control.^[17] Since there is great variety in the types of dysphoria experienced by people with BPD, the amplitude of the distress is a helpful indicator of borderline personality disorder.^[17]

In addition to intense emotions, people with BPD experience emotional lability, or changeability. Although the term suggests rapid changes between depression and elation, the mood swings in people with this condition actually occur more frequently between anger and anxiety, and between depression and anxiety.^[18]

Behavior

People with BPD act impulsively because it gives them immediate relief from their emotional pain.^[21] However, in the long term, people with BPD suffer increased pain from the shame and guilt that follow such actions.^[21] They can also suffer long-term consequences of hospitalization, incarceration, homelessness, and poverty.^[21] A cycle often begins in which people with BPD feel emotional pain, engage in impulsive behaviors to relieve that pain, feel shame and guilt over their actions, feel emotional pain from the shame and guilt, and then experience stronger urges to engage in impulsive behaviors to relieve the new pain.^[21] As time goes on, impulsive behaviors can become an automatic response to emotional pain.^[21]

Interpersonal relationships

People with BPD can be very sensitive to the way others treat them, feeling intense joy and gratitude at perceived expressions of kindness, and intense sadness or anger at perceived criticism or hurtfulness.^[27] Their feelings about others often shift from positive to negative after a disappointment, a perceived threat of losing someone, or a perceived loss of esteem in the eyes of someone they value. This phenomenon, sometimes called splitting or black-and-white thinking, includes a shift from idealizing others (feeling great admiration and love) to devaluing them (feeling great anger or dislike).^[28] Combined with mood disturbances, idealization and devaluation can undermine relationships with family, friends, and co-workers.^[29] Self-image can also change rapidly from very positive to very negative.

Sense of self

People with BPD have trouble seeing a clear picture of their identity. In particular, they have a hard time knowing what they value and enjoy.^[35]They are unsure about their long-term goals for relationships and jobs. This difficulty with knowing who they are and what they value can cause people with BPD to feel that they are empty and lost.^[35]

Cognitions

The intense emotions of people with BPD can make it difficult for them to control the focus of their attention. In other words, it can be difficult for them to concentrate.^[35] In addition, people with BPD might dissociate, which can be thought of as an intense form of "zoning out".^[36]Dissociation often takes place in response to a painful event, or to a "trigger" that causes someone to recall a painful event, and consists of directing partial or full attention away from that event.^[36] Although blocking out painful emotions provides relief from them, it inhibits the natural experience of emotions, and decreases the ability of people with BPD to function in their daily lives.^[36] Sometimes it is possible to tell when someone with BPD is dissociating, because their facial or vocal expressions might become flat or expressionless, or they may appear to be very distracted; at other times, dissociation might be barely noticeable.^[36]

Diagnosis

Diagnosis of borderline personality disorder is based on a clinical assessment by a qualified mental health professional. The assessment can include a physical exam, laboratory tests to check for thyroid conditions and levels of substance use, and a psychological evaluation. The psychological evaluation includes asking the client about the beginning and severity of symptoms, as well as other information about how symptoms impact the client's quality of life. Issues of particular note are suicidal ideations, experiences with self-harm, and thoughts about harming others.^[37] Diagnosis is based both on the client's report of his or her symptoms and on the clinician's own observations.^[37]

Millon's subtypes

Theodore Millon has proposed four subtypes of BPD. He suggests that an individual diagnosed with BPD may exhibit none, one, or more of the following:^[43]

Subtype	Features
Discouraged (including avoidantfeatures)	Pliant, submissive, loyal, humble; feels vulnerable and in constant jeopardy; feels hopeless, depressed, helpless, and powerless.
Petulant (including negativisticfeatures)	Negativistic, impatient, restless, as well as stubborn defiant, sullen, pessimistic, and resentful; easily slighted and quickly disillusioned.
Impulsive (including histrionic orantisocial features)	Capricious, superficial, flighty, distractible, frenetic, and seductive; fearing loss, becomes agitated, and gloomy and irritable; potentially suicidal.
Self-destructive (including depressiveor masochistic features)	Inward-turning, intropunitively angry; conforming, deferential, and ingratiating behaviors have deteriorated; increasingly high-strung and moody; possible suicide.

Family members

Parents of adults with BPD are often both over-involved and under-involved in family interactions.^[46] In romantic relationships, BPD is linked to increased levels of chronic stress and conflict, decreased satisfaction of romantic partners, abuse, and unwanted pregnancy. However, these links may apply to personality disorders in general.^[31]

Adolescence

Onset of symptoms typically occurs during adolescence or young adulthood, although symptoms suggestive of this disorder can sometimes be observed in children.^[47] Symptoms among adolescents that predict the development of BPD in adulthood include problems with body-image, extreme sensitivity to rejection, behavioral problems, non-suicidal self-injury, attempts to find exclusive relationships, and severe shame.^[10] Many adolescents experience these symptoms without going on to develop BPD, but those who experience them are 9 times as likely as their peers to develop BPD. They are also more likely to develop other forms of long-term social disabilities.^[10] A BPD diagnosis in adolescence might predict that the disorder will continue into adulthood.^[2]^[48] Among adolescents who warrant a BPD diagnosis, there appears to be one group in which the disorder remains stable over time, and another group in which the individuals move in and out of the diagnosis.^[49] Earlier diagnoses may be helpful in creating a more effective treatment plan for the adolescent.^[2]^[48] Family therapy may be an essential component of treatment for adolescents with BPD.^[50]

Mood disorders

Borderline personality disorder and mood disorders, such as major depressive disorder and bipolar disorders, are often comorbid.^[29] Some characteristics of BPD are similar to those of mood disorders, which can complicate the diagnosis.^[56]^[57]^[58] It is especially common for people to be misdiagnosed with bipolar disorder when they have borderline personality disorder, or vice versa.^[59] For someone with bipolar disorder, behavior suggestive of BPD might appear while the client is experiencing an episode of major depression or mania, only to disappear once the client's mood has stabilized.^[60] For this reason, it is ideal to wait until the client's mood has stabilized before attempting to make a diagnosis.^[60]

First, the mood swings of BPD and bipolar disorder have different durations. In some people with bipolar disorder, episodes of depression or mania last for at least two weeks at a time, which is much longer than moods last in people with BPD.^[59] Even among those who experience bipolar disorder with more rapid mood shifts, their moods usually last for days, while the moods of people with BPD can change in minutes or hours.^[62] So while euphoria and impulsivity in someone with BPD might resemble a manic episode, the experience would be too brief for a manic episode.^[60]^[62]

Second, the moods of bipolar disorder do not respond to changes in the environment, while the moods of BPD do respond to changes in the environment.^[60] That is, a positive event could not lift the depressed mood caused by bipolar disorder, but a positive event could potentially lift the depressed mood of someone with BPD. Similarly, a negative event could not dampen the euphoria caused by bipolar disorder, but a negative event could dampen the euphoria of someone with borderline personality disorder.^[60]

Third, people with BPD usually experience euphoria without the racing thoughts and decreased need for sleep that are typical of hypomania.^[60]Bipolar disorders generally involve high levels of sleep and appetite disturbance, but severe sleep disturbance is rarely seen among the symptoms of BPD.^[60]

Lying as a feature of BPD

Some theorists argue that patients with BPD often lie.^[137] However, others write that they have rarely seen lying among patients with BPD in clinical practice.^[137] Regardless, lying is not one of the diagnostic criteria for BPD.

The mistaken belief that lying is a distinguishing characteristic of BPD can impact the quality of care that people with this diagnosis receive in the legal and healthcare systems. For instance, Jean Goodwin relates an anecdote of a patient with multiple personality disorder, now calleddissociative identity disorder, who suffered from pelvic pain due to traumatic events in her childhood.^[138] Due to their disbelief in her accounts of these events, physicians diagnosed her with borderline personality disorder, reflecting a belief that lying is a key feature of BPD. Based upon her BPD diagnosis, the physicians then disregarded the patient's assertion that she was allergic to adhesive tape. The patient was in fact allergic to adhesive tape, which later caused complications in the surgery to relieve her pelvic pain.^[138]

Gender

Feminists question why women are three times more likely to be diagnosed with BPD than men, while other stigmatizing diagnoses, such asantisocial personality disorder, are diagnosed three times as often in men.^[139]^[140]^[141]

One explanation is that some of the diagnostic criteria of BPD uphold stereotypes about women. For example, the criteria of "a pattern of unstable personal relationships, unstable self-image, and instability of mood," can all be linked to the stereotype that women are "neither decisive nor constant".^[142] Women may be more likely to receive a personality disorder diagnosis if they reject the traditional female role by being assertive, successful, or sexually active.^[20] If a woman presents with psychiatric symptoms but does not conform to a traditional, passive sick role, she may be labelled as a "difficult" patient and given a BPD diagnosis.^[20]

Manipulative behavior

Manipulative behavior to obtain nurturance is considered by the DSM-IV-TR and many mental health professionals to be a defining characteristic of borderline personality disorder.^[145] However, Marsha Linehan notes that doing so relies upon the assumption that people with BPD who communicate intense pain, or who engage in self-harm and suicidal behavior, do so with the intention of influencing the behavior of others.^[146] The impact of such behavior on others – often an intense emotional reaction in concerned friends, family members, and therapists – is thus assumed to have been the person's intention.^[146]

Stigma

The features of BPD include emotional instability, intense unstable interpersonal relationships, a need for intimacy, and a fear of rejection. As a result, people with BPD often evoke intense emotions in those around them. Pejorative terms to describe people with BPD, such as "difficult," "treatment resistant," "manipulative," "demanding" and "attention seeking," are often used, and may become a self-fulfilling prophecy as the negative treatment of these individuals triggers further self-destructive behavior.^[149]

Physical violence

The stigma surrounding borderline personality disorder includes the belief that people with BPD are prone to violence toward others.^[150] While movies and visual media often sensationalize people with BPD by portraying them as violent, the majority of researchers agree that people with BPD are unlikely to physically harm others.^[150] Although people with BPD often struggle with experiences of intense anger, a defining characteristic of BPD is that they direct it inward toward themselves.^[151] One of the key differences between BPD and antisocial personality disorder (ASPD) is that people with BPD tend to internalize anger by hurting themselves, while people with ASPD tend to externalize it by hurting others.^[151] In addition, adults with BPD have often experienced abuse in childhood, so many people with BPD adopt a "no-tolerance" policy toward expressions of anger of any kind.^[151] Their extreme aversion to violence can cause many people with BPD to overcompensate and experience difficulties being assertive and expressing their needs.^[151] This is one way in which people with BPD choose to harm themselves over potentially causing harm to others.^[151] Another way in which people with BPD avoid expressing their anger through violence is by causing physical damage to themselves, such as engaging in non-suicidal self injury.^[16]^[150]

Society and culture

Film and television

There are several films portraying characters either explicitly diagnosed or with traits suggestive of BPD. The films Play Misty for Me^[162] andFatal Attraction are two examples,^[163] as is the movie Girl, Interrupted, based on the memoir by Susanna Kaysen, with Winona Ryder playing Kaysen. Each of these films suggests the emotional instability of the disorder; however, the first two cases show a person more aggressive to others than to herself, which is less typical of the disorder.^[164] The 1992 film Single White Female suggests different aspects of the disorder: the character Hedy suffers from a markedly disturbed sense of identity and, as with the first two films, abandonment leads to drastic measures.^[165]

Psychiatrists Eric Bui and Rachel Rodgers argue that the character of Anakin Skywalker/Darth Vader in the Star Wars films meets six of the nine diagnostic criteria; Bui also found Anakin a useful example to explain BPD to medical students. In particular, Bui points to the character's abandonment issues, uncertainty over his identity, and dissociative episodes.^[166] Other films attempting to depict characters with the disorder include The Crush, Mad Love, Malicious, Interiors, Notes On a Scandal, The Cable Guy, Mr. Nobody and Cracks.^[163]

Unfortunately, dramatic portrayals of people with BPD in movies and other forms of visual media contribute to the stigma surrounding borderline personality disorder, especially the myth that people with BPD are violent toward others.^[150] The majority of researchers agree that in reality, people with BPD are very unlikely to harm others.^[150] See The myth of violence under Stigma.

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