The Face of BPD - Part 9 of 9

Part 9 of my nine part series of what the diagnostic criteria (symptoms) of BPD look like in my own life.

Criteria 9. transient, stress-related paranoid ideation or severe dissociative symptoms

I have felt completely out of it today. More than just feeling tired, I feel sort of empty and disconnected, unable to focus. So although I don't know how well I'll be able to gather information and write on dissociation, I'm going to try anyway.

I've avoided writing on this last part of BPD because I don't fully understand it, nor do I know that it applies to me. In sitting down and doing some research, however, I think that I do perhaps show some mild symptoms of dissociation and paranoia. For example, while reading the following web site, I came across the following definition:

Dissociation may affect a person subjectively in the form of “made” thoughts, feelings, and actions. These are thoughts or emotions seemingly coming out of nowhere, or finding oneself carrying out an action as if it were controlled by a force other than oneself (Dell, 2001). Typically, a person feels “taken over” by an emotion that does not seem to makes sense at the time. Feeling suddenly, unbearably sad, without an apparent reason, and then having the sadness leave in much the same manner as it came, is an example.Or someone may find himself or herself doing something that they would not normally do but unable to stop themselves, almost as if they are being compelled to do it. This is sometimes described as the experience of being a “passenger” in one’s body, rather than the driver.

How many instances I've recounted where I feel "controlled" by my emotions, and how often do I do things out of the ordinary when my feelings are at the wheel!? And as I think about it, these instances are sparked by stress.

I wonder about my own paranoid thoughts. I've seen the most tragic depths of paranoia - people who so fear the world that it has cost them their lives. Obviously, I am lucky to not struggle with such an issue, but I wonder if my intense and constant self-consciousness, my feeling that someone can see all the silly and stupid things I do, is a form of paranoia in itself.

And I wonder too, how much effect my growing ability to regulate my emotions and deal with stress will have on any dissociative symptoms I have displayed (and I'm sure there have been many, since I strongly suspect that I've had BPD for five years now).

So, as I continue to recover and learn about myself and my condition, I am sure I will learn more about this aspect of it. In the meantime, if anyone out there has stories or information on their own dissociation or paranoia (or that of someone you know), I would love to hear the stories.

full list of BPD criteria here

The Face of BPD - Part 8 of 9

Part 8 of my nine part series of what the diagnostic criteria (symptoms) of BPD look like in my own life.

(I am ready to finish up this series and write more about my day to day life!!!) :-)


Criteria 8. inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

If you look at me or have just gotten to know me, you would never peg me as someone with an anger issue. My outward personality tends to be happy-go-lucky and I am a bit on the shy and quiet side. I love working with children, Victorian decorating, and playing in the snow. I seem to be the polar opposite of what an angry person would be like.

But the right combination of factors can set me off. When you put together situations that I am especially sensitive to (like cheating in relationships or lying to a friend), a recent line of stressors, and physical difficulties (being tired or having PMS), the mixture can be brutal.

These are the times when I don't have anger issues, anger issues have me. I'm completely controlled by my emotions, and even hurt, betrayal, sadness or loss can manifest itself as my default emotion, anger. In fact, my anger is so prevalent that I can wake up in the morning and with no outside reminder or trigger, remember something that happened months or years ago that made me angry, and I'll be seething all day long.

My anger is exactly who the DSM describe it for borderlines. The intensity can be unreal - at times its feels like my entire body is being electrocuted and I can't stop shaking. My mind thinks of nothing but how angry I am, and what I need to do to stop this terrible feeling. But all too often, the anger really is inappropriate. The wrong that's been done to me might not even be real, it may just be something I've assumed someone had done. Or it might be a small mistake or issue that my mind has blown completely out of proportion. The amount of anger I had is disproportionately larger than whatever has happened. But at these times, I lose it, and as I result I lash out - either at myself or another person, if they are involved. Either way, the end result is the same: me and possibly someone else get hurt. I either have an argument with someone (in which I say the most uncharacteristic things) which hurts my relationship with the person and might even hurt the person themselves. Either that, or I end up withdrawing from others and doing something that will hurt myself (such as self-injury).

Its been about 4 months since I've had a big, blown-out anger attack, yet I've had so many throughout my life, and they've shaped who I am today. As I work my way through DBT and learn how to regulate my emotions and tolerate stress, I know that the little skills that are helping me to deal with little moments of stress, irritation, or sadness will be ingrained in me when another big issue strikes me again. But the next time, for the first time, I will be ready.

full list of BPD criteria here

The Face of BPD - Part 7 of 9

Part 7 of my nine part series of what the diagnostic criteria (symptoms) of BPD look like in my own life.

(got very frustrated the last time I wrote this...my computer locked up and lost the entire entry and I started to struggle with overwhelming anger...but I calmed myself, got through it, and now will try again...)

Criteria 7. chronic feelings of emptiness

Probably the most self-explanatory of all of my symptoms, but, luckily, one that doesn't bother me all that much.

However, I do struggle with it. SO many times in my life, especially when things are bad or I'm going through a depressive episode, I wonder: what's the point? Why bother loving someone if you are just going to lose them, if they are just going to hurt or leave you? Why bother chasing dreams if you just feel unfulfilled all the time anyway (and so often I feel unfulfilled)? Why bother living when it doesn't feel worth it.

Because I can be so up and down, the emptiness creeps in mostly during the down times, but it can spill into the good times too. I try so hard to fight it when it comes around, remembering what the good times were like - those times when life was worth it. But its hard. Sometimes the memories of a worthwhile life just don't feel like they are enough to sustain me. Sometimes all I can do is accept that I feel lost and empty inside, and hope and pray that someday it will pass (so far, it always has). But then again, I have never thought that happiness is something that should be forced on those who struggle with depression. Sometimes, its enough just to press on...then to press on again....until the sun shines and happiness finds us again.

The Face of BPD - Part 6 of 9

Part 6 of my nine part series of what the diagnostic criteria (symptoms) of BPD look like in my own life.

Criteria 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).

This one is pretty self-explanatory, but to put it in simpler terms, I would basically call it intense bad emotional states that come on suddenly (often with little or no outside provocation) and go away just as quickly.

My periods of depression were just as described in this definition: I'd be doing great and all of a sudden slip deeply into terribly intense sadness. Sometimes there was a clearly obvious trigger: one time, when learning of the wedding of a guy I used to date, I went very suddenly into a spell of depression that lasted an entire summer. In that episode, I became despondent, detached, lost interest in things I loved, and had such as hard time functioning that I ignored several important life decisions that made a serious impact on my future. Often times, however, there were no obvious causes. Perhaps a series of tiny setbacks sparked my fall, but I will never know for sure.

The really bad depression came in episodes that lasted for several months, but an equally detrimental and just as common, symptom of my BPD was the intense rushes of depression on anxiety that came on suddenly, lasted a few hours, then went away. I could wake up feeling on top of the world and in love with life, then one small – even unimportant – setback could spark me into feeling so depressed I felt suicidal.

“Reactivity of mood” is one of the aspects I am learning to deal with, and having some small successes. In working with my therapist as well as my DBT workbook, I am learning how to be more mindful and aware of what I am thinking. I’ve found that, as a daydreamer, my mind often wanders onto thoughts that make me feel bad – such something a person said or did that hurt me, or frustrating situations in my career life. When I think about those things, I have an emotional reaction. An my emotions, like that of most borderlines, can race out of control in a matter of seconds.

I shared an example of this with my therapist today, recounting a situation in which I was thinking about having to cancel plans with a friend and ended up feeling angry and frustrated with her because I felt that she didn’t understand or care about me. But one of the beauties of DBT is learning two key skills: distress tolerance and emotional regulation. I’m not there yet, but knowing some of these skills helped keep me from lashing out at my friend or feeling much worse than I did.

So, like many with BPD, I have found hope. I know that recovery is possible. I am the proof.

full list of BPD criteria here

The Face of BPD - Part 5 of 9

Part 5 of my nine part series of what the diagnostic criteria (symptoms) of BPD look like in my own life.

WARNING: THE FOLLOWING POST MAY BE TRIGGERING TO PEOPLE WHO SELF INJURE. PLEASE DO NOT READ UNLESS YOU ARE IN A SAFE PLACE AND HAVE A METHOD TO COPE WITH S.I. URGES (SEE THE LINKS ON THE RIGHT FOR MORE INFORMATION)

Criterion #5: recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

I often question whether I am or have ever been suicidal because I have never made an actual suicide attempt. But I have felt that I wanted to cease living. When I was twelve I told someone I would kill myself, but I wasn't actually planning any way to do it. I've had the urge to crash my car into a tree while driving as well the strong desire to cut my wrists and watch them bleed, but I have never even started doing either of those things. I've checked myself into the emergency room several times saying I wanted to kill myself, but in retrospect I really only wanted to die and wasn't actually planning a method of suicide. I've wished I was never born, and I've prayed to God to take my life because I couldn't do it myself. Are all these things considered suicidal? I'm not sure...

But I have been a self-injurer for a while now. It started about five years ago, in the middle of an intense depression brought on by the end of a chaotic relationship. I had heard of cutting and self-injury, had known a few people who had done it. Randomly, in the middle of some of the most intense emotional pain I had ever felt, I self-injured for the first time. Crying on my bathroom floor, I lit a match, let it burn for a moment, then blew it out and stuck it into my upper arm. The release I felt and the rush of endorephins was compelely new to me. I injured a few more times, leaving severel small burns on my upper arms and thighs, then covered them with neosporin and band-aids to prevent scars. Although this may seem small in comparison with some self-injury stories, it was my entry into the world of S.I.

I suppose there were other signs in my life as well. Some have said that biting your cuticles or picking at scabs is a form of self injury. Throughout my life I have done both. A close observer could tell when I am really stressed by examining my hands: I will pick and chew at the edges of my thumbs until they are raw and bleeding. I have a hard time not touching or playing with pimples or small cuts and often develop tiny scars from this. And I've had several phases in my life where I pull the skin off the bottom of my feel (often using nail clippers or blades) until my soles are raw, sore and often bleeding.

Most recently I have dealt with my urges to self-injury by using replacement activities or distraction/relaxation techniques to help me avoid hurting myself. The book I am working on, The Dialectical Behavior Therapy Skills Workbook, as many great ideas for this. You can also find some here.

full list of BPD criteria here

The Face of BPD (part 4 of 9)

Part 4 of my nine part series of what the diagnostic criteria (symptoms) of BPD look like in my own life.

Criterion #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 covered in Criterion 5.

This criterion/symptom to me was easy to confuse with bi-polar disorder. In fact, when I first contacted the mental health center for an assessment, I told them I thought I might be bi-polar, even though in the back of my mind I knew it was in fact probably BPD. I felt validated the first day I visited my therapist and she said that's what it was.

Anyway, this is short and sweet: my impulsive areas are binge eating, substance abuse, and occasionally, spending.

Binge eating has been a problem for me because I am an emotional eater. When my feelings take control and I can't feel better, I eat to numb the pain, and the more food I can enjoy the better I feel. My favorite food to soothe myself with is fast food. I think it is because I don't have to do any work to prepare it and driving in my car while listening to music to go get it is also soothing to me. I think the biggest emotional meal I ever ate was a super size double cheeseburger meal with two apple pies from McDonald's. In my memory, I think I may have continued to eat food from the refrigerator after finishing this meal. Needless to say, in the past five years or so (coincidentally the same amount of time I can recognized symptoms of BPD) I have gained a significant amount of weight from binge eating.

One of my new year's resolutions this year (before I knew about the BPD) was to try to control my emotional eating. I have had some success with it. I have often tried to replace eating with other activities such as exercising or reading. However, I am not totally in the clear. I still binge eat occasionally when things are really bad, and its harder to avoid when I actually am hungry. But by admitting it is a problem and watching out for it, I have cut down on the times I binge and have even lost 17 pounds this year - another new year's resolution met!

Another area of impusivity is substance abuse. When I tell my therapist and others that is not really a problem or addition I feel they think I'm a typical user denying the problem, but I'm telling the truth. I'm not addicted and I don't have a problem with drugs or alcohol. In fact, as of today, its been over a month since I've even had a drop to drink. The only time I've ever used anything is in those really really bad episodes where I just can't deal with the pain. In those times, it seems that the only option is to either self-medicate or to self-injure. I chose the former since it seems (for me since I don't have an addiction) to be the safest. And in those moments the usage is pretty tame: I have a few drinks until I'm just tipsy enough to fall asleep without thinking of my pain or my problems, or I take one leftover prescription painkiller to knock me out. Though its never gotten to the point of me being an alcoholic or taking anything illegal, I know the impuslivity of it is the problem, the link to BPD.

Occasionally I do go on a spending spree, but this is very rare for me. The most recent example was this summer, when I all of a sudden took the notion that I had to have a new MP3 player. I had thought about getting a new one for a while, and planned to do some research on which would be the best choice for me and my budget. But one day, when I had first started to fall into an episode, I suddenly decided I needed one now and drove 1/2 hour to the store and bought one after 5 minutes of decision. Impulsive, yes...though not bad enough for me to worry too much about my impulsive spending.

It is my hope that, now that I am learning distress tolerance and emotional regulation through DBT therapy, that I will learn to turn to these new skills rather than to eat, drink, or spend to make myself feel better.

full list of BPD criteria here

The Face of BPD (part 3 of 9)

Part 3 of my nine part series of what the diagnostic criteria (symptoms) of BPD look like in my own life.

Criteria #3:Identity disturbance: markedly and persistently unstable self-image or sense of self.


I think many people learning about BPD might have a hard time understanding exactly what it means to have identity distrubance or an unstable self-image. I can give you lists of definitions or my own interpretation, but the best evidence I have is what it looks like in my own case. This involves my own personal sense of self, my life choices

My sense of who I am often changes. Like my moods, my feelings about who I am range from being a good person to a bad influence, from a happy over-achiever to a worthless loser. I might view myself in terms of being a family-oriented individual, then soon my focus shifts on how I want to succeed in my chosen career. My interests change as well, and I go through phases of what I enjoy doing the most. For several months I might be addicted to jogging; the next, knitting. It is hard for me to fill out "about me" surveys because who I think I am changes so often.

A large part of who we are deals with what we do with our life. My own life goals and career choices change so often, and have changed so often over the course of my life, that I am left feeling lost, floating on a sea of possibliities. In college I changed my major, quit, took a variety of exploratory courses, reenrolled in college, and changed my major again. Since graduation I have worked at a new job at least every year (sometimes several at a time). My career goals over the years of my adult life have included doctor, journalist, public relations, advertising, publishing or editing, teacher, nurse, pharmasist, legal aide, and social worker. Even today I am between jobs and looking to make a career change, yet every time I think I am sure I want to do one thing, I end up interested in another and change my direction altogether.

Very often, I feel like the character of Esther in Sylvia Plath's The Bell Jar:

I saw my life branching out before me like the green fig tree in the story. From the tip of every branch, like a fat purple fig, a wonderful future beckoned and winked. One fig was a husband and a happy home and children, and another fig was a famous poet and another fig was a brilliant professor, and another fig was Ee Gee, the amazing editor, and another fig was Europe and Africa and South America, and another fig was Constantin and Socrates and Attila and a pack of other lovers with queer names and offbeat professions, and another fig was an Olympic lady crew champion, and beyond and above these figs were many more figs I couldn't quite make out. I saw myself sitting in the crotch of this fig tree, starving to death, just because I couldn't make up my mind which of the figs I would choose. I wanted each and every one of them, but choosing one meant losing all the rest, and, as I sat there, unable to decide, the figs began to wrinkle and go black, and, one by one, they plopped to the ground at my feet.

Long before I was diagnosed with BPD, I noticed another peculiar aspect of the condition. The way I acted and felt about myself often changed depending on who I was around. If I around a person who I felt comfortable with, I am self-confident, laid back and fun. If I'm sure if the person likes me or think they might be judging me, I am extremely nervous, anxious and feel like I'm worthless. Around outgoing people I tend to be vibrant and extroverted; around reserved individuals I become reserved myself.

As my sense of identity continues to shift, I am hoping that I can discover more about myself through therapy and eventually come to a more stable idea of who I am.

full list of BPD criteria here

The Face of BPD (part 2 of 9)

Part 2 of my nine part series of what the diagnostic criteria (symptoms) of BPD look like in my own life.

Diagnostic Criteria #2: a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

This one of the most recognizable aspects of BPD. It involves others who in turn notice the problem, and it is also such a chaotic and detremental part of one's life that it is hard to overlook.

In my own exploration and eventual diagnosis, the symptoms of chaotic relationship and "splitting" were impossible to miss. I could write on specific situations for hours, but will limit this post to a few key examples. Most of the following deal with romantic relationships, because I tend to have more unstable interactions with men than with other women, whether it be a boyfriend or just a guy friend (I will touch on this later in this post)

One of the first problems I noticed is a tendency to get attached to a person very quickly and be unable to detach from them. Many people with BPD report that they fall in love easily and quickly. This is true for me. I am extremely picky when it comes to dating, but when I do find myself having even a slight attraction to somebody, it spirals quickly into love and slight obsession. I used to see this at just being a romantic and believing in "love at first sight" but I know now that it is a part of my BPD.

Similarly, once I became emotionally attached to a person it is very hard to let them go by either ending the relationship or ceasing to be friends. Because I become attached so very quickly to the person I have overlooked vital flaws or intense differences in our personalities or values, which means I often care very deeply for a person with whom I am incompatible. The relationship is doomed from the beginning, though I fail to see it because I am so lovestruck. Intense disappointment and passionate fighting almost always follow, and the breakup or movement away from the person entitles a very intense grieving process. Hurt, sadness, anger, disappointment, and lack of confidence violently combine when a relationship ends for me, leading to intense periods of depression.

Unfortunately, chaos is a theme in every one of my past romantic relationships. Dramas run the gamut from intense jealously over a the other person's activities to making demands that were impossible to meet. I've often questioned whether I subconsciously create some of the dramas to keep the relationship interesting or make it feel more alive, and I think this is sometimes the case for me. However, I know that most of the turmoil in the relationship comes from the aspect of splitting.

Splitting was a complicated concept for me to understand at first, but most simply defined it is a very quick and often frequent cycle of love (idealization) and hate (devaluation) in a relationship. I see it clearly in my past relationships. For example, I once met and fell very much in love (quickly) with a guy I had met at bible study I was attending. We shared a similar faith and as I grew to like him, I placed him high on a pedestal based on the comments he had made about his beliefs and values. To me, he was good, one of the nicest men I had ever met with no serious flaws. However, once we began dating I saw that, outside of a "religious" setting, he was a very different person. It did not take long for me to drag him off the pedestal and into the realm of my hatred. In my mind, he was an evil person and I began fighting with him based on the issues I took with him. Eventually, we would work out the issues or I would see another part of him that shifted him back into my good graces. That cycle continued many times over the course of both our dating relationship and our friendship, until eventually the whole thing ended with a large fight and I spiraled into a depressive episode that took a lot of effort to overcome.

The psychological basis of splitting involves several theories I don't fully understand, and as I work through the process in therapy I hope to learn why I have developed the tendency to think in the black and white terms of splitting. I have also been exploring the reasons that almost ever example of splitting in my life involves men and not women. Some possible reasons I see for this might involve growing up in an all-female household, damage from seeing and experiencing sexual harassment during my teen years, or a very unhealthy love relationship early in my dating life.

However, regardless of the reasons, being aware that I "split" and knowing the signs of it will be helpful to me. In the future, I can recognize that I fall in love too easily and use my developing skills to control my thoughts and emotions to develop healthier relationships. I can distinguish flaws or personality aspects that I can live with in a relationship to those that make me incompatible with a guy. I can also now recognize the precursors for splitting and try to avoid the quick changeover from love to hate or from good to evil.

full list of BPD criteria here

The Face of BPD (part 1 of 9)

Today I am starting this nine part series of what the diagnostic criteria (symptoms) of BPD look like in my own life. When I was first learning about BPD, simply reading the criteria didn't really give me a glimpse of what it was like living with the symptoms of BPD disorder on a daily basis, so I am hoping my description can help others describe their symptoms to their mental health provider.

Criterion 1: frantic efforts to avoid real or imagined abandonment. (does not include suicidal or self-injuring behavior covered in Criterion 5) full list of criteria here

Although this is the first on the DSM-IV's list of criteria (what I think of as symptoms) of BPD, it was definitely not one that I recognized right away. But as I dig deeper, I am seeing this to be one of the more subtle aspects of my condition, one I've dealt with overcoming before.

As a child, I suffered with separation anxieties. Leaving my home, my family, and especially my mother were extremely difficult. Even as an older child, going to school was often traumatic. Sleepovers often ended with me walking home from the friend's house in the middle of the night or my parents being called to come and get me. I suffered through the first several days of the week-long summer camp I went to every year (to the point of being physically sick and visiting the camp nurse). Even vacations with my entire family resulted in intense periods of homesickness that would leave me sick to my stomach. Even today, in my 30s, moving to a new place or starting a new job can be extremely traumatic for me.

As an adult, I can see these episodes as the beginning of abandonment issues. I'm not quite sure where they've come from, though I've spent time in the past working of some of the aspects of the attachment issues I've had with my parents. I know I still have work to do there, and perhaps one day I will figure it all out.

I think, too, that part of my often chaotic relationships are tied up in abandonment issues. In the last chaotic friendship that really effected my life, I had to have the last word. I had to be the one that said the final straw that ended the friendship. I couldn't just let go, couldn't walk away, though I knew deep down that the relationship was doomed and I was even better off without it. I wasn't seeing this person on a daily basis, so I could have just let go and ended it there. Instead, I chose to push my friendship unto to this person - and then I dug and dug until I had enough dirt on the way they were hurting others that I could finally have it out with them, tell them off, and FORCE THEM to walk away from me. In this way, I think I felt that I wasn't abandoned. It was me frantically taking control of the situation to avoid abandonment.

full list of BPD criteria here