Hey thanks for sharing!!! Did you find nofap helping? Other coping skills you found helping? Im just new diagnosed and try to find my way around. Thx
CAT didn't help much, apart from establishing categorically that my father was the cause of my mental health issues. MBT was very practical, although very challenging. It is one of the few psycho dynamic therapies that was designed specifically for treating sufferers of BPD. Maybe doing NoFap helps a bit, but I am not sure how. I am disabled and too ill to work. Yes, I live alone.
You need to have 5 out of 9 of the criteria to be diagnosed with Borderline Personality Disorder (BPD).
I know dude, I was in hospital @ the beginning of this year. My ambulant psychologist said, that I have bpd-behaviour in girlfriend relationship. I have long-term friendships, but after I have so extreme heavy loss fears in girlfriend relationships, that I handle like a typical guy with bpd and after a relationship end (like now) I am completely out of order. So, whether I have bpd or not, you can say, that all these mental illnesses always just "cluster" some typical behaviours. I am a studied male nurse and I always critizised this ICD-10-Shit, because its too vague (in my opinion).
Well, the ICD-10 is quite vague. But the DSM V is much more detailed and the explanation is very helpful (below)... Borderline Personality Disorder Diagnosis *DSM-IV-TR Diagnostic Criteria A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: (1) Frantic efforts to avoid real or imagined abandonment. (2) A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. (3) Identity disturbance: markedly and persistently unstable self-image or sense of self. (4) Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behaviour covered in Criterion 5. (5) Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour. (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). (7) Chronic feelings of emptiness. (8) Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). (9) Transient, stress-related paranoid ideation or severe dissociative symptoms. *Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Ass. Overview of the Borderline Personality Disorder Diagnosis Every person has a personality: longstanding ways of perceiving, relating to, and thinking about the environment and oneself. However, when these traits are inflexible, maladaptive and cause significant functional impairment or subjective distress, they constitute a personality disorder. There are 10 classified personality disorders and of those, Borderline Personality Disorder (BPD) is the most common, most complex, most studied, and certainly one of the most devastating, with up to 10% of those diagnosed committing suicide. BPD exists in approximately 2-4% of the general population; up to 20% of all psychiatric inpatients and 15% of all outpatients. Females predominate (about 75%) within psychiatric settings while males are more common in substance abuse or forensic settings. As a result of clinical observations since the 1930’s and scientific studies done in the 1970’s, psychiatrists determined that people characterized by intense emotions, self-destructive acts, and stormy interpersonal relationships constituted a type of personality disorder. The term “Borderline” was used because these patients were originally thought to exist as atypical (“borderline”) variants of other diagnoses and also because these patients tested the borders of whatever limits were set upon them. The diagnosis became “official” in 1980. While there has been much progress in the past 25 years in understanding and treating BPD, the diagnosis is underused. This owes mainly to the fact that BPD patients are difficult to treat and often evoke feelings of anger and frustration in the people trying to help. Such negative associations have caused many professionals to be unwilling to make the diagnosis. Many give precedence to co-occurring conditions such as depression, bipolar disorder, substance abuse, anxiety disorders and eating disorders. This problem has been aggravated by the lack of appropriate insurance coverage for the extended psychosocial treatments that BPD usually requires. An Explanation of the DSM-IV TR Criteria For a patient to be diagnosed with Borderline Personality Disorder, he or she must experience 5 out of the 9 criteria (see page 2) as set forth in the DSM-IV TR. Establishing the diagnosis is complicated by the fact that the presence of many of these criteria fluctuate. Here is a more detailed explanation of these symptoms: 1. Abandonment Fears. These fears should be distinguished from the more common and less severe phenomena of separation anxiety. The perception of impending separation or rejection, or the loss of external structure, can lead to profound changes in the BPD patient’s self-image, affect, cognition, and behaviour. Individuals with BPD are interpersonally hypersensitive and may experience intense abandonment fears and inappropriate anger even when faced with criticisms or time-limited separations. These abandonment fears are related to an intolerance of being alone and a need to have other people with them. Frantic efforts to avoid abandonment may include impulsive actions such as self-injurious or suicidal behaviours. It was originally postulated that fear of abandonment developed as a result of failures in a child’s development during the rapprochement phase (from age one-and-a-half to two-and-a-half). However, empirical evidence has not borne this out. 2. Unstable, Intense Relationships. Individuals with BPD are frequently unable to see significant others (i.e., potential sources of care or protection) as other than idealized (if gratifying), or devalued (if not gratifying). This is often referred to as “black and white thinking,” and in psychological terms, reflects the construct of “splitting.” When anger initially intended toward a loved one is experienced as dangerous, it gets “split” off to preserve the loved one’s goodness. Relationship instability is thought to be a symptom of early insecure attachment characterized by both fearful distrust and needy dependency. 3. Identity Disturbance. The disorder of self which is specific to borderline patients is characterized by a distorted, unstable or weak self-image. Borderline patients often have values, habits, and attitudes which are dominated by whomever they are with. The interpersonal context in which these identity problems get magnified is thought to begin with not learning to identify one’s feeling states and the motives behind one’s behaviours. 4. Impulsivity. The impulsivity of the borderline individual is frequently self-damaging, in its effects if not in its intentions. This differs from impulsivity found in other disorders such as manic/hypomanic or antisocial disorders. Common forms of impulsive behaviour for borderline patients are substance or alcohol abuse, bulimia, unprotected sex, promiscuity, and reckless driving. 5. Suicidal or Self-Injurious Behaviours. Recurrent suicidal attempts, gestures, threats, or self-injurious behaviours are the hallmark of the borderline patient. The criterion is so prototypical of persons with BPD that the diagnosis rightly comes to mind whenever recurrent self-destructive behaviours are encountered. Self-destructive acts often start in early adolescence and are usually precipitated by threats of separation or rejection or by expectations that the BPD patient assume unwanted responsibilities. The presence of this pattern assists the diagnosis of concurrent BPD in patients whose presenting symptoms are depression or anxiety. 6. Affective (Emotional) Instability. Early clinical observers noted the intensity, volatility and range of the borderline patient’s emotions. It was originally proposed that borderline emotional instability involved the same problems of affective irregularity found in persons with mood disorders, particularly depression and bipolar disorder. It is now known that although individuals with BPD display marked affective instability (i.e., intense episodic depression, unrest, anger, panic, or despair), these mood changes usually last only a few hours, and that the underlying dysphoric mood is rarely relieved by periods of well-being or satisfaction. These episodes may reflect the individual’s extreme reactivity to stresses, particularly interpersonal ones and a neurobiologically-based inability to regulate emotions. 7. Emptiness. Chronic emptiness, described as a visceral feeling, usually felt in the abdomen or chest, plagues the borderline patient. It is not boredom, nor is it a feeling of existential anguish. This feeling state is associated with loneliness and neediness. Sometimes their experience is considered an emotional state and sometimes it is considered a state of deprivation. 8. Anger. The anger of the borderline patient may be due to temperamental excess (a genetic vulnerability) or a longstanding response to excessive frustration (an environmental cause). Whether the cause is genetic or environmental, many individuals with BPD report feeling angry much of the time, even when the anger is not expressed overtly. Anger is often elicited when an intimate or caregiver is seen as neglectful, withholding, uncaring, or abandoning. Expressions of anger are often followed by shame and contribute to a sense of being evil. 9. Psychotic-like Perpetual Distortions (Lapses in Reality Testing). Borderline patients can experience dissociation symptoms: feeling unreal or that the world is unreal. These symptoms are associated with other disorders, such as schizophrenia and Post Traumatic Stress Disorder (PTSD), but in those with BPD the symptoms generally are of short duration, at most, a few days, and often occur during situations of extreme stress. Borderline patients also can be unrealistically self-conscious, believing that others are critically looking at or talking about them. These lapses of reality in the BPD patient may also be distinguished from other pathologies in that generally the ability to correct their distortions of reality with feedback remains intact. The borderline traits are usefully subdivided into four factors, each of which represents an underlying temperament (aka “phenotype”): 1. Interpersonal hypersensitivity (criteria 1, 2 and 7) 2. Affect (emotional) dysregulation (criteria 6, 8 and 7) 3. Behavioural dyscontrol (Impulsivity) (criteria 4 and 5) 4. Disturbed self (criteria 3 and 9)
