Borderline Personality Disorder (BPD) is a mental health condition characterized by unstable moods, behavior, and relationships. Individuals with BPD often experience intense emotions and have difficulty managing their feelings, leading to impulsive actions and challenges in maintaining stable relationships. The potential causes of BPD are believed to be
Hello, I accidentally discovered the concept of Borderline Personality Disorder and feel that my past issues seem to align somewhat with this disorder, but I'm not sure how to ask about it.
I also question the credibility of the information I find online...
According to the DSM-5, there are at least six criteria, and after reading the descriptions, I feel like I relate to almost all of them...
Or is it that everyone feels this way? (I apologize; I know doctors dislike it when people Google their conditions...) It’s frustrating to not know what’s wrong with me, and I’ve been troubled by these issues since middle school.
I started self-harming back then, initially not knowing why, but it gradually became a habit.
There was a time when I accidentally hurt myself deeply and bled profusely; that memory is something I can’t shake off.
I know that the scars will lead to further complications, so I have to wear accessories, dress in long sleeves, and be careful not to let my family or classmates see, among other things.
I often secretly consume too much food, usually carbohydrates, when I’m alone.
Yet, this leads to feelings of guilt about gaining weight, and the cycle of regret deepens as I can’t seem to stop.
These two issues haunt me like a nightmare.
As time passes, I feel like I’m facing even more problems than before.
The unknown, anxiety, pain, loneliness, worry, exhaustion, and emptiness seem to have intensified, making it feel like there’s a black hole in my chest.
I don’t know how to cope; sometimes I experience insomnia, and other times I feel sleepy early.
Sometimes I can’t eat much, while at other times I overeat, often consuming more than two meals’ worth of food in one sitting.
These feelings seem to come and go randomly.
During particularly difficult times, pretending to be okay is exhausting, and I often feel uncomfortable and just want to escape the crowd and go home.
I frequently feel inexplicably uneasy; even when I’m not deeply sad, I at least don’t think about dying every day.
I feel like it’s impossible to navigate this world alone, yet there’s no one I can rely on.
Even when I occasionally make friends, I cherish those moments, but I can quickly become annoyed with them over trivial matters.
I long for someone to accept me; otherwise, I really don’t want to continue living.
In the past, I was taken to a psychiatrist by my family due to self-harm.
I didn’t know what to say and couldn’t trust the doctor, especially since I felt forced to go.
I sensed that my parents thought I was a failure and needed correction.
I was told my issues were merely due to poor academic performance and that I had mild ADHD.
I seriously questioned whether I had ADHD, but I don’t believe I do.
I was also punished and scolded for self-harming.
Eventually, I chose to hide it from them.
I’ve been to numerous counseling sessions and various places, including deceptive counseling rooms and expensive therapy offices.
Recently, I thought visiting my school’s counseling center might help me understand myself better.
Perhaps it’s because I can’t articulate my feelings or be honest; I struggle to trust unfamiliar people and usually don’t want to say anything.
Recently, I attempted to express my issues regarding self-harm, binge eating, interpersonal relationships, and suicidal thoughts at the counseling center, but the response I received was simply: “You lack goals in life, and you fear people and the emotional scars that interpersonal interactions can bring.” It feels like no one truly cares about others; everyone ultimately thinks of themselves and what’s best for them.
I’m constantly afraid of this and that, navigating relationships with trepidation.
It’s exhausting and frightening, and lying is such a painful experience...
I always reflect on what I did wrong and wonder why I can’t just live happily and carefree, but no matter how I think about it, I don’t know.
Perhaps all the problems are just mine.
I don’t think it’s helpful to ask someone who doesn’t know what tomorrow holds to contemplate life goals.
Each day feels so lonely and empty; I keep telling myself not to eat too much to avoid gaining weight and to stop self-harming.
Just managing my issues leaves me utterly drained.
I don’t want to do anything, yet I have to; even when I feel like I’m dying inside, I still have to push through.
I feel like the only way to resolve my troubles is through death, as I don’t believe I can find someone who will accept and love me, someone who will accompany me on this journey.
I only feel like things are getting worse, with more problems piling up.
My family is unwilling to understand, and my current academic situation is overwhelming.
I wish I could quit and try a different life that might improve my situation, perhaps meet someone new.
As I continue studying, I feel like I’m just gathering information on mortality rates, methods, and success rates, and I’m convinced I’ll find a way to end my life properly.
Yet, I also feel utterly drained of energy to try a new life; even at home, I have to engage in social interactions.
Only when I’m alone do I have the space to break down.
But even then, it’s futile; tomorrow I have to wake up again...
If this is just a case of complaining without a real issue, perhaps that would be easier.
But if that’s the case, then maybe I shouldn’t even try; the problem is still me, my stubbornness, my misguided belief that counseling or psychiatry can solve my problems, and even my tendency to only express these thoughts online.
I don’t know; if I could understand more, would it alleviate my suffering? I’m sorry for writing so much; perhaps I can only express myself through text, as I find it awkward to speak.
But I don’t know how to articulate it well; there are too many troubles, and I can’t list them all.
Thank you for reading.
(Hands together)
E, 20~29 year old female. Ask Date: 2020/04/17
Dr. Peng Liyun reply Psychiatry
Hello, from your letter, it is evident that you are experiencing discomfort and distress.
It is important to discuss your diagnosis with a physician, but equally important is to ask yourself if you have coping strategies for these situations.
If you cannot find suitable ways to manage, or if these issues are indeed affecting your daily life and relationships, I recommend seeking further evaluation and treatment at a hospital.
Treatment options typically vary based on the severity of the condition.
Our clinic offers outpatient services from Monday to Friday in the morning and afternoon, and on Saturday and public holidays (excluding Sundays) in the morning as well.
I suggest you consider coming in for an evaluation to discuss the best treatment options together.
Reply Date: 2020/04/17
More Info
Understanding Borderline Personality Disorder (BPD) is crucial for those who may identify with its symptoms or know someone who does. BPD is characterized by a pervasive pattern of instability in interpersonal relationships, self-image, and emotions, often leading to significant distress and impairment in functioning. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), outlines specific criteria for diagnosing BPD, which include symptoms such as intense emotional responses, fear of abandonment, unstable relationships, and impulsive behaviors.
From your description, it seems you are grappling with feelings of confusion regarding your identity, emotional instability, and interpersonal difficulties, which are common among individuals with BPD. The onset of symptoms often occurs during adolescence, a period marked by identity exploration and emotional turbulence. For many, including yourself, these feelings can manifest as self-harm, eating disorders, and a profound sense of emptiness or loneliness.
The emotional turmoil you describe—oscillating between self-hatred and a desire for acceptance—reflects the internal conflict that many with BPD experience. This can lead to a cycle of self-destructive behaviors, such as binge eating or self-harm, as a means of coping with overwhelming emotions. It’s important to recognize that these behaviors are often attempts to manage intense feelings of anxiety, depression, or anger, rather than a reflection of your worth as a person.
Regarding the question of whether everyone experiences these feelings, it’s essential to understand that while many people may experience emotional ups and downs, the intensity and frequency of these feelings in BPD can be debilitating. The struggle to maintain a consistent self-image and the fear of abandonment can lead to chaotic relationships and a sense of isolation, as you’ve described.
The genetic and environmental factors contributing to BPD are complex. Research suggests that individuals with a family history of personality disorders or mood disorders may be at a higher risk of developing BPD. Additionally, traumatic experiences, particularly in childhood, can play a significant role in the development of the disorder. It’s not uncommon for individuals with BPD to have experienced neglect, abuse, or unstable family dynamics, which can contribute to their emotional and relational difficulties.
Treatment for BPD typically involves psychotherapy, with Dialectical Behavior Therapy (DBT) being one of the most effective approaches. DBT focuses on teaching skills to manage emotions, improve interpersonal effectiveness, and develop distress tolerance. Medication may also be prescribed to address co-occurring symptoms such as depression or anxiety, but it is not a primary treatment for BPD itself.
If you find yourself struggling with thoughts of self-harm or suicide, it’s crucial to seek help from a mental health professional. Your experiences are valid, and you deserve support. It’s understandable to feel distrustful of therapists, especially if past experiences have been negative. However, finding a therapist with whom you feel comfortable can be transformative. They can help you navigate your feelings, develop coping strategies, and work towards a more stable sense of self.
In summary, while your feelings of confusion and distress are significant, they are not uncommon among those with BPD. Understanding the disorder, seeking appropriate treatment, and finding a supportive therapeutic relationship can help you manage your symptoms and improve your quality of life. Remember, you are not alone in this journey, and there is hope for healing and growth.
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