28 March 2008

BPD

Disturbances suffered by those with borderline personality disorder are
wide-ranging. The general profile of the disorder typically includes a pervasive
instability in mood, extreme
"black and white" thinking, or "splitting",
chaotic and unstable interpersonal
relationships
, self-image, identity,
and behavior, as well as a
disturbance in the individual's sense of self. In
extreme cases, this disturbance in the sense of self can lead to periods of dissociation.[2]
These disturbances have a pervasive negative impact on many or all of the
psychosocial facets of life. This includes the ability to maintain relationships
in work, home, and social settings.

A DSM diagnosis of BPD requires any
five out of nine listed criteria to be present for a significant period of time.

  1. Frantic efforts to avoid real or imagined abandonment. [Not including
    suicidal or self-mutilating behavior covered in Criterion 5]
  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., promiscuous sex, eating disorders, binge
    eating
    , substance abuse, reckless driving).
    [Again, not including suicidal or self-mutilating behavior covered in Criterion
    5]
  5. Recurrent suicidal behavior, gestures,
    threats, or self-mutilating behavior
    such as cutting, interfering with the healing of scars, or picking at oneself.
  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, worthlessness.
  8. Inappropriate 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

Studies suggest that individuals with BPD tend to experience frequent, strong
and long-lasting states of aversive tension, often
triggered by perceived rejection, being alone, or perceived failure.[9]
Individuals with BPD may show lability
(changeability) between anger and anxiety or between depression and anxiety[10]
and temperamental sensitivity to emotive stimuli.[11]
The negative emotional states particularly associated with BPD have been
grouped into four categories: extreme feelings in general; feelings of
destructiveness or self-destructiveness; feelings of fragmentation or lack of
identity; and feelings of victimization.[12]

Individuals with BPD can be very sensitive to the way others treat them,
reacting strongly to perceived criticism or hurtfulness. Their feelings about
others often shift from positive to negative, generally after a disappointment
or perceived threat of losing someone. Self-image can also change rapidly from
extremely positive to extremely negative. Impulsive behaviors are common,
including alcohol or drug abuse, unsafe sex, gambling, and recklessness in
general.[13]
Attachment studies suggest individuals with BPD, while being high in intimacy-
or novelty-seeking, can be hyper-alert[8]
to signs of rejection or not being valued and tend towards insecure, avoidant or
ambivalent or fearfully preoccupied patterns in relationships.[14]
They tend to view the world generally as dangerous and malevolent, and
themselves as powerless, vulnerable, unacceptable and unsure in self-identity.[8]

Individuals with BPD are often described, including by some mental health
professionals (and in the DSM-IV),[5]
as deliberately manipulative or difficult, but analyses and findings generally
trace behaviors to inner pain and turmoil, powerlessness and defensive
reactions, or limited coping and communication skills.[15][16][17]

邊緣性人格障礙症患者經常處於危機狀態,經常有情緒的波動,經常一下子好辯激動,轉眼間又憂鬱哭泣,一會兒可能覺得感受不到自己的感覺。

因為這群人既依賴又充滿敵意,他們相當依賴周遭親近的人,但當其依賴無法滿足時,則表現強烈的憤怒,因此難以維持深度而親密的關係,意即他們對人的觀感陷入全好或全壞兩極端中,旁人可給予他關心注意,使之有安全感之時刻,便將旁人理想化;但當旁人的付出不能符合其需求時,便對之充滿憤怒嫌惡與批評;反之,他們極怕被依賴的對象所背叛,往往激起對象的生氣憤怒,或率先背叛對方,以測試對象的容忍程度,當對象果真離開他後,他則陷入極大的情緒混亂中,並強化世界無人可信賴,自己是空虛孤獨的存在信念;另一方面他們缺乏自我認同,故無法忍受獨處的孤寂,有長期的空虛感。



Well, the Chinese description was the most scary bit - scarily fit - that hardly deniable. So is this what the problem was? Apparently BPD can last for a decade, and from what I recall now is nearly the end of the decade. Maybe this is the reason why I started to consider what has gone wrong and how can it be fixed from late last year.

Actually, I never be able to say I am thinking exactly in this way until I see this and I never know this is more problematic than just a difference in thinking until... very very late, probably less than a year. I thought I was a bit moody, but I thought whatever I was angry or depress about really have enough reasons for me to act so. I only started to realise not everyone acts like this and "moody" for other people do not mean the same very recently. I didn't know that "splitting" was a problem. I didn't know that unstable self image and behaviour was a problem. I didn't know that feeling about others shift easily between two end was a problem. The only thing I did notice a bit earlier but keep denying is I get angry easily about things that normally people would not, and usually it results into crying or even fighting. I think my strong rational side and aversionof pain saved me from committing any suicidal action, although they weren't able to save me from imagining it.

Anyway, no matter I really had BPD or just hypochondriasis, I am pretty sure I am doing better now. I think, still need some times though, but will get there.

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