My life (part 2)

Please take the time to read this. There may be someone in your life suffering with this disorder.

Borderline Personality Disorder: Poorly Regulated Emotions.

Mood Swings and Poorly Regulated Emotions

A number of experts in the field believe that difficulty in regulating emotions is the driving force behind many of the other symptoms of borderline disorder. If you have borderline disorder, your emotions may change quickly and you may find it difficult to accurately perceive and express your emotional responses, especially to an unpleasant event. Most often, you may overreact emotionally. However, at other responses one would anticipate from the average person, only to be followed by hyperemotional reactions at a later time. Here are the major symptom indicators of poorly regulated emotions.

The emotions of people with borderline disorder are often very unstable and undergo rapid changes that they have difficulty controlling. This is referred to as emotional liability. These labile emotions can include negative feelings of  anxiety, anger, fear, loneliness, sadness, and depression. Less often, these emotions can also include positive feelings such as happiness, joy, enthusiasm, and love. Your emotions fluctuate quickly from feeling good to feeling bad, sometimes for reasons that are obvious to you, but at other times for causes that are not apparent. Because of these rapid fluctuations in mood, and because you are more likely to develop feelings of depression and episodes of major depressive disorder, than people who do not have borderline disorder, at some point you may have been diagnosed as having bipolar disorder or complex post traumatic stress disorder.

Your feelings may also be hyperreactive, that is, you may seriously overreact emotionally to some situations. For example, you may become very upset over criticisms, separations, or disagreements that other people seem to take in stride. Such events may cause a wave of anxiety, sadness, anger, and desperation. In addition, you may find that you have greater difficulty calming down your emotions and soothing yourself by focusing on reassuring thoughts or by engaging in usually pleasant activities. During these periods of sever hyperemotionality, or "emotional storms", as they're called, you may feel so desperate that you turn to alcohol or drugs for relief, lash out in anger or rage, or engage in other destructive behaviors.

Recent research also suggests that people with borderline disorder have more difficulty in accurately identifying the emotional responses of other people and in balancing mixed feelings, and have more intense responses to the negative emotions of others than people who do not have the disorder. Emotions do not return to their normal level as quickly as someone without the disorder.

You may also be hypersensitive to the real or perceived negative behaviors of others toward you, always on the lookout for the slight frown, raised eyebrow, or minor change in a person's tone of voice that indicates they are irritated or angry with you. When you believe you detect such critical reactions, no matter how subtle, your response may often be way out of proportion to the situation. You may feel anxiety, self-recrimination, and anger that are simply not warranted under the circumstances. You may be vaguely aware that you are overreacting, but the feelings are just too real and too strong to ignore.

Inappropriate Intense Anger or Difficulty Controlling Anger

Poorly controlled anger is very common and causes significant problems in people with borderline disorder. You may feel irritable and angry much of the time, and often can be argumentative, quick-tempered and sarcastic. You may even become furious, sometimes enraged, in circumstances that do not warrant such a response. The slightest event or exchange can result in an angry, often cruel, outburst. You may then say and do things that are very destructive, and later regret that you did so. Recent research has show that people with borderline disorder have greater changes in anger and depression than other people, and that they may fluctuate between anger and anxiety more readily as well.

You may realize in the midst of your rages that you are overreacting, but seem unable to control the strong emotions that are sweeping over you. As one patient put it, "I know my husband does not deserve all the anger and abuse I put upon him, but he's the one around most of the time. I don't seem to be able to control the anger. At the time, I think he deserves it - so he gets it." Your family, your spouse if you are married, and others close to you have learned that they must be very careful about what they say or do. Many say "It's like I'm walking on eggshells all the time. I never know what I will do to cause her (or him) to blow up." This apprehensiveness on the part of your family can result in persistent low level of tension in your home. Since you may be very sensitive to the negative feelings of others, this can make an already tense living situation even worse.

Chronic Feelings of Emptiness

Another strong feeling you may experience is a sense of persistent emptiness. This sense of emptiness is often accompanied by feelings of boredom and loneliness. In turn, these feelings may lead to dissatisfaction with the people in your life, and with your life in general. Dissatisfied with your life, you may be prone to change friends, jobs, engage in brief affairs and even end long term relationships. For a time, these changes can feel very exciting and temporarily relieve the emptiness, loneliness, and boredom. However, the feelings return after a while and the life patterns of inconstancy repeat themselves. One young patient told me recently, during our initial meeting, that these feelings of emptiness and boredom were so strong that she felt as if she had a big hole inside her that wouldn't go away. It did diminish when she was involved in a new relationship with a young man, at least for a while, then would return in full force when they fought or when she decided to leave him because of the hypersensitivity to his responses. She added that, when severe, this feeling was so emotionally painful she would almost do anything to relieve it, even cut or burn herself, although the emotional pain always returned shortly thereafter.

Another patient told me early in her treatment that when she felt empty and bored for a long period, she would leave her husband without notice and travel to another city. There she would see a former teacher for a brief two-or-three day affair, then go back to her husband. Although she temporarily felt excited, desired, and satisfied by these escapades she dreaded having to deal with her husband about her absences. Nonetheless, the pattern continued until she was able to understand the nature of the feelings and the life situations that triggered this behavior, then to take measures to gain control over it. Fortunately, her husband was able to tolerate the behavior until she was able to develop alternative and much more effective responses to the emptiness and boredom she often felt.

Impulsivity

The tendency toward impulsive, self-damaging behavior is so common and so strong in people with borderline disorder that some experts in the field consider it the most important problem in the disorder. They believe it is more important than the symptoms of emotional instability and impaired reasoning, because impulsivity appears to be the best predictor of the long-term outcome of the disorder. Those people with borderline disorder who are very impulsive tend to have a much worse prognosis than those who are not as impulsive. Research suggests that impulsivity in people with borderline disorder is the result of an imbalance between those neural systems (nerve cell pathways that control specific behaviors) that regulate emotions, impulse control, and reasoning. Research has also show that impulsive behavior is present to some degree in most people with borderline disorder. Following are the major groups of symptoms within the broad category of impulsivity.

Impulsive Behaviors that Harm You

If you have borderline disorder, there are many ways that you could behave impulsively, such as binge eating and spending money recklessly on clothes or other items. You may also engage in other more serious impulsive acts like excessive drinking, sexual promiscuity, violent, aggressive acts or uncontrollable outbursts of rage.

In general, impulsive behaviors often follow episodes of emotional storms and disruptions in close relationships, especially real or threatened abandonment. They also appear to be more common in people with borderline disorder who have been physically or sexually abused as children. In order to fit this particular diagnostic criterion, you need to exhibit impulsive behavior in at least two of the self-destructive ways mentioned above.

Suicidal Behavior, Gestures, Threats, or Self-Mutilating Behavior

This is a particular striking group of impulsive symptoms that occurs among many, but by no means all, people with borderline disorder. They are referred to as parasuicidal acts. The severity of these behaviors ranges from very serious acts that may be life-threatening, to threats that often attempts to control a situation, gain attention, or seek help. You may do these things in a desperate attempt to have someone take care of you, or to "get even" with them, or to get your way. More often, you may hurt yourself in order to help reduce the emotional pain you frequently feel when it reaches an intolerable level.

Munchausen's Syndrome

A very striking and serious form of self-injurious behavior that may occur in people with borderline disorder is Munchausen's Syndrome, also known as factitious illness. People with this disorder hurt themselves intentionally, but in a way that looks like a bonafide medical problem.

Impaired Perception and Reasoning

People with borderline disorder often say they have difficulty with their memory; especially under stress. You may also misperceive experiences, expecting the worst from others, even when nothing negative is intended. You may have difficulty with your concentration, and with organizing your thoughts and behaviors. You may not be able to think a complex problem through adequately and determine reasonable alternative, and the consequences of these alternatives. These difficulties with the perception of important events, thinking, and reasoning may result in faulty decisions that could have highly detrimental consequences.

It is not surprising that you may have difficulty in participating in reasonable conversations to solve problems when you are in a hyperemotional state, or to remember accurately the content of these situations afterward. In other words, emotional hyperreactivity often gets in the way of normal reasoning in social or interpersonal situations. This difficulty in social reasoning seriously impairs the learning and developing skills you need to have mature, successful, and sustained personal relationships.

Brief Episodes of Paranoid Thinking

Research shows that people with borderline disorder are more likely to expect others to behave badly toward them than people without the disorder. When exposed to severe stress (usually criticism), or imagined (or real) abandonment, when under the influence of alcohol or drugs, or when treated with certain classes of stimulants such as amphetamine, or with certain antidepressants, some people with borderline disorder become very suspicious and have difficulty thinking rationally. Brief episodes of paranoid thinking may occur, when they falsely believe that others are planning harm against them. Hallucinations, such as hearing strange voices, music, or other sounds is also common.

Dissociative Symptoms

You may notice that there are periods of time during which you can't recall what you said or did. These are called dissociative episodes. At their extreme, dissociative episodes can be so severe that the person actually splits off part of their feelings, thinking, and behavior, and temporarily creates one or more separate personalities. When this occurs, it's referred to as multiple personality disorder. Multiple personality disorder is experienced by an unknown percentage of people with borderline disorder.

Magical Thinking

In addition, you may have odd thoughts, such as unrealistic and magical thinking. Magical thinking is the use of highly unrealistic thoughts to solve current emotional distress in your life. For example, you may believe that someone you will become a successful architect and design your first building in less than a year, even before graduating college. You may also believe you have a sixth sense or are even clairvoyant.

Depersonalization

You may have episodes of depersonalization during which you feel unreal, as if in a dream, and strangely detached from the world, or outside your body. You may feel numb or hollow.

Unstable Self-Image or Sense of Self

You may often feel that you have little self-worth, and that your self-concept depends mainly on the attitudes and behaviors of people close to you. If they seem loving & attentive, you feel good about yourself. But their criticisms may cause you great anxiety, feelings of worthlessness, and despair. Regardless of what you have accomplished, it doesn't seem to counterbalance the opinions of others. In other words, you may feel as if you have little self-esteem, that your esteem is almost totally dependent on others.

You may often feel unsure of who you really area, what values you truly believe, what career you should truly pursue, what causes you should support. You may have difficulty feeling "centered", and in developing a constancy of purpose in your life that serves to stabilize and to give integrity and predictability to your peace of mind and behavior. As one patient put it, "I feel as if I too easily adopt the characteristics of the people I am with. I am desperate that they like me. I adopt mannerisms, their way of speaking, and their attitudes, even the ones that I don't usually agree with. Other people's opinions of me are much more important to me than my own opinions and convictions. I feel as if I have an emptiness inside of me that only other people can fill."

However, there may be times when you swing to the other extreme. Then, you may be very critical, inflexible, and dogmatic about certain beliefs, to the point that you offend people around you. As a result of these difficulties, it's understandable that you may do better in stable, highly structured situations, especially with people whose behaviors and personal values are solid and stable.

Marked Disturbed Relationships

Given the above information, it's not surprising that your life may be marked by tumultuous relationships. Usually, the closer the relationship you have, the greater the turmoil. During childhood and early adolescence, the major problems in relationships usually occur with parents, other family members, teachers and friends. Later in life difficulties occur with boyfriends or girlfriends and, in adulthood, with spouses, children, co-workers, and employers.

A Pattern of Unstable and Intense Personal Relationships

You may have noticed that you fluctuate dramatically and quickly in your feelings and attitudes toward those people who are very important to you. At times, you may perceive someone to be more wonderful than anyone could reasonably be; capable of making you feel happy, safe, important, and alive under any circumstance. In other words, you unrealistically overvalue and idealize this person who is so central to your sense of well being. You may find that you cling almost desperately, to these people and worry continually that they will leave you.

Of course, no one is able to live up to these unrealistic standards for very long. Then, disappointed that the relationship cannot stabilize YOUR feelings and life, you may have an abrupt change in attitude that moves too far in the other direction. For example, after a small slight, you may perceive the other person to be uncaring, unsupportive, selfish, and even punitive, to a much greater degree than is actually the case. In doing so, you devalue the importance of that person, finding fault with them at every turn. You won't be able to tolerate this situation for very long, so you may abruptly swing back to the other extreme, only to find the cycle repeats itself, over and over, until you push this person away, often regrettably.

A Black-and-White Life

Many people with borderline disorder report that they see themselves, other people, and the world in general as black or white, as good or bad, and they have great difficulty in dealing effectively with the gray areas of relationships. These gray areas, of course, constitute the vast majority of human interactions. You may have a hard time accurately weighing positive characteristics and behaviors against ones that you don't like, in part because you often over-respond emotionally to negative actions, and also because of your difficulty in social reasoning.

Consequently, it may be quite difficult for you to reach a well-balanced and reasonably integrated opinion about people, especially those important to you. This makes it difficult for you to deal with important relationships in positive ways that enable you to adapt well to the reasonable frailties of other people. It follows naturally that you may also find it difficult to determine effective ways to have others adapt well to your own shortcomings. To some degree, this may be because, when you're symptomatic, you believe unrealistically that your difficulties are mainly the result of the behaviors of other people, not your own.


::That's it .......I can't write anymore tonight::

-Des