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Helping A Partner Who Has BPD (Borderline Personality Disorder)

Helping A Partner Who Has BPD (Borderline Personality Disorder)

Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic, mental disorder. As defined by the National Institute of Mental Health (NIH), “borderline personality disorder is an illness characterized by an ongoing pattern of varying moods, behavior, and self-image.” Individuals with borderline personality disorder feel prolonged, intense emotions and are unable to return to a neutral emotional baseline after facing an emotionally charged experience in a timely manner. This can affect all areas of one’s life as the duration it takes an individual with BPD to process, integrate, and recover from emotional challenges is elongated. Individuals with borderline personality disorder often struggle with relationship issues, lack self-esteem, have a poor self-image, and have an inability to appropriately self-regulate. Borderline personality disorder is not an uncommon disorder, as the National Institute of Mental Health (NIH) estimates that 1.4% of the adults in America experience BPD. 

Diagnostic Criteria 

There is no definitive medical test to diagnose borderline personality disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), borderline personality disorder is diagnosed when an individual experiences “a pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood” and must experience five or more of the following symptoms in a variety of contexts:

  • Emotional instability
  • Feelings of emptiness
  • Efforts to avoid abandonment
  • Impulsive behaviors
  • Identity disturbances
  • Inappropriate, irrational and/ or intense bouts of anger
  • Transient paranoid and/ or dissociative symptoms
  • Unstable interpersonal relationships
  • Suicidal and/ or self-harming behaviors

Due to its illusive nature, borderline personality disorder can be extremely difficult to diagnose. As such, to obtain the most accurate mental health diagnosis it is imperative to undergo a comprehensive evaluation that is conducted by one or more qualified mental health professionals. 

What You Can Do

Despite the challenges that BPD can bring to a relationship maintaining self-care practices and utilizing effective communication skills are essential for both partners, and integral to the health of the relationship. Consider the following suggestions to help you navigate your partner’s BPD:

  • Increase empathy: learn as much as you can about borderline personality disorder to increase empathy in your partnership
  • Remain calm: do not engage in serious conversations unless your partner is calm 
  • Be supportive: provide your partner with emotional support and understanding, and be sure to let your partner know that you fully support their treatment 
  • Avoid shame and blame: remember that labeling and blaming is not productive nor will it help to de-escalate or resolve any situation
  • Take threats seriously: threats of self-harm should not be minimized or ignored, and should prompt you to seek immediate professional help

It is important to bear in mind that although BPD is a chronic condition, with proper support, is it possible for an individual diagnosed with borderline personality disorder to learn strategies, techniques, and tools to effectively manage the symptoms associated with BPD, reducing the severity of symptoms experienced and increasing one’s quality of life.

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

Are Binge Eating and Borderline Personality Disorder (BPD) Connected?

Are Binge Eating and Borderline Personality Disorder (BPD) Connected?

Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic mental health disorder. It characterized by a pervasive pattern of instability in interpersonal relationships, self-image issues, and difficulty managing emotions and behaviors, which interfere with one’s ability to function in everyday life. Although there is no single cause of borderline personality disorder, the National Institute of Mental Health (NIH) alludes to research that “suggests that genetics, brain structure and function, and environmental, cultural, and social factors play a role, or may increase the risk for developing borderline personality disorder.” Akin to BPD, the exact cause behind why individuals develop eating disorders remains unknown, but research has found that it is likely due to a combination of psychological, biological, and environmental factors. 

 

Binge eating disorder (BED) is listed in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) as a severe, life-threatening eating disorder. According to National Eating Disorder Association (NEDA), it is characterized by “recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards and not regularly using unhealthy compensatory measures (e.g., purging) to counter the binge eating.” Binge eating disorder is currently known to be the most common eating disorder in the United States.

 

Are They Connected?

Yes, binge eating, and borderline personality disorder are connected. More so, research has found an undeniably strong relationship between borderline personality disorder and dysregulated eating behaviors, such as binge eating. The symptoms of BPD often result in reckless and hasty actions, negatively affecting one’s relationships. Some highly regarded professionals in the mental health field suggest that it may be that the symptoms of BPD play an active role in the development of binge eating disorder. For example, common symptoms of BPD such as chronic impulsivity and urges to self-harm could lead to an individual engaging in detrimental eating behaviors, which would subsequently increase one’s susceptibility for developing an eating disorder. Conversely, engaging in dysregulated eating behaviors may cause an individual to experience overwhelming stress, which may trigger BPD in someone with a genetic vulnerability for the disorder. The prevalence of eating disorders is about 6 to 11% in those with borderline personality disorder, which is far greater than individuals with an eating disorder in the general public that amount to an approximate 2 to 4%. Hence, the rate of BPD in people with eating disorders is notably elevated when compared to the general population.

 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment. 

Signs of Self Harm and Treatment Options

Signs of Self Harm and Treatment Options

Self-injury, synonymous with self-harm, refers to the non-suicidal act of deliberately harming one’s own body. While the most common form of self-injury is cutting, there are a number of ways in which an individual can harm themselves, such as:

  • Breaking bones
  • Hitting or punching
  • Burning (with matches, cigarettes, hot objects, etc.)
  • Head banging
  • Carving symbols into skin
  • Piercing
  • Picking at a wound that interferes with healing
  • Biting
  • Pulling out hair

There is no diagnostic test for self-injury, rather diagnosis is based on a physical and psychological evaluation. 

Signs and Symptoms

Every person is unique and those that struggle with self-harm may exhibit slightly different signs and symptoms. Some of the possible examples that may indicate that an individual is engaging in self-harming behavior could include, but are not limited to any combination of the following, provided by Delta Specialty Hospital:

  • Cuts or burn marks on legs, arms, abdomen
  • Hiding sharp objects (e.g., box cutters, knives, razor blades)
  • Bizarre excuses for injuries 
  • Strange scars on one’s body
  • Difficulty sleeping
  • Broken bones
  • Agitation 
  • Wearing long sleeve clothes in hot weather
  • Depression
  • Difficulty with interpersonal relationships
  • Emotional instability
  • Changes in eating habits
  • Self-imposed social isolation

Many people that engage in self-harming behaviors will do so in a location on their body’s that is not visible. Furthermore, it is not uncommon for an individual to become attached to their scars and will repeat the behaviors directly over them (e.g., cutting in the same spot). This behavior occurs as an individual self-harming views his or her scars as a physical sign of strength, which is reinforced by inflicting, continued self-harming behaviors in the same location.

Treatment Options

There are a variety of treatment options available for an individual struggling with self-harm. Typically, self-injury is most effectively treated by attending a formalized treatment program. There are outpatient mental health programs that require an individual to participate in the treatment program for a certain number of hours, daily. There are also acute inpatient mental health treatment programs that offer twenty-four-hour care and support throughout the duration of the program. In severe cases, hospitalization may be necessary. Regardless of the format, an individual in treatment for self-injury will be provided with a customized treatment plan to accommodate his or her nuanced needs. Generally, the treatment protocol for individuals that engage in self-harm will include some combination of different psychotherapy approaches. Certain therapeutic modalities that are commonly integrated into treatment plans include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), psychodynamic psychotherapy, mindfulness-based cognitive therapy (MBCT), expressive arts therapies, and more. Depending on one’s needs, treatment plans may also include medication. Certain medications can be helpful in decreasing uncomfortable symptoms associated with other underlying mental health issues, which in turn can reduce the urge to self-harm. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

Diagnosing and Treating Depression

Diagnosing and Treating Depression

Depression has become an integral term used in American society to describe sadness. However, depression, also known as major depressive disorder (MDD) or clinical depression, is listed as a medical illness in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and is recognized as a serious mood disorder. The World Health Organization (WHO) explains that depression is “characterized by persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities,” resulting in significant impairment in one’s daily life. An individual who suffers from clinical depression has a chemical imbalance in his or her brain, resulting in an inability to return to an emotional equilibrium as quickly as others when experiencing an emotional low. According to the Centers for Disease Control and Prevention (CDC) depression affects nearly 10% of the general population in America.

DSM-5 Diagnostic Criteria

To be diagnosed with major depression, a person’s symptoms must fit the criteria outlined in the DSM-5. An individual must be experiencing five or more of the following symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure:

  1. Depressed mood most of the day, nearly every day.
  2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
  3. Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day.
  4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
  5. Fatigue or loss of energy nearly every day.
  6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
  7. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
  8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

These symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition.

The Treatment Process

There are many approaches to treating depression. For those who have a mild case of major depressive disorder the treatment could comprise primarily of psychotherapy. There are many different types of therapeutic modalities that could be incorporated into one’s treatment plan, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), expressive arts therapy, and interpersonal psychotherapy (IPT). CBT is a type of therapy that combines behavioral therapy with talk therapy. DBT primarily uses mindfulness-based principles to help an individual learn tools and techniques to work towards achieving one’s therapeutic goals through understanding one’s emotions and subsequent behaviors related to one’s emotions. IPT uses an interpersonal filter to explore and examine the relationships and their effects on one’s life. 

Some people diagnosed with severe major depressive disorder may benefit from including medication into the treatment plan, in conjunction with various therapeutic methods. The different types of medications prescribed for MDD include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) and norepinephrine and dopamine reuptake inhibitors (NDRIs). A quality treatment program will consider all treatment options and create a nuanced treatment plan, incorporating medication when needed as well as the best possible therapeutic modalities that are expressly geared to one’s personal needs. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

What Is Radical Acceptance?

What Is Radical Acceptance?

Radical acceptance is tool used in dialectical behavior therapy (DBT), that is designed to keep pain from turning into suffering. Psychologist Marsha M. Linehan developed dialectical behavior therapy in the late 1980s as a means to help better treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). It is an evidence-based psychotherapy that is founded on principles of cognitive behavioral therapy (CBT), but places greater emphasis on the psychosocial aspect of treatment. It combines standard CBT techniques for emotional regulation and reality testing with concepts derived from Buddhist meditative practice such as awareness, mindfulness, and attentiveness to current situations and emotional experiences to encourage acceptance. DBT specifically focuses on providing therapeutic skills in the following four key areas, as provided by the Linehan Institute:

  1. Core Mindfulness: skills focused on improving an individual’s ability to accept and be present in any given moment.
  2. Distress tolerance: skills focused on increasing an individual’s tolerance of negative emotions instead of attempting to avoid or escape them.
  3. Interpersonal effectiveness: skills focused on increasing an individual’s communication strategies.
  4. Emotion regulation: skills focused on helping an individual identify, name, and understand the function of emotions, and increasing one’s ability to regulate emotions. 

Radical acceptance, specifically, is a skill that is addressed in the distress tolerance module. According to VeryWell Mind, “Radical acceptance can be defined as the ability to accept situations that are outside of your own control without judging them, which in turn reduces the suffering that is caused by them.” Much like every component of DBT, radical acceptance is a skill that requires practice, as it involves letting go of the need to control a situation.

How to Practice Radical Acceptance

Marsha M. Linehan provides the following ten steps for practicing Radical Acceptance using DBT:

  • Watch for thoughts that you are fighting against reality. 
  • Remind yourself that reality cannot be changed. 
  • Acknowledge that something led to this moment and think about the cause of events that you are unable to accept. 
  • When you are in a situation that causes extreme emotions, try focusing on breathing deeply and examining the thoughts you are having (and let them pass).
  • List what your behavior would look like if you did accept the facts then act accordingly.
  • Create a plan of action for events that seem unacceptable, think about what you will do, and how to appropriately cope.
  • Practice a feeling of total and complete acceptance through positive self-talk and relaxation strategies.
  • Remain mindful of physical sensations throughout your body such as tension or stress.
  • Embrace feelings such as disappointment, sadness, or grief.
  • Accept that life is worth living even when experiencing pain. 

Radical acceptance is achieved when one lets go of the urges to fight reality, does not succumb to the need to respond with impulsive or destructive behaviors, and releases the bitterness that may be trapping an individual in a cycle of suffering. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment. 

Borderline Personality Disorder Triggers

Borderline Personality Disorder Triggers

Borderline personality disorder (BPD) is a serious psychological condition that is characterized by pervasive instability in moods, emotions, behaviors, and interpersonal relationships. Individuals with borderline personality disorder feel prolonged, intense emotions and are unable to return to a neutral emotional baseline after facing an emotionally charged experience in a timely manner. This can affect all areas of one’s life as the duration it takes an individual with BPD to process, integrate, and recover from emotional challenges is elongated. Individuals with borderline personality disorder often struggle with relationship issues, lack self-esteem, have a poor self-image, and have an inability to appropriately self-regulate. Borderline personality disorder is not an uncommon disorder, as the National Institute of Mental Health (NIH) estimates that 1.4% of the adult population in America experience BPD. 

BPD Triggers

Johns Hopkins Medicine explains “Triggers are external events or circumstances that may produce very uncomfortable emotional or psychiatric symptoms, such as anxiety, panic, discouragement, despair, or negative self-talk.” Many borderline personality disorder triggers arise from interpersonal distress. While BPD triggers can vary from person to person, there are some types of triggers that are common in BPD. Examples of commonly reported BPD triggers can include, but are not limited to the following:

  • Perceived or real abandonment
  • Rejection of any kind
  • Loss of a job
  • Locations that invoke negative memories
  • Reminders of traumatic events
  • Ending a relationship

A trigger, in relation to BPD typically refers to something that precipitates the exacerbation of one’s BPD symptoms.

Symptoms

The symptoms associated with borderline personality disorder can pervasively interfere with an individual’s ability to function optimally in his or her daily life. Common symptoms of borderline personality disorder can include any combination of the following examples, provided by the Mayo Clinic

  • Ongoing feelings of emptiness
  • Risky behavior (e.g., gambling, having unsafe sex, etc.)
  • Intense fear of being alone or abandoned
  • Fragile self-image
  • Unstable relationships
  • Erratic moods
  • Frequent displays of intense anger
  • Stress-related, fleeting paranoia
  • Suicidal behavior
  • Threats of self-injury

It is not uncommon for people with BPD to feel extremely intense emotions for extended periods of time. This makes returning to a stable emotional baseline far more challenging, especially after experiencing an emotionally triggering event. The symptoms that manifest because of borderline personality disorder often mimic those of other mental health disorders such as histrionic personality disorder, narcissistic personality disorder and bipolar personality disorder, which can make the diagnosis process rather challenging. 

Diagnostic Criteria

There is no definitive medical test to diagnose borderline personality disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), borderline personality disorder is diagnosed when an individual experiences “a pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood” and must experience five or more of the following symptoms in a variety of contexts:

  • Emotional instability
  • Feelings of emptiness
  • Efforts to avoid abandonment
  • Impulsive behaviors
  • Identity disturbances
  • Inappropriate, irrational and/ or intense bouts of anger
  • Transient paranoid and/ or dissociative symptoms
  • Unstable interpersonal relationships
  • Suicidal and/ or self-harming behaviors

Due to its illusive nature, borderline personality disorder can be extremely difficult to diagnose. As such, to obtain the most accurate mental health diagnosis it is imperative to undergo a comprehensive evaluation that is conducted by one or more qualified mental health professionals. 

Disclaimer:

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment. 

 

Is Addiction A Disease?

Is Addiction A Disease?

Yes, addiction, also referred to as substance use disorder, is a mental health disorder listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). It is characterized by compulsively engaging in rewarding stimuli (often, dangerous, risky, and/ or unhealthy) regardless of the ensuing negative consequences. Engaging in habitual substance abuse is a slippery slope that can quickly lead to addiction. The type of substance abused, the duration of one’s substance abuse, the potency of the drug abused, one’s personal health history, as well as one’s family health history will all contribute to the length of time it may take for an individual to develop an addiction. An individual that struggles with addiction will put his or her need for satisfying a drug craving above all else in his or her life. Therefore, addiction has the propensity to affect every aspect of an individual’s life. It is important to note that addiction does not develop overnight, nor should an individual expect his or her recovery from addiction to occur instantaneously. The treatment process for recovering from an addiction will require steadfast dedication and will be a lifelong commitment.

Habitual use of any substance can lead to increased tolerance, meaning an individual will require more of the substance (e.g., higher dosage, frequency of use, etc.) to achieve the same feeling. When an individual constantly abuses drugs and/ or alcohol, his or her body must make accommodations to properly function with the substance present. When a substance that one’s body has become accustomed to functioning with is absent or has less of the substance in his or her system, it will react accordingly. Adverse withdrawal symptoms will ensue, and the individual will be unable to function optimally. When an individual is unable to stop using a substance without experiencing withdrawal symptoms, he or she has reached some level of dependence. An individual that struggles with drug and/ or alcohol dependence and continues to abuse drugs and/ or alcohol increases his or her susceptibility to developing a full-blown addiction

Risk Factors

The precise reason behind why an individual develops an addiction remains unknown. There are, however, several risk factors that have been reported to increase one’s propensity for developing an addiction. According to the National Institute on Drug Abuse (NIH) these include environmental risk factors, genetics, drug of choice, method of use, and the age an individual started abusing drugs and/ or alcohol. Every individual is different and will have or lack various predispositions that can contribute to developing an addiction. Nevertheless, it is important to note that anyone can develop an addiction, regardless of social status, beliefs, or background. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment. 

Borderline Personality Disorder’s Effects on Relationships

Borderline Personality Disorder

Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic mental health disorder. It characterized by a pervasive pattern of instability in interpersonal relationships, self-image issues, and difficulty managing emotions and behaviors, which interfere with one’s ability to function in everyday life. The symptoms of BPD will often result in reckless and hasty actions, negatively affecting one’s relationships. The cause for borderline personality disorder remains unknown. However, the National Institute of Mental Health (NIH) alludes to research that “suggests that genetics, brain structure and function, and environmental, cultural, and social factors play a role, or may increase the risk for developing borderline personality disorder.” Though these factors can contribute to one’s susceptibility for developing BPD, exposure to one or more risk factors does not indicate an individual will inevitably to go on to develop borderline personality disorder. Most commonly, BPD develops in early adulthood, often with more severe symptoms occurring in the early stages of onset. 

Effects on Relationships

Borderline personality disorder directly affects how one feels about him or herself, one’s behavior as well as how an individual can relate to others. According to the DSM-5 key signs and symptoms of BPD that will have a direct effect on one’s relationships may include:  

  • Unstable personal relationships that alternate between idealization and devaluation, sometimes referred to as splitting
  • Frantic efforts to avoid real or imagined abandonment by family and friends
  • Impulsive behaviors resulting in dangerous outcomes (e.g., engaging in unsafe sex, reckless driving, abuse of drugs, etc.)
  • Distorted and unstable self-image, affecting one’s moods, relationships, goals, values, and/ or opinions
  • Self-harming behavior (e.g., suicidal threats)
  • Chronic feelings of emptiness and/ or boredom
  • Periods of intense depressed mood, irritability and/ or anxiety lasting anywhere from a few hours to a few days long
  • Dissociative feelings
  • Intense, inappropriate, and/ or uncontrollable anger, typically followed by feelings of guilt and/ or shame

People with borderline personality disorder have a more difficult time returning to an emotional baseline, which can make sustaining relationships challenging. The quick changing nature of BPD symptoms (e.g., emotional peaks and valleys) can lead to conflict-filled, chaotic relationships. Hence, people with BPD typically have rocky relationships with others, both platonic and romantic.

Treatment

Although BPD is a chronic condition, there are a variety of treatment options available for a person diagnosed with borderline personality disorder. Treatment for BPD will help an individual learn strategies, techniques, and tools to effectively manage the symptoms associated with borderline personality disorder, reducing the severity of symptoms experienced and increase one’s quality of life. Every individual is different and will require a somewhat tailored treatment plan when it comes to BPD. Often treatment plans include a combination of medication and psychotherapy (e.g., dialectical behavior therapy, cognitive behavioral therapy, etc.). Some individuals that experience severe symptoms will require inpatient, intensive care, while others may never need emergency care or hospitalization. With proper treatment an individual can have healthy relationships despite BPD. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.