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BPD Symptoms and Features

kellyann-graceful-warrior

I received anonymous message asking what BPD is and what the symptoms and features are in it (Borderline Personality Disorder/Emotional Regulation Disorder).
I decided to make a post instead as this is very important for awareness and education on the topic.

BPD has been known to be an extremely complex, debilitating, condition overall. For short, BPD is a chronic mental disorder caused by emotional hypersensitivity + dysregulation.
It is characterized by this emotional hypersensitivity plus an impaired ability to regulate the extremities, resulting in instability of behaviors, relationships, and the self/identity.
This means the emotions fire off and react easily, longer, rapidly, and with more intensity (hypersensitivity). The reactions thus do not regulate out, or balance out very well, so to speak.
As it is a chronic disorder, it is “life-long,” and cannot be cured, though symptomology may be managed through treatment.

Personality describes the enduring, characteristic ways of individual people across life and situations: behavior, emotions, thought patterns (cognition), and perception. It is the basis of one’s typical, standard self.
Having a personality disorder means it affects those base areas of one’s every day life and disrupts the typical interacting and functioning of an individual, rather than in discrete mood episodes like most people know about in depressive disorders and bipolar disorders.

To further understand the hypersensitivity and dysregulation, some factors that contribute to the development of this disorder consist of:
-A result of an overactive sympathetic nervous system, easily triggered by panic, anger, anxiety, etc. (the fight or flight system)
-An under-active parasympathetic nervous system (The system that is responsible to regulate the fight or flight system)
-Less active and smaller in volume abnormalities in the limbic system, which has functions linked to: emotional reactions, memory, decision making, motivation, behavior, learning and developmental ability, thought pattern, instincts, psychotic symptoms, seizures, and senses/the way the body perceives external stimuli.
-Reduced volume in frontal lobe which has functions linked to: decision making, communication responses, ability to comprehend consequences, emotional-based memories and triggers, and relations to people, events and situations.
-Abnormal blood flow to parts of the brain that control emotions, resulting in one to be more reactive
-Emotional reactions shown to fire off 20% longer compared to those without it
-And other factors (it is highly genetic, has chemical/transmitter abnormalities, and can be reinforced through trauma/environmental circumstances, for example).

The reactions typically occur as a reaction to an outside cause and stimulant.  
As the reactions fire off easily, longer, rapidly, and with more intensity, this leads to a series of symptoms, described as: Depression instead of sadness, humiliation instead of embarrassment, rage instead of anger, euphoric reactions instead of excitement/happiness.
The baseline of the emotions of someone with BPD is at a higher level.
For example, if we look at this as a literal baseline: if people without it react at an emotional baseline of 20-30, the person with BPD would continuously be at 80, as well as take longer to reach a stable emotional baseline when it shoots up from reactions.

Particularly, a guideline of main symptom criteria includes:

1. Persistent depressive symptoms: dysphoria, hopelessness, chronic feelings of emptiness, frequent feelings of being miserable and down, pervasive shame, feelings of inferiority, and extreme difficulty recovering from such symptoms

2. Anxiety based symptoms: Tenseness, panic, anxiety, and nervousness, persistent worries, apprehensions, feelings of “falling a part or losing control”

3. Anger/rage symptoms: Extreme rage and discomfort in response to ‘minor’ slights/remarks,situations, or events, unbearable discomfort and irritation, and aggression

4. Identity and sense of self based symptoms: Dysphoria (Dissatisfaction, uselessness, and worthlessness of the self), unstable and radical behavior and/or appearance changes, despising oneself, excessive self-criticism, fluctuating between and a lack of direction with goals, values, morals, opinions, aspirations, and choices.

5. Real or perceived abandonment, rejection, and criticism based symptoms: Extreme reactions to such, including a lack/loss of autonomy, dependency, intense grief, humiliation, perceptions of extreme negative bias, distorted cognitive empathy, and/or other reactions (anger, depression, panic, etc)

6. Impulsive and/or reckless based symptoms: (Impulsive) sense of urgency to engage in impulsiveness, extreme intrusive thoughts and urges for a relief of emotional turmoil, acting on the moment in response to a reaction and stimuli, acting without plan or consideration, difficulty establishing/following plans, and so on. AND/OR (Reckless) a lack of care for well-being, denial of one’s limits, danger, and outcomes, and engagement in reckless behaviors such as substance abuse, reckless driving, spending, sex, etc..

7. Thought pattern based symptoms: Splitting and idealization/devaluation (x)

8. Suicidal ideations (gestures, preoccupied and extensive thoughts, role playing, planning) and self-harm (cutting, burning, bone breaking, bruising, etc)

9. People with BPD may often experience transient reactions of paranoia and dissociation and/or of psychotic symptoms (meaning symptoms that lack reality): hallucinations, delusions, body dysmorphic figures, and so on, in response to an intense emotional reaction.

10.
Emotional hypersensitivity/reactivity: (As partly mentioned) they frequently and typically occur as a reaction to an outside stimulant. Reactions that are quick happening, easily aroused, intense, and can last minutes, hours, or even extreme seconds, and sometimes days. Other times, symptoms can remain more persistent (e.g. depressivity).

Because of the complexity and various symptom reactions affecting “all” the ranges of emotions, it is often described as “on the borderline” of multiple other mental disorders and symptoms (depression, anxiety, dissociative, etc). This is where it got its name. It ranged from psychotic to neurotic.

With this said, there are various other symptoms and features to recognize this very complex, and unfortunately, highly stigmatized and misunderstood disorder.
Here are a few indicated in research.
(Please note:
One with the disorder may display some or most of these, but no symptom is guaranteed; Each person with the disorder is an individual. Don’t use these as assumptions. Some may not have the same symptoms as others.
They are rather a guideline and have been shown through research to mental health workers and are recognized in certain ways in the disorder.
ALSO NOTE- Others without BPD can obviously display/relate to some of this from time to time, as everyone can have trouble sleeping, be impulsive, and so on. For another example, while everyone is going to dislike abandonment, symptoms of bpd revolve around the mentioned intense grief stages, reactions to minor incidents (brief separation) distorted empathy perceptions, and such. Please note it’s completely different than that. The cause of the symptoms, severity, and pattern is different. This is a chronic disorder that disrupts one’s everyday functioning. I simply don’t want this to be confused. This post is just for awareness/education purposes since not many know about it, how to deal, and what to expect. Also note that this is not a checklist. This is condition awareness).

Percentages show that 1-2% of the population has BPD. To get a better picture, that makes it about as common as red hair. Of this percentage, 8 out of 10 of these individuals attempt suicide, while 1 out of 10 complete it. Stigma and assumptions don’t help this issue, but awareness does. 

11. Distorted/irregular eating patterns- (e.g. reduced food intake, impoverished diet)

12. Sleep deprivation or irregular sleeping patterns (too little, too much)

13. “Acting out”- addressing and expressing emotions by extreme and intense actions and behaviors, rather than words

14. A lack of object consistency (inability to recall that people or objects are ‘still there,’ consistent, and reliable when they are not currently being seen, plus difficulty maintaining these feelings) (A cause of the abandonment symptoms).

15. Attachment to people, places, or certain objects

16. Baiting

17. Unstable relationships

18. Maladaptive day dreaming 

19. Extreme reactivity to surroundings: curiosity, enthusiasm, passion, and interest

20. Reactive voice/tone changing

21. Nociception (pain tolerance) differences: Studies show alterations in acute pain processing in over 50% of those with BPD, showing they have a higher tolerance for such. The cause of this comes from different systematic responses and may be a result of long-term self harm behavior in some cases. On the other hand, they may have a lower tolerance for chronic pains.

22. Obsessive compulsive spectrum features-(e.g. perfectionism, intrusive thoughts)

23. With proper balance, self discipline/work orientation as a result of repetitive features have been observed in BPD individuals

24. Promiscuity

25. Mimicking/mirroring

26. Flashbacks

27.
Nightmares  

28. Difficulty processing and taking in information

29. Difficulty focusing, concentrating, and a poor attention span

30. Very high numbers of people with BPD have been shown to have various other physical conditions and difficulties, which are specifically: high blood pressure, diabetes, chronic migraines, back pain, stomach aches, arthritis, and fibromyalgia.

31. BPD rarely stands alone when it comes to having other mental disorders. At least 85% of people with BPD have a second mental disorder.

32. Feelings of fear, negativity, or rejection of authority or important figures

33. Alluring/seductive behavior

34. Extreme need for acceptance and reassurance

35. A need to prove themselves over and over, as identity may be graded on a scale of what was done that very day (with no consideration and thought of what was done in the past)

36. Extreme apathy, boredom, dullness, and indifference

37. Flat affect: lack of emotional reactivity, an inability to express/show emotions verbally and non-verbally, absence of emotional response, and restriction of expressions. Typically very extreme and differs from being depressed and apathetic.

38. Creativity/creative thinking

39. Persistently perceiving neutrality as anger in others’ expressions, and reacting to such, is a unique feature that was found in research among BPD individuals, as opposed to those without. This includes reactions to real/perceived negative meaning in words.

40. Isolating oneself

41. Defensive and protective reactions

42. Magical thinking (e.g. assumed causalities between events and actions: certain correlations and interconnections)

43. Illusions: the brain’s misinterpretation of a real sensory stimulus, perceiving and interpreting the sense to be different or distorted than what it really is
(whereas, hallucinations are a sensory (seeing, hearing, tasting, smelling, etc) perception that aren’t there at all)

44. Hypersensitivity to caffeine, alcohol, some sugars and foods. Can trigger reactivity and symptomology

45. Memory lapses and distortions: from dissociation, trauma, or intense emotional reactions distorting the perception

46. Extreme avoidance or escape-coping

47. Euphoric reactions

48. Detachment

49.
Avoidance of eye contact and other non-verbal struggles

50. Difficulty transitioning to life circumstances, such as changes to plans, environments/surroundings, arrangements, relationships, work, and school. Typically has a more difficult time in even a mildly unstructured environment,.

51. Difficulty with awareness and surroundings

52. Sensitivity, anxiety, irritability to intense sensory perceptions (lights, sounds)

53. Resistance and reluctance to: change, decisions, and intense reactions

54. Difficulty completing tasks

55. “Rapid” or excessive speech 

56. Restlessness and difficulty relaxing

57. Extreme sense of security, comfort, and connection with animals/nature and inanimate objects, such as transitional objects

58. Undermining a goal, success, or relationship (quitting a good job right after a promotion, dropping out of school right before graduation, just to name a few examples for a better idea)

59. Often occurs with PMDD (Premenstrual dysphoric disorder) or worse reactions to menstrual cycles because of the hypersensitive and systematic changes

60. Sarcasm (Yes, this is actually in the DSM)

61. Flight of ideas, racing thoughts, or rapid thought patterns

62. Brief remission of symptoms in response to certain events (positive reactions, obtaining what is perceived to be a return in care and nurturance from a friend, parent, partner, or caregiver, just for two examples)

63. Disrupted or delayed education, relationships, and jobs

No particular order. If you may need a source, example, description/explanation for more understanding for any of these, feel free to ask :)
*Final edit: 2/26/16

So

I’m not allowed to walk away from relationships and people that make me feel horrible, that I tried my best for, that I gave multiple chances to, that made me feel alone and gave me massive anxiety.
I’m supposed to feel guilty. Yeah right, fuck you.