Psychiatry Center in Karolinska Sjukhuset, which is running the Borderline Unit in Stockholm, writes on their website:
”Patients with borderline are often impulsive, intense and emotionally unstable. They often have a negative mental image of themselves, and their images of people in their immediate surroundings tend to alternate between black and white. Their mood is often rapidly changing, emotions tend to be intense and they are triggered very easily and the environment can have difficult to understand the borderline patient’s response patterns. Self-mutilation, suicide attempts, and comorbidity by, for example depression, eating disorders, addictions and anxiety disorders is common.
Patients with borderline personality disorder are usually impulsive and emotionally unstable people. Impulsivity and instability pervades most of the borderline patient’s inner and outer worlds. Self-image is often unstable, and people with Borderline Personality Disorder often have beliefs, meaning, deep-seated opinions about themselves, which in most cases are about that they are ”worthless” or ”impossible to love.”
Their relationships tend to be stormy, intense and chaotic, and their perceptions about others commute often between idealization and devaluation. This often gives rise to problems when they are in health care, perhaps particularly in psychiatric care. If the attending staff is not really aware of the patient’s difficulties with the integration of ”good” and ”bad” sides in the patients thoughts, the care may be troubled and difficult to handle without conflicts. Although the patient is rapidly changing moods, it can cause a lot of difficulties.
People with borderline are extremely emotionally vulnerable. Some little thing can get them completely out of balance, and often it is very difficult to understand what it is having triggered the strong emotional reaction. The emotional vulnerability, combined with impulsivity often leads to self-mutilation or even suicide attempts. People with borderline often stay in relationships because of their extremely strong fear of separation, separation anxiety. Separations are painful for most people but a person with borderline often perceive separation as a bottomless pit of despair, a feeling of total abandonment and a bottomless emptiness that seems impossible to live with, quite often involving self-mutilation and suicide attempts because of the fear to be left alone.
The mortality rate by suicide is very high. Approximately 90 percent of patients with borderline who have been treated at a psychiatric clinic have one or more serious suicide attempts. 10 percent of people with borderline die by suicide.
Patients with borderline have a very high comorbidity compared with other psychiatric disorders. The most common triggers include depression, anxiety disorders, eating disorders and addiction, in the end, leading to death. Comorbidity and suicide attempts are the most common reasons that people with borderline want to have psychiatric care. They understand that otherwise, the whole thing is going to end
Patients with borderline often describe that they have difficulty in managing to get others to understand how they feel. It may appear if they are wearing a ”mask”, which makes it difficult to understand them. For example, a deeply depressed, suicidal borderline person can on the surface seem to be almost neutral, so the therapist doesn´t even get the idea to ask about suicidal thoughts. Self-injury behaviors and suicide attempts can sometimes be triggered by the patient’s difficulties in communicating their inner pain to the world. Here we find the young girls who are cutting themselves.
”I thought I had everything I could ever wish for me,” complained Sara, ”but now I feel just emptiness. There is no longer anything I think is important.” She described the waves of boredom followed by tension, which escalated to such intensity that she just could banish it by causing the pain. So she began beating on his ankles with a mallet, just enough for it to hurt. This time, she had underestimated the power of the beat.
This is about Sara in the book Vilse i speglingar by Richard A. Moskovitz (I don´t remember the English title just now).
Dissociation and splitting are the defense mechanisms that are used by a person with borderline personality disorder, BPD. The painful memories are locked up in a corner and there they can stay. If they come out, the anxiety is coming with the memories. Some of borderline patients cut themselves, some use alcohol and drugs.
In extreme cases, the dissociation is so severe that it develops a multiple personality and the child (and later an adult) is living in the same body, as two, and possibly some more personalities, and they live there without knowing about each other’s existence.
The person with BPD doesn´t knows who she/he is. Instead, he or she feels a chronic sense of emptiness and the mood is swinging very much and all the time. Paranoia may occur as well as impulsive and suicidal behavior. It is likely, but not sure, that the person has sometimes been a victim of abuse, but this is too painful to remember. Instead, the person keeps it away by having a self-destructive behavior.
There are many varieties of this disorder, but these persons use to need medication before beginning therapy. Otherwise the therapy doesn´t work.
Sara in the book could accept her experiences and she became a functioning individual. This does not apply to everyone but not everyone with BPD is in the condition she was.
Goodbye Norma Jean
The photo from:http://www.mobieg.co.za/articles/borderline-personality-disorder/