When to get help for mental health: borderline personality disorder

No one is perfect, so when do mental health issues become such a challenge they merit spending hundreds, if not thousands of dollars on help?

There are many days when I think I am just being over emotional, or can get by with my variety of personality disorders and fake it enough to seem normal to the outside world. Then the walls come crashing down and a tsunami of reality floods in. Life is great and yet I still feel empty, depressed, lost. This is why I’m 99% sure I have some sort of co-morbid cocktail of Borderline Personality Disorder and others. Borderline personality disorder happens to also be hardest to treat because deep down people with BPD don’t really want to be helped.

Borderline personality disorder (BPD) is a personality disorder described as a prolonged disturbance of personality function in a person (generally over the age of eighteen years, although it is also found in adolescents), characterized by depth and variability of moods.The disorder typically involves unusual levels of instability in mood; black-and-white thinking, or splitting; the disorder often manifests itself in idealization and devaluation episodes, as well as 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.

Yes, that describes me well, minus the dissociation bit. It’s quite confusing to sort out which criteria fall under the NPD (Narcissistic Personality Disorder) bucket vs BPD, and it doesn’t help that they are considered to often occur co-morbidly despite being so similar.

“Borderline and narcissistic patients both idealize and devalue others. However, there are important differences in the ways in which they do so. The borderline patient alternates between idealization and devaluation like a young child who changes best friends and whose frustration tolerance and capacity to delay gratification have not matured. Nevertheless, the borderline patient cares about the other person, even though the alternating attitudes may lead to a slow deterioration of the relationship. The narcissistic patient is more exploitative; the idealization is related to an idealized projection of an omnipotent self. It” the other person tails to manifest this delegated omnipotence for the patient’s benefit, the other is cast aside as no longer of use to the narcissistic patient, who then shifts to a new person who is expected to enhance the patient’s grandiose fantasy. The narcissistic patient’s rage is more of a contemptuous nature when manipulation of and extraction from the other are no longer possible. The borderline patient’s trigger is usually a threat to the patient’s dependency needs rather than a threat to the patient’s grandiosity. The narcissistic patient’s idealization is related to power, influence, glamour, and status that will further self-aggrandizement and carries little evidence of human caring. The narcissistic patient “borrows” a friend’s car with a feeling of entitlement and without permission, whereas the borderline patient does so from a boundary problem—that is, not distinguishing between “mine” and “not mine.”

In that sense, I definitely relate more to BPD than narcissism. I sincerely don’t think I’m the most important person in the world or deserve more than other people, or that everything should be all about me. There are definitely times when I feel threatened over being seen as not special, but this is always in relation to being able to maintain my relationships with other people. I do not understand how to be in a healthy relationship with another person (romantic, friendly, or professional) without convincing them that I am special and worth keeping around.  This is why although I fit many of the symptoms of narcissistic personality disorder, I’m pretty sure the truth is I am borderline. My parents are narcissistic in a much more typical manner. It hurts me to see this behavior. I do not want to hurt people. I just don’t know how to relate to them. And I crave deep, meaningful relationships but feel like there is no way to have these relationships, especially with “normal” people. From the outside I probably appear fairly normal, or, for those who know me better, appear narcissistic, but it’s never really about thinking I need to be the best (though my parents trained me to crave this) — it’s more about a need to fake it in order to not be thrown out of other people’s lives.

Most people with borderline personality disorder had severe trauma in their lives, and many were sexually abused. I am very grateful that I was not sexually abused as a child. But I have a feeling that my father beating me, and even more, his emotional abuse compiled with my mother’s inability to empathize really fucked me up in the head. You might say everyone has issues, everyone is messed up in the head in some way, and that’s probably true, but the severity of these issues – when they get in the way of leading a normal productive life, are when you should theoretically seek help.

The woman I reached out to for Borderline Personality Disorder therapy is $225 an hour. Should I spend $1,000 a month treating a disorder that isn’t treatable? Do I just push on and cope as I go? I’m so scared of being the person I am today and — within the next few years — becoming a wife and mother. Maybe having a child to care about and love will help, but I realize that being a mother is extremely challenging and I’m in no mental state to approach this phase of my life yet. I need help to get there. I don’t know how much money is required to fix me, or if I can be fixed. I wish I knew that answer, I hate wasting money on therapy that goes no where, especially when only I can change who I am, what I want, and resolve to a much simpler appetite for contentment in exchange for some irrational form of manic happiness.

 

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4 comments

  1. omk says:

    Dear HECC,

    Again I feel you and I are quite similar, and will be reading this article again and researching and following those links. At least be assured that you are not the only person having these issues, which I guess you know anyway.

    I like your writing! :-)

  2. Andrea @SoOverDebt says:

    I'm taking off my blogger hat and putting on my licensed therapist hat for this one. :)

    First, if you are recognizing signs of BPD, you are MILES ahead of most people with the disorder. One of the hardest parts of treatment is helping someone accept the fact that s/he has it in the first place. It can be hard to hear something like that without freaking out, but you've passed that stage.

    The only treatment that works for BPD is Dialectical Behavior Therapy. Marsha Linehan is the guru for DBT, and she has published a number of books and workbooks that can help you learn to integrate your emotions with reason, or "use your wise mind" as she calls it. There are tons of acronyms you can use to help you in interpersonal situations or to regulate emotions.

    Most of these exercises can be done independently since you're already aware of the traits and ready to deal with them. Personally, I would recommend reading up on DBT and if you still feel you need a therapist's help after that, you could see someone. But at $225 an hour, it might be worth it to see what you can accomplish on your own first. Just my two cents!
    Andrea @SoOverDebt recently posted..What My Mom Taught Me About Money

  3. hellen says:

    Great differentiation between BDP and NDP. I had a b/f who likely has both but this certainly helps sort out the differences (he seemed to genuinely care in some ways, but not so much in other ways, he was petrified of me abandoning him, but in the end he left me for "greener pastures"). Anyway, from what I read about BDP treatment some of it seems to relate to mindfulness. I've been studying mindfulness and meditation for my own issues and it helps in some very profound ways. If you haven't already you should do some research on it. It's not an easy fix by any means, but it can have a very helpful and lasting impact on your mental health.

  4. financialanarchist says:

    A series of events happened, or rather, when I realized that as I approach 30, I should no longer be doing the crazy, irresponsible things I've been doing, I started to recall some conversations I had with my therapist (who I dropped after 3 sessions, too hard). She wanted me to get tested with BPD and see a some other specialists.

    I kind of forgot about it, until I noticed how often I would find myself in the same destructive situations.

    Even as I'm aware of it, I try really hard not to do dumb things, but I still slip up.

    Perhaps I will do some reading on DBT as Andrea recommended. That, staying away from drugs, alcohol and situations where those things are abundant, and securing my financial independence (I feel like having this fast-pace, high-pressure career makes me act out even more in my non work life), will go a long way towards my search for finding inner peace, which I think should be my full-time job :P

    Check out this personal essay "I hide my mental illness" it's spot on: http://www.xojane.com/issues/front-til-you-cant-f
    financialanarchist recently posted..Slight Change to 2012 Planning and Goals

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