VERY imformative article on Borderline Personality

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Dr. Leland M. Heller Discusses Borderline Personality Disorder

“…Epilepsy was once thought to be a psychiatric problem, until the underlying neurological abnormalities were understood. Researchers have uncovered medical and neurological abnormalities in borderlines. Many symptoms are likely due to malfunction in the brain’s limbic system. In my opinion, the borderline personality disorder is primarily a medical problem. It can now be treated.

The Borderline Experience

Imagine you are faced with a minor stress – a flat tire, a clogged-up sink, or a trivial disagreement with your spouse, friend, lover, child, etc. Instead of finding an acceptable solution, your mind seems to panic. A sense of unease develops, possibly causing discomfort in the stomach or chest. Feelings of anxiety complicate the increasing sense of uneasiness and restlessness. This is followed by progressively worsening anger – eventually becoming a rage so strong it overwhelms you – even though you realize it’s excessive. Over the next few minutes to hours, other negative sensations creep in – including memories of past hurts – until you are experiencing virtually every bad emotion a human can feel.

You feel trapped and vulnerable. Your psychological defenses are overwhelmed by unbearable emotional pain. You feel depressed. You find yourself unable to cope as your mind and body are now in a full scale panic. You lose proper perception of reality – jumping to erroneous conclusions in a futile effort to make sense of what’s happening. As the pain continues to intensify the nervous system creates bizarre sensations such as emptiness, numbness, and unreality. You become incapable of rational thinking as the panic continues to worsen.

Your mind now desperately tries to find a way out of the pain and searches for solutions. It recalls past activities that have made you feel better. Once a method is found, your mind frantically forces you to pursue that activity to a self-destructive excess – finally resulting in a biochemical rescue. Brain chemicals are released that stop the pain and let you feel ‘normal’ again.

But how can you ever feel normal again knowing that such a horrible experience will return? How can you feel normal again when your self-destructive and inappropriate behaviors are witnessed by family, friends, employers and/or co-workers? How can you feel normal again when those behaviors result in financial, interpersonal, physical, or legal trouble?

For those not afflicted with the Borderline Disorder this is a nightmare we hope never happens to us. Borderlines experience it over and over – especially when confronted with stress. While individual borderlines may feel some symptoms differently, the horrible feelings described in the first paragraph (called ‘dysphoria’) intrude frequently into a borderline’s life.

Borderlines will do almost anything to make dysphoria go away. Most impulsiveness and self-destructiveness is an effort to relieve dysphoria. Some borderlines, especially those suffering very severely, will literally cut their bodies during dysphoria. The self-mutilation is itself painless (the cuts don’t hurt), yet it relieves the dysphoria.

Borderlines also suffer from intense, frequent and unpredictable mood swings that can cause ‘dysphoria’ even without stress. The mood swings cripple a borderline’s efforts to live a happy, successful life. Borderlines are victims of an incredibly painful illness…

Like victims of epilepsy, muscular dystrophy, and neurofibromatosis (the ‘Elephant Man’s’ disease), victims of borderline neither asked for, deserved or caused their affliction. The symptoms can be so unpleasant to those interacting with borderlines that feelings of compassion and understanding may be difficult or impossible to feel. Borderlines desperately want to be loved, but their illness makes them at times seem unlovable. They are terrified of being abandoned, yet are powerless to keep the illness from destroying relationships.

This is the borderline experience.

The Facts
…Genetic factors are important – borderline tends to run in families. The risk of developing borderline is 6 times higher when a close relative has the disorder. In studies of identical twins, researchers have discovered that many personality traits are genetically determined. There is an association between some personality characteristics and blood type (called ‘blood group antigens’).

Borderlines commonly suffer from other disorders as well. PMS, depression, hypothyroidism, vitamin B 12 deficiency, other personality disorders, anxiety, eating disorders, and substance abuse problems are the most common. Intelligence is not affected by the disorder, but the ability to organize and structure time can be severely impaired. There is no association with Schizophrenia.

…While many borderlines suffered from abuse or neglect in childhood, some developed the disorder from head injuries, epilepsy, or brain infections. Early parental loss and incest are commonly associated with borderline.

The facts indicating a medical origin are impressive: Brain wave studies are frequently abnormal. Neurological physical examinations are abnormal. Sound interpretation is impaired. Memory and vision are impaired. Glandular function may be abnormal. Sleep is abnormal. The response to some medications is bizarre. When injected intravenously, the medication procaine normally causes drowsiness, but a borderline will feel the ‘dysphoria’ described in the first paragraph. If borderline was exclusively an emotional illness, why would all these medical neurological abnormalities be present?

Borderlines likely have abnormalities with the neurotransmitter ‘serotonin’ – an incredibly important brain chemical. Serotonin problems can cause anxiety, depression, mood disorders, improper pain perception, aggressiveness, alcoholism, eating disorders and impulsivity. Excess serotonin can depress behavior.

Serotonin deficiencies can cause many problems, especially suicidal behavior. Low levels of serotonin increase the risk of self-destructive or impulsive actions during a crisis. The most violent suicides (hanging, drowning, etc.) are usually committed in patients with low serotonin metabolite (waste product) levels in the spinal fluid. In those who attempted suicide unsuccessfully, 2% will likely be dead within one year. If the serotonin metabolite level is low, that risk increases to 20%.


Due to new developments in medicine, borderlines can now be treated and often cured. The medication fluoxetine (Prozac) usually stops most of the mood swings in a few days. It is, in my opinion, as big a breakthrough for borderlines as insulin was for diabetics. Borderlines generally see themselves very profanely. I frequently tell my borderline patients ‘you’re not an *#%@*, your brain is broken.’ Once this concept is understood, the borderline patient usually feels an enormous sense of relief. They need to know they have value as a human being. Feelings of desperation and hopelessness are often replaced by optimism and motivation once Prozac stops the mood swings and the patient begins to realize that a happier, more successful life is possible.

All borderlines need psychological counseling. It’s almost impossible to live for years as a borderline and not need psychological help. While the underlying problems are probably structural within the brain, the borderline is left with a lifetime of bad experiences and inadequate skills for recovery.

No medication should be given without proper medical supervision. This is particularly true for the drugs used to treat the borderline disorder. Some medicines make the symptoms of borderline worse, especially amitryptilline (Elavil) and alprazolam (Xanax). Possibly a third of borderlines may suffer from low thyroid (hypothyroidism) – despite a normal ‘TSH’ blood test. They may need to take thyroid medication.

The antidepressant fluoxetine (Prozac), a serotonin increaser, virtually eliminates the mood swings. Feelings of anger, emptiness and boredom are often eliminated or reduced as well. Most borderlines I’ve treated consider Prozac to be a miracle. While some need the medication indefinitely, many have been able to stop it after a year without the mood swings returning. Side effects are rarely a significant problem.

Neuroleptics…have been proven effective. They are remarkably helpful for treating dysphoria and psychosis, and can be preventive when the borderline is undergoing stress. They seem to ‘put on the brakes’ when the thoughts are racing. They should only be used as needed, like using an antacid for heartburn. These medications can be effective at low doses, and must be taken with great caution.

While medications can help with some symptoms, the brain is clearly broken. After a stroke, the brain needs therapy to let the healthy areas take over for the broken ones. The same is true for recovering borderlines. I feel strongly that the brain must be retrained. Affirmations…will work, as the human brain can believe almost anything if told it enough times…

The psychology of positive thinking is very helpful. I strongly recommend massive brain re-education. Devote as much time as possible for 3-6 months reading positive self-help books and listening to motivational tapes – especially those by the motivational speaker Zig Ziglar…

Sometimes symptoms of ‘temporal lobe’ involvement (similar to epilepsy) complicate the disorder. Common symptoms include unawareness spells, feeling like things are unreal, and numbness of body parts. These symptoms are more common under stress, depression, severer dysphoria, and incest crisis. They can be treated with the epilepsy medication carbamazipine (Tegretol)…

Borderlines are VICTIMS – they did not cause their illness. They do not want their illness. They want to be treated and possibly cured. They deserve that opportunity.

The National Institute of Mental Health (NIMH) has been the single most influential source of unbiased study and information regarding the true biology behind the borderline personality disorder.

Landmark studies, such as those produced by Drs. Cowdry and Gardner in 1987 showed the effectiveness of Tegretol (carbamazepine) and neuroleptics, and the dangers of Xanax (alprazolam). This article was published in the Archives of General Psychiatry Feb 1988. A subsequent article showed that conclusions of low brain serotonin in the BPD were erroneous, low levels were associated with suicide, not the BPD.

Dr. Cowdry was the acting director of NIMH for the last few years, and will likely be involved with further research.”



Daily affirmations for contemplation

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I Bless my family with love – If I want love and acceptance from my family, then I must have love and acceptance.

Each person is part of the harmonious whole – I choose to believe that “everyone is always helpful.” Therefore, wherever I go in life, people are there to help me.

I allow others to be themselves – I do not try to heal my friends. I do my own mental work and heal myself. This is the best thing I can do for others.

– Louise L. Hay

Please share your thoughts, stories and questions below. Your interaction creates a living wisdom for us all to benefit from.

Psychology appointment

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So tomorrow I have my first psychologist appointment and im pretty scared. It’s not that I’ve never been before I have seen at least five others and its safe to say that I have never taken the process seriously. I always tell myself they don’t know what they’re talking about or they just repeat what I say back to me in their own words. If I wanted to know what I thought id talk to a mirror – wouldnt I? But this time its different i need this to work, ive tried everything else now so many different types of medications, psychiatrists and doctors. I think that this psychologist could be the missing part to the puzzle – my puzzle. I am worried that I will not turn up tomorrow or that I will go and then not tell him everything. I am not sure which parts are important what he will want to know.

At least the weather has cooled down for tomorrow because it seems to be zapping my energy. I have been trying to eat metabolism boosting and healthy foods lately – to keep my weight under control as my medication causes me to gain weight, a diet of sorts. I have been making a lot of jewellery recently too really getting into it. Made a lot of christmas presents and I make more every other day its fun somewhat calming to put all my energies/ frustrations into something constructive a type of creative expression. I have a design idea in my head right now so I will probably finish my post here for today so I can get to it (I will post some pics soon), wish me luck with my appointment!!

Ketamine : A Promising New Treatment For Depression

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Ketamine : A Promising New Treatment For Depression

Ketamine is a fast-acting liquid anesthetic used mainly by veterinarians; it’s also used in human medicine, even in children, because it doesn’t depress breathing.

It’s also an illegal club drug, known as “special K” or “vitamin K.”

The street version is usually sold in a powder form that can be snorted or mixed into drinks, or dissolved into a liquid and injected.

It acts like LSD, causing vivid hallucinations in users and a sensation of floating outside their bodies.
Researchers at Yale University have discovered that a single dose of ketamine helps the brain to form new synaptic connections between neurons and can begin to relieve depressive symptoms in a little as 40 minutes.

In contrast, Prozac and other types of antidepressants can take anywhere from two weeks to a full month before they start to demonstrate any real results, in which benefits can only be seen in about a third of patients. This new antidepressant is now being tested in Canada with promising results.

Dr. James Kennedy, director of the neuroscience research department at the Centre for Addiction and Mental Health in Toronto states that ketamine might alleviate what has been known as a “major clinical problem”. The 2 – 4 weeks that patients await relief is a critical time where devastating outcomes, such as suicide, can occur because they begin to feel more energetic but depressive symptoms remain. Not only is there hope for those with difficult to treat depression, ketamine could actually save lives.
Earlier studies involving patients with “treatment-resistant” depression have found that those given a single dose of ketamine experience rapid and significant improvement in symptoms.

In a small study published earlier this month on patients with bipolar depression, 71 per cent of participants responded to ketamine versus six per cent who responded to placebo.
In addition to being fast-acting, studies show that relief can last for 7 – 10 days, according to professor of psychiatry and neurobiology at Yale, Ronald Duman, who calls ketamine a “magic drug”.

Duman also believes that this so-called magic drug may be able to reverse the effects of stress on the brain by repairing damaged connections between neurons caused by chronic stress.

Although ketamine may not be the ideal long-term solution for treating depression, it could certainly lead to the development of similar compounds that may produce the same effect, but can be more easily administered with less potential for abuse.

“Imagine someone who is in the ER (emergency department) and is highly suicidal. It would be a way to decrease the suicidal risk” says Dr. Pierre Blier, director of mood disorders research at the Institute of Mental Health Research and Canada Research Chair in Psychopharmacology at the Royal Ottawa Mental Health Centre, who has started using ketamine on some of his patients.

‘Magic drug’ gives hope to bipolar patients – Ketamine is mainly used as an anesthetic by vets but shows promise in treating depression


Severe mental illness robbing years from lives

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This article topic really hits home the hours, days and years I have given up to Mental illness really begins to snowball over the years.


Severe mental illness robbing years from lives
Victoria Colliver, Chronicle Staff Writer

Thursday, October 21, 2010

Barbara Redfield shudders when she thinks of the last time she saw her brother. He had been treated throughout his life for paranoid schizophrenia and developed multiple forms of cancer that went undetected until his final days.

“There was this scrawny – looked like he was in his 80s – man on his deathbed with bruises up and down his arms because they had him tied to the bed because he didn’t want a catheter,” said the San Francisco woman. “It was just horrible, and he died the next day.”

Her brother, Sherwood Roberts Jr., was 53.

People diagnosed with severe mental illnesses, such as schizophrenia, major depression and bipolar disorder, die much earlier than the general population. Studies show they die as much as 25 to 30 years sooner, with an average life expectancy of about 54 years.

Research has shown that while suicides and accidents account for up to 40 percent of premature deaths, 60 percent of early mortality in people with schizophrenia, for example, is because of medical conditions such as cardiovascular, pulmonary and infectious diseases.

Most people with mental illnesses are dying for the same reasons as the rest of the population – they’re just developing illnesses at an earlier age and dying a lot sooner.

Risk isn’t whole story
Clearly, the behaviors of some mentally ill people put them at greater risk. They have higher rates of smoking, drug and alcohol abuse and unsafe sexual practices. People with these conditions also more likely to be homeless, unemployed, poor and socially isolated – all factors that would lead to poorer health.

But people diagnosed with schizophrenia, bipolar and major depressive disorders are associated with natural medical causes of death, such as cardiovascular disease, that are two to three times the rate of the general population.

“It’s easier to understand why someone on the street will die a lot sooner. But a lot of people are living with families and with really great care, and they are still at risk of dying earlier,” said Dr. Margot Kushel, associate professor of medicine at UCSF, who is based at San Francisco General Hospital and researches health issues of the homeless.

Anger hinders intervention
In the case of Redfield’s brother, he was not homeless and had family members monitoring his care when he was institutionalized. Roberts did not take illegal drugs or have a weight problem. He had a healthy diet, although he would occasionally get strange ideas about certain foods being poisonous.

But he was a large man who was prone to raging outbursts that frightened the hospital staff. Roberts kept complaining that his heart was “busted” but refused to undergo medical testing.

Redfield suspected her brother was physically ill and had talked to the staff at the site where he was living, but his paranoia and hostility made intervention difficult. “He had been complaining about physical ailments for a while,” she said of her younger brother, an athletic and popular Southern California boy until his first psychotic break at 17. “For a while, he also believed his teeth had been drilled on by dentists who came in the middle of the night. That was one of his delusions.”

Prevention key
People with serious mental illnesses also are rarely treated for physical illnesses because so many have limited access to primary care screenings or treatment. For example, 88 percent of people with schizophrenia who had high cholesterol weren’t getting treatment, according to a 2006 study published in the journal Schizophrenia Research.

Many of the mentally ill also are chronically homeless, making them more likely to adopt unhealthful behaviors – from drug use to poor nutrition – as well as increasing their chances of being victims of violent crime.

Confessions Of A Borderline Girlfriend (via Spliit: A Borderline Personality Disorder Blog)

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I think that the analysis of this popular song is very interesting and its comparison to Borderline Personality

I think this song describes me to a T. Let's take a closer at the lyrics: Hot N' Cold By Katy Perry You change your mind Like a girl changes clothes I continuously flip flop and it's so hard for me to make decisions. As I split from one extreme to the other, some options look good and then they look bad. In the end I just make some sort of impulsive decision to get it out of the way. Yeah you, … Read More

via Spliit: A Borderline Personality Disorder Blog

New Theory Links Depression To Chronic Brain Inflammation

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New Theory Links Depression To Chronic Brain Inflammation
21 Oct 2010

Chronic depression is an adaptive, reparative neurobiological process gone wrong, say two University of California, San Diego School of Medicine researchers, positing in a new theory that the debilitating mental state originates from more ancient mechanisms used by the body to deal with physical injury, such as pain, tissue repair and convalescent behavior.

In a paper published in the September online edition of Neuroscience and Biobehavioral Review, Athina Markou, PhD, professor of psychiatry, and Karen Wager-Smith, a post-doctoral researcher, integrate evidence from diverse clinical, biological and behavioral studies to create a novel theory they hope will lead to a shift in thinking about depression.

“In contrast to other biological theories of depression, we started with a slightly different question,” said Wager-Smith. “Other theories address the question: ‘What is malfunctioning in depression?’ We took a step back and asked the question: ‘What is the biology of the proper function of the depressive response?’ Once we had a theoretical model for the biology of a well-functioning depressive response, it helped make sense of all the myriad differences between depressed and non-depressed subjects that the biomedical approach has painstakingly amassed.”

According to the new theory, severe stress and adverse life events, such as losing a job or family member, prompt neurobiological processes that physically alter the brain. Neurons change shape and connections. Some die, but others sprout as the brain rewires itself. This neural remodeling employs basic wound-healing mechanisms, which means it can be painful and occasionally incapacitating, even when it’s going well.

“It’s necessary and normal so that an individual can adapt, change behavior and deal with altered circumstances,” Markou said. Real problems occur only “when these restructuring processes go into overdrive, beyond what is necessary and adaptive, and for longer periods of time than needed. Then depression becomes pathological.”

The theory extends findings made by other researchers that the neurobiological substrates of physical and emotional pain overlap. Just as the body’s repair mechanisms for physical injury can sometimes result in chronic pain and inflammation, so too can the response to psychological trauma, resulting in chronic depression.

Markou and Wager-Smith argue that existing, conflicting views about depression actually describe different aspects of the same phenomenon. Psychoanalytic and sociological theories refer to the psychological transformation that occurs during a productive depressive episode. Biomedical theories relate to the neural remodeling that underlies this psychological change. And neurodegenerative theories account for remodeling malfunctions.

“The big question, of course, is why aren’t all people affected the same way,” said Markou. “Why do some people deal effectively with stress, but others perpetuate a pathological state? This is an interesting question for future research.”

The researchers’ findings may have clinical ramifications as well. If psychological and physical pain responses share similar biological mechanisms, then analgesic agents could be useful in treating at least some symptoms of depression. Similarly, if chronic depression is proven to be a neuroinflammatory condition, then anti-inflammatory treatments should also have some antidepressant effects. Several small trials with depressed patients have already been published that support this possibility, though Markou cautioned that much more specific research and larger clinical trials are required.

Funding for this work came from a National Institutes of Health National Research Service Award and a grant from the National Institute of Mental Health.

University of California, San Diego Health Sciences

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