Manifestations of Borderline Personality Disorder

Snowflake,  you’re not the only one.

We are not all alike. We are not the same. Just like everyone else.

::smiles:: 

When someone is initially introduced to Borderline Personality Disorder it’s easy to think that all Borderlines are the same, especially with such common stigmas surrounding the disorder. Anger, hostility, self-harm, empty, low self-esteem, lunar laser based world destructo-beam contruction, etc… they’re all thought to be commonly shared.  According to the DSM-IV and the checklist that clinicians will use to diagnose you with, it’s very easy to assume that there are a limited number of combinations and therefore a limited number of ways to view BPD. Thus resulting in a general conclusion that all BPD sufferers are the same type of people. What you don’t hear about are the differences. Every person is different and therefore has a different combination of symptoms. Even if you inevitably have the same sets of symptom as someone else (there’s only a limited set of 9 criteria listed in the DSM); how they present in you, affects you, consumes you, are probably very different from the next person. Except for the lunar laser based world destructo-bream construction part. I mean, who doesn’t want that?

I found a blog break down by another person whose life was affected by BPD. It’s not from a scientific article, it does not have any accredited backing, it was not written by a mental health professional. However, I found it an interesting assessment. It captures another perspective on how you can view various presentations of BPD.

 It’s broken down into 5 manifestations of Borderline Personality Disorder.

§  Low Functioning Borderline – The “Low Functioning” borderline is what most people think of when they are first introduced to the condition. Low functioning BPDs are a living train wreck. They have intense difficulties taking care of their basic needs, are constantly experiencing mood swings. They also have an extremely hard time managing any sort of relationship with another human being. Low Functioning BPDs are often hospitalized more than other BPD types, for the very reason that they can’t live productively without constant coaching and supervision. These patients are challenging for all but the most experienced psychiatrists. Unless otherwise treated, low functioning borderlines lead self-destructive lives and attempt to manipulate those around them with desperate acts, including self-harm (cutting, etc.).

§  High Functioning Borderline– The High Functioning Borderline Personality shares many core aspects of the low functioning borderline personality, except for the fact that they can manage their lives, appear to be productive, and generally keep their relationships civil (even diplomatic in nature). High Functioning borderlines can appear to be normal, driven people one moment; then moody, inconsolable, and manipulative the next. Somehow, there is a mechanism within the minds of High Functioning Borderlines that allows them to lead somewhat “competent” lives, despite the fact that they are in a constant battle with BPD. High functioning BPDs are no better than low functioning: it’s basically the same face wearing a different mask.

§  Extroverted Borderline– Anyone familiar with the Meyer-Briggs personality tests will understand the psychological differences between extroversion and introversion. When these characteristics are mixed with BPD, there are two different results. The Extroverted Borderline pushes all their feelings, fears, manipulation, rage, and moodiness outward to the people around them. In essence, if you are around an extroverted BPD, you feel like you’re living through their emotions while coping with your own at the same time. Further, extroverted BPDs will attempt self abusive acts in plain view of others in order to avoid abandonment or to express their rage. For example, an Extroverted BPD might cut themselves and then immediately share it with family and friends around them, hoping to gain sympathy or attention. In most cases, these types of behaviors frighten non-Borderlines, and they wonder whether or not the Extroverted BPD should be committed to a psych ward.

§  Introverted Borderline– Contrary to popular belief, “introverted” doesn’t necessarily describe someone who is a recluse (agoraphobic). Instead, introversion is characterized by experiencing life in a self-reflective, private, and at times distant manner. To others, introverts may appear shy or lacking in people skills. This might be true, however, introverts make up for their lack of social skills with rich inner lives, thoughts, and deep thinking. As a result, the introverted Borderline primarily focuses all their BPD emotions and reactions inward. Instead of having a rage episode in public, they might retreat to their rooms and cry for hours on end, perhaps even cutting themselves for their own amusement or as stress relief. Introverted Borderlines live in an odd world: on one hand, they spend most of their time in personal thought and reflection, looking to fill themselves with a viable sense of self; but on the other, they are conflicted by emptiness and the bottomless emotional pit that BPD produces. Introverted BPDs might be harder to “spot” unless you happen to know one personally, in which case you might notice occasional depressive symptoms and evidence of self harm.

§  Transparent Borderline– The Transparent Borderline is a bit of a mix between a high functioning borderline and either extroverted or introverted tendencies. In plain terms, Transparent Borderlines live double lives: on the surface, “in public”, they appear one way, but in private, amongst immediate family and friends, they appear completely different. As a result, they may or may not be high functioning due to this conflicted state of mind. Transparent Borderlines spend most of their emotional energy trying to balance the personality demands of Dr. Jekyll and Mr. Hyde, the both of which experience strong BPD emotions like anyone else with the disease. Like Introverted Borderlines, Transparent Borderlines are harder to spot, and often only confess their true disposition after a harrowing rage, major break up, or other severely traumatic event that brings all their BPD feelings to the fore.

I’ve talked about High-Functioning vs. Low-Functioning Borderlines before. This takes it just a step further.

While I was reading through these I mentally noted that I seemed to fit both High-Functioning and Introverted.  While I was younger I definitely would have fit Extroverted more, but as I’ve grown older I am much more the picture of the Introvert.  When I got to Transparent Borderline I was amused by the opening line talking of being a mix of these.

As I was mentioning yesterday about not being able to maintain my mask, this statement really caught me:  “on the surface, “in public”, they appear one way, but in private, amongst immediate family and friends, they appear completely different.” I’ve talked about unstable sense of identity before and it still rings so true for me. I do realize that I appear to be different people in different situations. To the point where people don’t feel like they know me at all. I can maintain one identity, or another, but when I try to mingle them it becomes too much for me. I don’t have the energy for it because it does feel like I’m trying to be two people at once. I need one role to play.

No one would point to me and assume I have a Borderline Personality Disorder at first glance. Not until they’ve managed to get through my wards and break down my walls. Then it becomes increasingly obvious. I’m trying something different with a new buddy of mine.  I’m letting him know, quickly, how I tend to react to certain situations. I can’t actually let down the walls and let it be seen, but I can acknowledge this and give voice to my behaviors. I’ve not stated directly that I’m BPD, but I’ve alluded to the notion that I have a PD and given obvious clues as to which it would be. I think saying “Hi, I’m Borderline, RUN!” would skew my assessment of the whole thing. Thus far it doesn’t seem to be a deterrent. This may be either his blindness in favor of my more redeeming qualities (I do have them, I swear), his wanting to jump into my pants, or a typical male trait of hearing what he wants to hear (sorry guys! I know you’re not all like this!).  

Whichever manifestation of Borderline you or a loved one falls into, it doesn’t change the fact that they’re all devastating to us and those close to us. We shouldn’t all be treated the same.

High Functioning, low functioning – Part two: High function in Borderline Personality Disorder

Getting back on track.

“High–functioning borderlines act perfectly normal most of the time. Successful, outgoing, and well-liked, they may show their other side only to people they know very well. Although these BP’s may feel the same way inside as their less-functional counterparts, they have covered it up very well-so well, in fact, that they may be strangers unto themselves. Non-BP’s involved with this type of BP need to have their perceptions and feelings confirmed. Friends and family members who don’t know the BP as well may not believe stories of rage and verbal abuse. Many non-BP’s told us that even their therapists refused to believe them when they described the BP’s out-of-control behavior. 

This description of High Functioning BPD is spot on for me. Even down to the comment about the therapist refusing to believe me when I told her about the out of control behavior of my youth. The violence and uncontrollable wrath. (Which I discuss here).

One of the biggest differences between high functioning and low functioning BPDs is the ability to recognize how much of a problem this disorder is and not allow it to overrun their lives completely. To recognize how adversely it will affect their professional and social lives if they let anyone see it. To make a conscious decision to present a different image. I see clearly how easily it can consume my life and destroy my relationships. I can foresee the results of letting go of  my control. Foresee how other people will react to how I feel and impulsively want to react; alienation and abandonment from the people I need to have around me. In understanding how this impulsive behavior can affect me, I can avoid some of these behaviors.

I’ve always refused to be controlled. By anyone, or even by my Self; me darker urges. Always fighting against letting this overrun my life. I won’t tell you this is easy. It’s a constant struggle, one that I am not able to overcome some days. Often it feels like a losing battle. But this war isn’t over and I’m doing all that I can to gain an advantage over this enemy within. I analyze myself, my behavior, how I interact with others, how I present myself. I push myself to get out of bed and live my life out loud.

When I meet new people it sometimes feels like I’m living a split personality. The witty, sociable, successful woman that knows everyone and laughs a lot. It’s not until I reluctantly let someone closer to me, that my façade begins to break down. Little by little letting them see who I really am. I guess part of me still is that sociable hostess that smiles and masquerades. It’s not a complete picture though. I hide the darker aspects of myself as long as I can. To the casual observer, I do this very well. To those rare few that are willing to break through my mask, they see how much I’m crumbling inside. Maybe not the full extent, because part of me still refuses to show such weakness to anyone, but when I am in closer contact with people that seem to care about me, it is impossible to continue to hide who I can be.

Low functioning BPDs tend to externalize their problems; unable to maintain a regard for those around them, consumed by their own emotional catastrophes, they lash out at each instance of instability; lost in the moment. While high functioning BPDs may feel the exact same emotional crisis, they tend to internalize more. Instead of lashing out in the moment, they control the impulse and wait until they are alone and take it out on themselves. Only affecting those absolutely closest to them. To the person suffering, and to those around and caring for the person suffering, one is not better than the other. Not emotionally, not mentally. For me, while I may not be able to stop the emotional melt down, I can usually recognize that, despite how it feels, my world is not actually ending. Having at least one solid relationship, one stable support makes an incredible difference as well. Knowing that there is someone I can turn to, that is willing to help me, see that there will be a tomorrow can make all the difference. Tomorrow I will pick myself up, and do what I need to do. The same as the day before, and the day before that. There is a small comfort in knowing the sun does continue to rise, and tomorrow is one more chance to keep going. Sometimes we just need a reminder.

High functioning BPs often consume their daily lives with a self imposed structure; scheduling away every hour, every minute. Proactively attempting to avoid emotional disaster. This provides an external stability that makes the internal instability a little easier to bear. While things are so frantic inside, there is a calm in knowing there is order in the world. I have done this ever since I was little. Every hour scheduled away with activities, sports, studying. At University when I was so often alone, at some of the loneliest points I’ve ever been in, I kept a ridiculous course load, maximizing the number of credits I could take, developing rigorous study schedules that consumed my day allowing little time to be left to my own thoughts. This didn’t always work. It didn’t actually fix the fact that the sadness and depression was still there, waiting to surface when I could no longer keep up my guard. But in pushing myself, providing myself with a goal, I had something to reach for. Something to motivate me to keep going.

Maybe that’s another attribute of the high functioning BP; the ability to look to the future. Having something to look forward to, to reach for and achieve… It’s hard not to feel a little proud, a little relieved in knowing that such things can still be accomplished, despite it all.