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.
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High Functioning, Low Functioning: Part 1 – Low Function in Borderline Personality Disorder

High functioning vs. Low functioning. These dividers can be applied to most any mood or personality disorder. What this means is that people with BPD vary a great deal in how they function in their every day lives. From the ability to live a normal lifestyle, maintain a steady job, cope with mundane trials of the day to day, relate and interact with the people around them, etc.

“People who are close to low functioning BP’s often find themselves living from crisis to crisis. They often feel manipulated by self-mutilation and suicide attempts. However, because the BP is obviously ill, non-BP’s continue to offer their support. Some BP’s are so incapacitated by their illness that they are unable to work. They may spend a great deal of time in the hospital because of self-mutilation, severe eating disorders, substance abuse, or suicide attempts. BPD makes it very hard for them to form relationships, so they may have a weak support system. They may be so incapable of dealing with money that they have no cash for food or a place to live.”

My best friends in college really made me see just how pervasive BPD was in my life. Our lives were so parallel, so exactly the same. When her mood would shift, my mood would have shifted in the same way (even before we had talked to each other and knew how the other felt). When I was up, she was up. It was actually pretty creepy how synced our lives were. She was the first person I ever met that truly understood how my brain worked. How we fuctioned was our one difference. Where she was low functioning, I was very clearly high functioning.

She mostly managed to do the essential things. But more often than not, if she was down, she couldn’t get out of bed. She’d lie there for days trapped in her depression, lost to the world. Everything dragging and painful. Her relationships were traumatic and charged with furious fights and tears. She’d get drunk, drive to a secluded spot and cut her arms, waiting for her girlfriend to find her. Continuing the fight. Not wanting to be with her, but being afraid to lose her at the same time. Every relationship was marked by the last encounter. She would count the days until the next explosion and measure the value of her relationships by how long the ‘good periods’ lasted. Which, inevitably, weren’t very long. Her home life was a mess of turbulence, pushing away even her family who she believed couldn’t accept her and wouldn’t support her in seeking the help she needed. Her emotions were written all over her face. There was no hiding how she felt. No hiding from how she functioned. Her anxiety made it impossible for her to face the world. Every action that someone did, everything someone said could have a dozen different meanings, all of them bad and meant to injure her. Of course, this wasn’t generally true, but it’s what it felt like for her. This made her push people away, refuse to allow closer bonds to form, or if they did she’d pick them apart looking for weak links that could be used against her.

In time though, she realized she couldn’t keep living like this. She has since started therapy and is on anti-anxiety medication. She is engaged and is successfully completing University. It took dedication on her part, but she’s slowly pulling herself up.

Of course, there’s a lot of room in between high-functioning and low functioning BP’s.