I think I might be borderline?

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I think I might be borderline?

Post by The Wisp on Sat Mar 28, 2015 9:02 pm

So, first thing's first: I don't expect you guys to diagnose me over the internet, and yes I will bring this up with my therapist.

I recently discovered the concept of borderline personality disorder. I can relate to a lot of it:

- "Markedly disturbed sense of identity" Yep, I have often felt that I "lose" my sense of self when I interact with others, particularly in person. I often feel like I'm very easily swayed by the opinion of whomever I happen to be listening to/interacting with/reading, even if at some rational level I disagree. My sense of self fluctuates on a lot of issues.

- "Intense or uncontrollable emotional triggers" Yes! More the intense part, but still. See, sex negativity, certain strains of feminism and social justice, anything that reminds me of past awkward social situations or rejections, certain kinds of lefty politics

- "Unstable interpersonal relationships and self-esteem" Yep. The instability is more in how I view people and my relationship to them than how I act, but it's there. I go from being really angry at people, to feeling distant and uncaring towards them, to fantasizing about us being much closer and friendlier than we actually are, to feeling rejected and empty. I started making an internet friend a few years ago, met her in person, was convinced we were best friends, then realized she was uncomfortable with how much time and attention of hers I wanted, so I shut it down and pretty much ceased contacting her within a few weeks. Another example, and this has happened to me too many times to count, is I will have one little positive interaction with somebody, and then get these really intense, good-feeling fantasies about us being really close in the future and being emotionally intimate. If they're a women, sometimes these are sexual as well. But often from minor things, and then when I give myself a reality check I plummet back to Earth.

Also true for self-esteem, where I feel like I fluctuate between almost comic self-confidence (almost always when alone) to feeling really down on myself, at times fairly rapidly.

- "Concerns about abandonment" Story of my life. Even semi-awkward social situations often feel like a complete rejection of me. Also I often avoid people because I don't trust them to be caring of me.

I also get angry at other people a lot and fairly easily, though I control it more now. Often, though, I just become dissociated or apathetic to control it. I have struggled with dissociation a lot. Also, I feel really intense emotions, particularly around my interactions with other people.

Borderline is stereotyped as involving being externally erratic and intense (e.g. throwing tantrums, being super expressive), but for me I hold my emotions in a lot, often out of fear that they will become too intense and I'll lose control (which used to happen to me in social interactions in the past). I can relate a lot to what is called "quite borderline". But, I can see the external manifestations of it in my interactions on the old forum and DNL Prime when I was initially around, where I would get really angry and confrontational with people, and then at some point feel really meek and ashamed about it.

Ugh, it just fits so well. Not all of these are in the Wikipedia article, but other things I relate to that are associated with borderlines. I feel a lot of emptiness around my social interactions, I have social anxiety (which often occurs with BPD), I really really desire super ridiculously intense emotional relationships with others deep down (I fantasize about this a lot), I feel like a victim a lot, I feel really emotionally needy even if I don't act on it, I frequently feel really misunderstood and ignored, etc.

The only area I don't really relate to is the suicidal/self-harm bit, which is often done to gain attention. I will say, I've been halfway tempted by self-harm to get attention at times, but only half-way. I do occasionally hit my thigh or something to pull me out of intense emotions but that is it as far as physical harm. I have done emotional harm in the past, like almost compulsively reading websites and bloggers who triggered me and made me feel like shit.

I almost wonder why this hasn't come up with any of my therapists before? Because borderline is stereotyped as being feminine? Or because it is stereotyped as involving "acting out" frequently?

I'm bringing this up with my new-ish therapist Monday and see if it makes sense to him (I am currently seeing a new therapist through my school on an interim basis until my previous one returns from maternity leave).

Anyway, sorry for the rambling, I'm just processing a lot right now.
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Re: I think I might be borderline?

Post by jcorozza on Sat Mar 28, 2015 9:23 pm

Another central trait for BPD is black and white thinking - especially when it pertains to social situations (like, X didn't return my call, therefore X hates me and is not really my friend - rather than thinking about the option that maybe X was busy, or didn't see the missed call yet) - do you find yourself assuming something negative when things like that happen?

It's actually not unusual that, if you do have it, a therapist wouldn't have diagnosed it, because a lot of those symptoms can look like other disorders - the rapidly cycling emotions could look like bipolar or depression, as could concerns about abandonment - and some it can look like anxiety or a different personality disorder. Glad that you're going to bring it up with your therapist - make sure he/she takes it seriously, though - and if not, follow up with someone else. Even though you are not currently suicidal/self harming, roughly 70% of those diagnosed with BPD attempt suicide, so it's not something you'd want to leave untreated!
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Re: I think I might be borderline?

Post by The Wisp on Sat Mar 28, 2015 9:47 pm

jcorozza wrote:Another central trait for BPD is black and white thinking - especially when it pertains to social situations (like, X didn't return my call, therefore X hates me and is not really my friend - rather than thinking about the option that maybe X was busy, or didn't see the missed call yet) - do you find yourself assuming something negative when things like that happen?

Yes! Very much so, that's my natural impulse, and my parents for my whole life have described me as being pretty black-and-white in how I think about people. That internet friend I mentioned above that I smothered was like that. After she cancelled us meeting up at the last minute twice, I did a very quick fade and stopped talking to her and felt like the whole friendship had been a waste. Or, recently, I had a conversation with a professor after class that ended on a slightly awkward note, and my first thought was "god, that fake smile he had on is only hiding his disdain and annoyance with me, he probably wouldn't be interested in what I had to say if it wasn't his job to listen. I don't always trust those black and white thoughts anymore, but they're my first impulse and often I do still believe them at some level even if my observational mind is skeptical of them.

It's actually not unusual that, if you do have it, a therapist wouldn't have diagnosed it, because a lot of those symptoms can look like other disorders - the rapidly cycling emotions could look like bipolar or depression, as could concerns about abandonment - and some it can look like anxiety or a different personality disorder.


That's good to hear. One thing that has frustrated me in therapy (which I've been in for 8 years seeing 4 different therapists, as well as three separate support groups) is that I've never had a concrete diagnosis. The immediate cause for me to seek out therapy was social anxiety, but all the other stuff was just described as being "highly emotionally sensitive" by my therapists, and they often seemed to be throwing spaghetti at the wall and seeing what stuck (which wasn't much) with my therapy. I can see why they wouldn't make that leap, especially because typically BPD is thought of as involving outbursts and external volatility.

Glad that you're going to bring it up with your therapist - make sure he/she takes it seriously, though - and if not, follow up with someone else. Even though you are not currently suicidal/self harming, roughly 70% of those diagnosed with BPD attempt suicide, so it's not something you'd want to leave untreated!

I agree. I've never had suicidal tendencies, in fact I am very afraid of death, but that's a sobering statistic all the same (if I do have BPD). Plus, it should bring my other more immediate issues into clearer focus and hopefully help me and my therapist develop a game plan. I'm actually considering just copying my first post here and emailing it to my therapist before our meeting so he knows what's going through my mind before our meeting.

Thank you for listening jcorozza! Smile
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Re: I think I might be borderline?

Post by jcorozza on Sat Mar 28, 2015 10:05 pm

Unfortunately, mental health diagnosis is a messy business. On the other hand, I think a lot of the treatment for BPD is probably not too different for the treatment for some of those other things, so some of that 8 years has paid off - and it looks like it has helped you be more self-aware and more self-reflective, which are great tools to have in your belt. I think it's good to bring up the thoughts to your therapist, but make sure it doesn't come off as, "oh, I read about this disorder, and now I think I have it" think that psych students tend to do when they start reading anything in the DSM.

I admit, I love hearing stories from people who are being proactive about their mental health. Keep up the good work!
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Re: I think I might be borderline?

Post by The Wisp on Sat Mar 28, 2015 10:55 pm

jcorozza wrote:Unfortunately, mental health diagnosis is a messy business.  On the other hand, I think a lot of the treatment for BPD is probably not too different for the treatment for some of those other things, so some of that 8 years has paid off - and it looks like it has helped you be more self-aware and more self-reflective, which are great tools to have in your belt.  I think it's good to bring up the thoughts to your therapist, but make sure it doesn't come off as, "oh, I read about this disorder, and now I think I have it" think that psych students tend to do when they start reading anything in the DSM.

What would be a good way to bring it up? I'm having a hard time thinking of a way that doesn't sound like that.
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Re: I think I might be borderline?

Post by jcorozza on Sat Mar 28, 2015 11:08 pm

I think it depends how you've approached your problems before - have you mentioned wishing you had a more definite diagnosis? That might be a way to start the conversation? Like, you've been thinking about what you've experienced, and have looked into what some of the possibilities were? That way, it's clear that you've already noticed these things, not just that you noticed them based on the power of suggestion? It might even work to says something like, "I know when people read about a diagnosis, they start to think they have it, but..."

In general, though, the best way to offset that possibility is to be really specific about situations where you've felt/experiences these things - not just "I've felt really emotional/moody", but have examples of the times in your arsenal already so that you've thought about it seriously. (Man, there are so many areas where "show, don't tell" is useful advice!)
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Re: I think I might be borderline?

Post by The Wisp on Sat Mar 28, 2015 11:36 pm

jcorozza wrote:I think it depends how you've approached your problems before - have you mentioned wishing you had a more definite diagnosis?  That might be a way to start the conversation?  Like, you've been thinking about what you've experienced, and have looked into what some of the possibilities were?  That way, it's clear that you've already noticed these things, not just that you noticed them based on the power of suggestion?  It might even work to says something like, "I know when people read about a diagnosis, they start to think they have it, but..."  

No, I haven't mentioned it yet. I only mentioned that previous therapists didn't seem to diagnose me, but I didn't give an opinion on that.

I've only had one individual session with him so far, though he also runs the men's group I'm in which has met I think 5-6 times at this point so he does know me somewhat.

In general, though, the best way to offset that possibility is to be really specific about situations where you've felt/experiences these things - not just "I've felt really emotional/moody", but have examples of the times in your arsenal already so that you've thought about it seriously.  (Man, there are so many areas where "show, don't tell" is useful advice!)

That's very wise, thank you!
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Re: I think I might be borderline?

Post by The Wisp on Sun Mar 29, 2015 12:23 am

Sorry for the double post, but now I'm actually feeling a bit worried. I worry my therapist won't listen to me if I don't say "I think I'm borderline" because I won't be able to communicate it well. I mean, there's like a dozen different symptoms in my first post, and I feel like he might listen but not really listen. Maybe I'm worrying too much. He hasn't given any indication that he'd do that. I guess I worry about coming off as too unsure or something.
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Re: I think I might be borderline?

Post by jcorozza on Sun Mar 29, 2015 12:36 am

I realized once I said it that if someone told me that, it's something that would immediately cause me to worry about it.

I think if you can frame is as something you looked into because you were concerned about the experiences/emotions you've had, rather than something you came across by chance, that will make a difference.

Another option is to not specifically mention BPD at all, but mention what you've experienced that fits with that diagnosis, and see what he says from that. I'm curious, though, what type of therapist you have (social worker vs counselor vs psychologist) - this may affect how likely he is to think in terms of diagnosis rather than just treatment.

This may or may not be helpful, but because you're worried about being taken seriously, that worry will probably be obvious to your therapist, and that might make him more likely to believe that you are legitimately concerned/confused/etc., rather than just trying to earn some kind of therapy points for self-diagnosing. But if you make it clear how serious you are about it, and he still dismisses your problems...he is not the the best therapist for you. A good therapist will pay attention to what is worrisome for you!
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Re: I think I might be borderline?

Post by The Wisp on Sun Mar 29, 2015 12:51 am

jcorozza wrote:I realized once I said it that if someone told me that, it's something that would immediately cause me to worry about it.

I think if you can frame is as something you looked into because you were concerned about the experiences/emotions you've had, rather than something you came across by chance, that will make a difference.  

Another option is to not specifically mention BPD at all, but mention what you've experienced that fits with that diagnosis, and see what he says from that.  I'm curious, though, what type of therapist you have (social worker vs counselor vs psychologist) - this may affect how likely he is to think in terms of diagnosis rather than just treatment.  

He's a licensed professional counselor with an MA in psychology. I'm not sure to what degree he would diagnose people. It's not necessarily that I feel a great need to be diagnosed for identity reasons but rather because I feel like it may help him make connections he might not have. Maybe I will just bring up the specific emotions and experiences I've had. I suppose I don't want to come off as listing random symptoms that aren't obviously connected. Maybe I could just list the ones that deal with my relationships with others, as those are the ones that I most want to work on.

This may or may not be helpful, but because you're worried about being taken seriously, that worry will probably be obvious to your therapist, and that might make him more likely to believe that you are legitimately concerned/confused/etc., rather than just trying to earn some kind of therapy points for self-diagnosing.  But if you make it clear how serious you are about it, and he still dismisses your problems...he is not the the best therapist for you.  A good therapist will pay attention to what is worrisome for you!

I was thinking with maybe just opening the conversation with my fear that he won't listen or take me seriously. That will let him know that I want to be clear about what I'm saying. Then I can bring up my experiences of feeling really emotionally sensitive to others, feeling like I lose myself talking to them, feeling empty and unsatisfied in my interactions, feeling angry at people, and so on. Perhaps, though maybe I won't mention borderline specifically upfront, I should otherwise be very clear about my thoughts and concerns.
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Re: I think I might be borderline?

Post by jcorozza on Sun Mar 29, 2015 1:02 am

The Wisp wrote:

It's not necessarily that I feel a great need to be diagnosed for identity reasons but rather because I feel like it may help him make connections he might not have. Maybe I will just bring up the specific emotions and experiences I've had. I suppose I don't want to come off as listing random symptoms that aren't obviously connected. Maybe I could just list the ones that deal with my relationships with others, as those are the ones that I most want to work on.


Ah, okay, if that's more what you're looking for, I think you're right to go the route of "emphasize wanting to be taken seriously and focus on the feelings and experiences rather than a diagnosis" - this way even if it turns out not to be BPD, or if he's not completely sure (you may fit some of the diagnostic criteria, but not others - this is pretty common), he can still help you work on those particular issues that are of the most concern to you even if he can't pinpoint a diagnosis.
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Re: I think I might be borderline?

Post by The Wisp on Sun Mar 29, 2015 1:28 am

jcorozza wrote:
The Wisp wrote:

It's not necessarily that I feel a great need to be diagnosed for identity reasons but rather because I feel like it may help him make connections he might not have. Maybe I will just bring up the specific emotions and experiences I've had. I suppose I don't want to come off as listing random symptoms that aren't obviously connected. Maybe I could just list the ones that deal with my relationships with others, as those are the ones that I most want to work on.


Ah, okay, if that's more what you're looking for, I think you're right to go the route of "emphasize wanting to be taken seriously and focus on the feelings and experiences rather than a diagnosis" - this way even if it turns out not to be BPD, or if he's not completely sure (you may fit some of the diagnostic criteria, but not others - this is pretty common), he can still help you work on those particular issues that are of the most concern to you even if he can't pinpoint a diagnosis.  

Well, I do think that an diagnoses might be helpful for identity reasons and self-understanding, too, but helping with therapy is the primary reason I'm thinking about this. I think this is the route I will take, though. Maybe I'll bring up BPD if it makes sense in context but I won't have the intention of bringing it up.
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Re: I think I might be borderline?

Post by jcorozza on Sun Mar 29, 2015 7:32 am

It may eventually be useful for insurance purposes/medication, too, so it's something that should happen in the long run - maybe think of it as a more long term goal, and the therapy/help for your specific concerns and the more urgent, short term ones?
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Re: I think I might be borderline?

Post by The Wisp on Sun Mar 29, 2015 2:41 pm

jcorozza wrote:It may eventually be useful for insurance purposes/medication, too, so it's something that should happen in the long run - maybe think of it as a more long term goal, and the therapy/help for your specific concerns and the more urgent, short term ones?

Yeah, that sounds like a good way to look at it. Thank you for letting me talk this out with you! Smile
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Re: I think I might be borderline?

Post by jcorozza on Sun Mar 29, 2015 8:51 pm

Happy to help!
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Re: I think I might be borderline?

Post by The Wisp on Mon Mar 30, 2015 9:55 pm

So I brought up the emotional things I wanted to and he listened to me and seemed to get it. I didn't bring borderline up and I'm glad I did. I remembered that I'm only seeing him for 5 more sessions before I return to my previous therapist, so why get bogged down in diagnoses?

Anyway, he's big on acceptance and commitment therapy, which I think might be useful. He's told me to work on being embodied and relaxed just by myself

As far as the feelings of emptiness and and negative feelings around socializing and the yearning for deep connections, we talked a bit about me trying to value the mundane social interactions a little more so I had more motivation to get out and socialize.

Anyway, I'm encouraged! We'll see how this goes.
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Re: I think I might be borderline?

Post by jcorozza on Mon Mar 30, 2015 10:09 pm

Sounds good! - hopefully you have/will have a plan for after those 5 sessions!
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