Archives for 

bad behavior

Borderline Personality Disorder or Traumatic Stress Disorder

Borderline Personality Disorder – What if it is a traumatic stress disorder?

When most people think of Borderline Personality Disorder – they think of bad behavior.  It is someone that is very difficult to deal with, someone that you have to be on guard against, Borderline Disordersomeone who will try their best to manipulate you.
But, while that may be the outcome, just like most psychiatric disorders, it isn’t exactly their fault.

One of the problems with BPD is that since it is a “personality disorder“, there is often no recognized medical treatment.

We simply expect that the patient should self-monitor and control their behavior.  Therapy may help this, but how many of us (psychiatric patients, in general) really want to go to therapy.

Many of us have already spent hundreds of hours with a therapist – who may or may not help.  In addition, the best therapists are likely people who can “see through the bullshit” and refuse to be manipulated.  This obviously goes against the nature of someone with Borderline Personality Disorder.

In fact, the stigma is so bad that some therapists won’t even work with Borderline patients.

Co Morbid DisordersOne theory may help.  Some therapists have developed an automatic assumption that a Borderline patient is also a trauma victim.  While this co-morbid condition may not always be true, it can help some therapists feel more comfortable treating the patient.

Due to many soldiers returning from impossible battlefields in the Middle East, Post Traumatic Stress Disorder is fairly well recognized.  Remember; I am not saying that it is easily treatable, but to some extent, the stigma is less.

When therapists look at Borderline patients as truly a PTSD patient, they may be more willing to treat the disorder. And they will attempt to get to the underlying causes of abandonment, impulsive and destructive issues, loss of control and poor self-image.

While PTSD is well defined by the professional psychiatric community, a longer-term disorder currently known as complex traumatic disorder is not.  Most examples of CTSD still involve soldiers, or they may involve women who had difficult pregnancies or who were violently sexually abused, repeatedly.

However, what if you don’t fit any of those recognized categories?

There are more ways to treat traumatic stress disorders such as Cognitive Behavioral Therapy or a newer one, Dialectical Behavior TherapyDBT focuses on four major areas:

•    Regulation of emotionsPost-Traumatic Stress Disorder
•    Tolerance for distress
•    Interpersonal effectiveness
•    Mindfulness

Unlike CBT, there is no “processing” component – making it work well as an initial treatment, starting before the patient has developed coping skills.  It builds up the feeling of emotional safety so that coping skills may develop.

Differentiating between “plain” Borderline patients – and those whose behavior is brought on by traumatic experience may help to eliminate some of the stigma still associated with BPD.  It may also offer actual, more effective treatment than CBT or other approaches.

Melissa Lind

What NOT to Say to a Bipolar Person

Stupid things said to people with bipolar disorder

Bipolar Disorder has become a bit more recognized lately, most likely due to the “coming out” of celebrities with outrageous behavior.  This has been good in raising awareness about bipolarity somewhat, but it has been bad because a lot of people think they know all about it.

In addition to not completely eradicating the stigma – it is also highly annoying when someone says something mean, wrong, funny, or even just plain stupid about bipolar disorder.  If you aren’t bipolar – don’t give advice to people who are.  Here are some of the things you should not do:

Don’t try to “join in”

Soo DepressedDon’t try to tell me you “know how I feel”.  Don’t relate your stories about how you were soooo depressed when your dog died.  Don’t try to tell me about how bad your insomnia is.  Don’t try to tell me about how you seriously almost destroyed a poster once or how embarrassed you were when…. Don’t.  Unless you are bipolar, you cannot understand the depression, the agitation, the anxiety.  I can understand that you want to show concern and make me feel “normal” but don’t.

Don’t tell me I should do better

Don’t tell me I can fix this.  Don’t tell me that I brought this on myself.  Don’t tell me to try harder.  Don’t tell me that it could be worse.  Don’t tell me that only religion can make me better.  I am doing the best I can; I didn’t want this disease, and frankly, I don’t want to hear it.

Don’t minimize

Don’t tell me to “snap out of it” or “get off my ass.”  Don’t give me platitudes like “this too shall pass” or “cheer up.”  Don’t tell me Not to Bipolar People“tomorrow will be better” or “everyone has a bad day sometimes.”  My disease, my experience is as bad as it is.  You can’t make it go away by acting cheerful or sympathetic.

Don’t try to shame me into being better

Don’t tell me that I am a real downer or that I am “dragging you down.”  Don’t tell me all about my bad behavior and how being around me is so painful – like “walking on eggshells.”  Don’t tell me about life not being fun…I already know.  If you don’t like it, it would be better if you just leave.

Don’t blame every disagreement on my disease

Don’t say anything about bipolar “shit” in the middle of an argument.  Just because I am angry doesn’t mean I am off my meds.  It doesn’t mean I am crazy.  Using my illness to win an argument is just plain wrong.  I have a right to be angry sometimes, and sometimes I am.

These are just a few things you should not do.  We have a lot of rules – some of which change just like us.

Happy Day!

Melissa Lind