In the course of the last ten years

I've been given a plethora of diagnoses in an attempt to figure out my psychology. Obssessive-compulsive disorder, generalised anxiety, social phobia, borderline personality disorder, and bipolar II, all possible pieces of the puzzle. I guess it just comes down that I'm a little bit nuts, although high-functioning nuts, and with medication and counseling I do much better. I don't know if they've ever figured out what's really wrong with me, which diagnosis should stick, or if they're all right. But I do know one thing...

Of all of them, borderline personality is the most difficult, intractable of them all. It won't just go away with a pill, although they can help. It isn't simple brain chemistry. Some researchers suggest that along with a genetic predisposition, environment can have a lot to do with it, especially abuse in childhood or even more nebulous but certainly no more damaging, neglect of emotional needs where the child is constantly told that things are not as he or she perceives them to be and that his or her feelings are invalid.

Some people with BPD cut themselves or otherwise do self-harm, just to feel alive, because they're empty inside. A goodly proportion kill themselves, more than in the mood disorders, which I'm assuming includes depression. BPD patients tend to swing radically emotionally and have black-and-white thinking where something is all good and then all bad depending on the moment. Their relationships are very rocky. Get two of them together and it's much worse. They tend to do damaging behaviours like spend money, break laws, drink or do drugs, etc. And they're absolutely the worst patients because they tend to be needy, roller-coaster bundles of emotion who are draining and often drop out of therapy when the real work begins.

I got to thinking about all this again because of a Time article called The Mystery of Borderline Personality Disorder.

It provides an excellent overview of BPD (better than I could do here) and talks about the hope of a particular course of treatment called dialectical behaviour therapy (DBT). DBT was created by therapist Marsha Linehan. I spent a year or more in it a few years back, and I must say, whether it's BPD or bipolar disorder that I actually have, it really helped. DBT works on mindfulness (being in the moment and being aware of what you're doing so you can have better control over it) and distress tolerance as a couple of its main aims. It helps brings the emotions under control. It gives the tools needed for people who didn't get the coping mechanisms in the first place to learn how to deal with their lives better and reduce the drama. It's quite often a life saver. I would actually suggest anyone would benefit from DBT, especially children.

Of course, having been diagnosed and having gone through DBT, I knew about the subjects covered in the article, and was just admiring what a decent job they did, when they brought Linehan in the picture. She is apparently (as I believe the saying goes) 'one tough broad'. My favourite quote from the article runs like this:

If the patient says, 'I'm going to kill myself,' the therapist might reply, 'I thought you agreed not to drop out of therapy.'

I really admire that.

If you think you have BPD, read the article, and please see a professional. It can be treated. You can get your life back again. There are lots of resources and support groups online, too.