The most common mental health conditions.

There are many different conditions that are recognized as mental illnesses. According to BPDFamily.com, the more common types include:

• Anxiety disorders: People with anxiety disorders respond to certain objects or situations with fear and dread, as well as with physical signs of anxiety or nervousness, such as a rapid heartbeat and sweating. An anxiety disorder is diagnosed if the person's response is not appropriate for the situation, if the person cannot control the response, or if the anxiety interferes with normal functioning. Anxiety disorders include generalized anxiety disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, and specific phobias.

• Mood disorders: These disorders, also called affective disorders, involve persistent feelings of sadness or periods of feeling overly happy, or fluctuations from extreme happiness to extreme sadness. The most common mood disorders are depression, mania, and bipolar disorder.

• Psychotic disorders: Psychotic disorders involve distorted awareness and thinking. Two of the most common symptoms of psychotic disorders are hallucinations -- the experience of images or sounds that are not real, such as hearing voices -- and delusions -- false beliefs that the ill person accepts as true, despite evidence to the contrary. Schizophrenia is an example of a psychotic disorder.

• Eating disorders: Eating disorders involve extreme emotions, attitudes, and behaviors involving weight and food. Anorexia nervosa, bulimia nervosa and binge eating disorder are the most common eating disorders.

• Impulse control and addiction disorders: People with impulse control disorders are unable to resist urges, or impulses, to perform acts that could be harmful to themselves or others. Pyromania (starting fires), kleptomania (stealing), and compulsive gambling are examples of impulse control disorders. Alcohol and drugs are common objects of addictions. Often, people with these disorders become so involved with the objects of their addiction that they begin to ignore responsibilities and relationships.

• Personality disorders: People with personality disorders have extreme and inflexible personality traits that are distressing to the person and/or cause problems in work, school, or social relationships. In addition, the person's patterns of thinking and behavior significantly differ from the expectations of society and are so rigid that they interfere with the person's normal functioning. Examples include antisocial personality disorder, borderline personality disorder, obsessive-compulsive personality disorder, and paranoid personality disorder.

Other, less common types of mental illnesses include:

• Adjustment disorder: Adjustment disorder occurs when a person develops emotional or behavioral symptoms in response to a stressful event or situation. The stressors may include natural disasters, such as an earthquake or tornado; events or crises, such as a car accident or the diagnosis of a major illness; or interpersonal problems, such as a divorce, death of a loved one, loss of a job, or a problem with substance abuse. Adjustment disorder usually begins within three months of the event or situation and ends within six months after the stressor stops or is eliminated.

• Dissociative disorders: People with these disorders suffer severe disturbances or changes in memory, consciousness, identity, and general awareness of themselves and their surroundings. These disorders usually are associated with overwhelming stress, which may be the result of traumatic events, accidents, or disasters that may be experienced or witnessed by the individual. Dissociative identity disorder, formerly called multiple personality disorder, or "split personality", and depersonalization disorder are examples of dissociative disorders.

• Factitious disorders: Factitious disorders are conditions in which physical and/or emotional symptoms are created in order to place the individual in the role of a patient or a person in need of help.

• Sexual and gender disorders: These include disorders that affect sexual desire, performance, and behavior. Sexual dysfunction, gender identity disorder, and the paraphilias are examples of sexual and gender disorders.

• Somatoform disorders: A person with a somatoform disorder, formerly known as psychosomatic disorder, experiences physical symptoms of an illness even though a doctor can find no medical cause for the symptoms.

• Tic disorders: People with tic disorders make sounds or display body movements that are repeated, quick, sudden, and/or uncontrollable. (Sounds that are made involuntarily are called vocal tics.) Tourette's syndrome is an example of a tic disorder.

Other diseases or conditions, including various sleep-related problems and many forms of dementia, including Alzheimer's disease, are sometimes classified as mental illnesses because they involve the brain.

Author: Skip 

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BPDFamily.com provides support, education, tools, and perspective to individuals with a loved one affected by Borderline Personality Disorder. BPFamily is a non-profit, co-op of nearly 75,000 volunteer members and alumni formed in 1998. We welcome you to join our free 24 hour on-line support community with its nearly 3 million postings and grow with us as we learn to live better lives in the shadow of this disorder. For more information or to register, please click here. www.bpdfamily.com

Do people with Borderline Personality Disorder lack of Empathy?

To show empathy is to identify with another person’s feelings.  Empathy is a sophisticated human response.

It begins with awareness of another person's feelings. It would be easier to be aware of other people's emotions if they would simply tell us how they felt. But since most people do not, we must resort to asking questions, reading between the lines, guessing, and trying to interpret non-verbal cues. Emotionally expressive people are easiest to read because their eyes and faces are constantly letting us know how they are feeling.

Once we are aware of another persons feelings, we briefly imagine ourselves in their place - feel what they feel - and then respond to them in ways that would comfort us. This requires great deal of emotional maturity.

When Do Our Empathy Skills Fail

Having empathy isn't so easy when we are in a distraught emotional state ourselves. It can be hard to give when we are needy. We have all been there at times. Showing empathy isn't so easy when the person we are trying to comfort is having an experience we can't relate to - either in terms of noticing it or it terms of how to respond to it. We have all found ourselves in this situation at times.

A Person With BPD Fails for the Same Reasons as We Do

Having empathy isn't so easy when one is in a distraught emotional state. Keep in mind that BPD sufferers are often flooded with conflicted and painful emotions. During times of dysregulation, an emotional response that is more intense than normal, Borderline Personality sufferers can be so overwhelmed with emotion that makes them, at worst, incapable fo normal functioning , and at best, internally focused, self centered and self absorbed.

Often a person with BPD doesn’t have emotional energy to spare to consider the emotions of others. 

Showing empathy isn't so easy when it's an experience we can't relate to.  People suffering from BPD have a problem with poor emotional vocabularies, meaning they find it hard to label and understand - their own feelings - let alone understand others. This inability to understand or accept their own feelings leads to feelings of confusion, shame and self hatred, one of the defining traits of a BPD sufferer. Additionally, a person suffering from Borderline Personality Disorder is often not very kind to themselves. They often comfort themselves by dysfunctional means - cutting and self injury are a good examples of dysfunctional soothing.

Even worse, if a pwBPD perceives they are being attacked or criticized by our pain and suffering, or that there is even the possibility of being attacked, their defenses may go into over drive and the attack rather than empathize.

What Can We Do?

Being hurt and defensive doesn't help.

Being the target of someones dysregulation (which can often feel irrational and unjustified) is painful. And while the natural reaction is to become defensive – this takes us further from receiving the empathy we desired or need. This is why independent support is very important to individuals in relationships with people suffering from Borderline Personality Disorder. 

BPD is a true mental disorder. A person with this disorder often can't be empathetic. We need to recognize this and find comfort elsewhere.

If we see that the person with BPD can't respond appropriately we need to just step away - let it go - find support in another way. Family, friends, and support groups are very important for those in a relationship with a person suffering from this disorder.

Do We Need to be Show Empathy for the Person with BPD?

When we try to understand others behaviors from a logical standpoint, we are judging our loved one based on how we believe they “should” perceive. This focus on “logic” leads to the conclusion that the pwBPD "should" be able to do better. Believing these “should’s” prevents us from full acceptance that our loved one is mentally ill. But, lets face it, it’s hard to comprehend how someone’s emotions can get in the way .

A recent study at Harvard Medical school using brain scanning to analyze how anger is processed, demonstrated that people who were depressed had a decrease in blood flow to critical areas of the brain, reducing their inhibitions and interfering with their ability to consider the consequences of their actions. They experienced what researchers described as a double hit, “A decrease in blood flow to these areas of the brain reduces both their ability to control impulsive acts and their feelings about the consequences of those acts, say punching someone in the mouth. There is both a lack of emotion and a lack of control. A double hit that adds up to inappropriate, even violent rage.”

Someone who suffers from BPD is constantly on the alert for any possible invalidation. Even the slightest criticism or hint of rejection hurts them and drives them into defense and attack mode. They become hyper vigilant to any possible threats (often making mountains out of molehills in the process) as a defensive measure to protect themselves.

Until we can accept this, we won't be able to adjust and make our lives and theirs less chaotic and hurtful.

Authors: Skip and United for Now 

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BPDFamily.com provides support, education, tools, and perspective to individuals with a loved one affected by Borderline Personality Disorder. BPFamily is a non-profit, co-op of nearly 75,000 volunteer members and alumni formed in 1998. We welcome you to join our free 24 hour on-line support community with its nearly 3 million postings and grow with us as we learn to live better lives in the shadow of this disorder. For more information or to register, please click here. www.bpdfamily.com

Childhood sexual abuse more than doubles the likelihood of developing psychosis

BPDFamily.com reports that a study published in the November Archives of General Psychiatry suggests that children who are sexually abused may be at twice the risk for developing schizophrenia and other psychotic disorders.

In this study, Margaret C. Cutajar of Monash University, Victoria, Australia, and colleagues linked data from police and medical examinations of sexual abuse cases to a statewide register of psychiatric cases.  They compared the rates of psychiatric disorders among 2,759 individuals who had been sexually abused when younger than age 16 to 4,938 random individuals. Over a 30-year period, individuals who had experienced childhood sexual abuse had more the twice the incidence of psychosis (2.8 percent vs. 1.4 percent) and schizophrenia disorders (1.9 percent vs. 0.7 percent).

This is consistent with prior studies studies that have established that abused children are more likely to develop depression, anxiety, substance abuse, borderline personality disorder, post-traumatic stress disorder and suicidal behavior, according to background information in the article.  This study found that a history of sexual abuse with penetration especially increased the risk.

Participants experienced abuse at an average age of 10.2, and 1,732 (63 percent) of cases involved penetration of a bodily orifice by a penis, finger or other object. Those exposed to this type of abuse had higher rates of psychosis (3.4 percent) and schizophrenia (2.4 percent).

“The risks of subsequently developing a schizophrenic syndrome were greatest in victims subjected to penetrative abuse in the peripubertal and postpubertal years from 12 to 16 years and among those abused by more than one perpetrator,” the authors write.

“Children raped in early adolescence by more than one perpetrator had a risk of developing psychotic syndromes 15 times greater than for the general population.”

The results establish childhood sexual abuse as a risk factor for psychotic illness, but do not necessarily translate into abuse causing or increasing the risk of developing such a disease, the authors note.  “The possibility of a link between childhood sexual abuse and later psychotic disorders, however, remains unresolved despite the claims of some that a causal link has been established to schizophrenia,” the authors write.

Many cases of childhood sexual abuse never come to light, and the overall population of abused children may be significantly different from those whose abuse is detected by officials.

“Establishing that severe childhood sexual abuse is a risk factor for schizophrenia does have important clinical implications irrespective of questions of causality and irrespective of whether those whose abuse is revealed are typical,” the authors conclude.

“Children who come to attention following childhood sexual abuse involving penetration, particularly in the peripubertal and postpubertal period, should receive ongoing clinical and social support in the knowledge that they are at greater risk of developing a psychotic illness.”

“Such treatment in our opinion should focus on improving their current functioning and adaptation to the demands of the transition from adolescent to adult roles rather than primarily on the abuse experience itself.

“Such an approach should benefit all victims, irrespective of whether they have the potential to develop a psychotic illness.”

The study is found in the November issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

Schizophrenia and Other Psychotic Disorders in a Cohort of Sexually Abused Children
Margaret C. Cutajar, DPsych, MAPS; Paul E. Mullen, DSc, FRANZCP, FRCPsych; James R. P. Ogloff, PhD; Stuart D. Thomas, PhD; David L. Wells, MA, FACLM; Josie Spataro, PhD, MAPS  Arch Gen Psychiatry. 2010;67(11):1114-1119.

Author: Skip 

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BPDFamily.com provides support, education, tools, and perspective to individuals with a loved one affected by Borderline Personality Disorder. BPFamily is a non-profit, co-op of nearly 75,000 volunteer members and alumni formed in 1998. We welcome you to join our free 24 hour on-line support community with its nearly 3 million postings and grow with us as we learn to live better lives in the shadow of this disorder. For more information or to register, please click here. www.bpdfamily.com

Extinction Bursts - Important to Understand when your Partner has BPD.

We all know that life is a journey and that it’s important to have focus and objectives. This can become difficult if the person "traveling" with us has Borderline Personality Disorder (BPD).  Because of the associated impulsiveness, hypersensitivity, and dysfunctional coping, people with this disorder often "wander off the path". And we often feel compelled to chase after and cater to them, which, in turn, diverts our focus and often results in anxiety, abuse, and dysfunction for everyone.

According to BPDFamily.com, extinguishing this pattern isn’t easy, yet it is an essential first step in having a healthy relationship.  Taking care of ourselves may feel like a selfish focus - but as the emotionally healthier one, it’s important  that we not get bogged down in BPD induced dramas.  And it's important that we understand that our BPD loved ones aren’t mentally fit to be leading the relationship.

So what do we do?   When the person with Borderline Personality Disorder becomes dysregulated or depressed. BPDFamily.com recommends that you give them the space to self sooth - not try to do it for them.  Take a deep breath and politely and non-aggressively disengage. It’s not easy to block out the distraction and emotional pleas for our attention, yet it is only with a critical pause that we can really stay on a constructive and healthy pathway.

This act is called extinction. We essentially remove our reinforcement in an attempt to stop the  behavior. We simply stop rewarding the behavior.

When our partner doesn’t get the expected response (reinforcement by us) it may scare or anger them and they may try harder to  engage us using threats, violence, destruction, intimidation, name calling, belittling, promises of withholding necessary things, retaliation, or any other painful thing they can think of to get us to engage.   This escalation is know as an extinction burst.

Extinction Burst - The term extinction burst describes the phenomena of behavior temporarily getting worse, not better, when the reinforcement stops. Spontaneous Recovery - Behavior affected by extinction is apt to recur in the future when the trigger is presented again. This is known as spontaneous recovery or the transient increase in behavior. Be aware of this eventuality. It is a part of the extinction process. Don't be discouraged.

This is OK, as long as we anticipate it, understand it, and are prepared for it.  The same is true for spontaneous recovery.


They won’t like this, but it is a necessary for them to experience and to learn to self sooth their own frustrations in life.  It is what will bring on the opportunity for change.   When we do it, we block this opportunity for change and we subvert our own emotional health.

We can not allow others to lead us astray on our journey. In time, if we stay committed to our path our partners will adjust.  And we won’t be subjecting ourselves to as much pain.  

Authors: United for Now, Skip 

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BPDFamily.com provides support, education, tools, and perspective to individuals with a loved one affected by Borderline Personality Disorder. BPFamily is a non-profit, co-op of nearly 75,000 volunteer members and alumni formed in 1998. We welcome you to join our free 24 hour on-line support community with its nearly 3 million postings and grow with us as we learn to live better lives in the shadow of this disorder. For more information or to register, please click here. www.bpdfamily.com

Borderline Personality Disorder Prevalence 5.9%

BPDFamily.com reports that Borderline Personality Disorder is three times more prevalent than previously thought and is possibly the most common of the personality disorders.

A recent study by the National Institute of Health projects that BPD affects more individuals and their families than previously believed. See member discussion here:

A sample of findings:

• the prevalence of the disorder is 5.9%;
• that prevalence in men is the same as women;
• BPD was more prevalent among Native American men, younger and separated/divorced
  /widowed adults, and lower income and education;
• BPD was less prevalent among Hispanic men and women, and Asian women;
• BPD prevalence was greatest among people with bipolar disorder (50%), panic disorder, or drug dependence. Smokers were also more likely to have BPD'
• 24% had comorbidity with another personality disorder. The rates of NPD/BPD and ASPD/BPD were higher among women;
• lower incidence was seen in adults over 44 years of age.

There are many family members who are hurt by their loved one’s disorder. A person who suffers from a personality disorder can often be rigid and exhibits heightened emotions and responses, leaving them highly distressed in their life. This ultimately affects most of the relationships closest to them. BPDFamily.com estimates that 18 million individuals are struggling in their relationships with their husbands and wives, romantic partners present and past, friends, coworkers, their parents, siblings, children, in-laws, etc.

Are you in love with someone with borderline personality disorder? Do you think your mother, child, friend, neighbor or coworker has BPD? Can we help you to untangle the mysteries, dissolve the chaos and reclaim your life? Please leave a comment if any of this sounds like a situation that you are or have been in you may want to visit the BPDfamily support group.

Authors: DreamGirl, Skip 

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BPDFamily.com provides support, education, tools, and perspective to individuals with a loved one affected by Borderline Personality Disorder. BPFamily is a non-profit, co-op of nearly 75,000 volunteer members and alumni formed in 1998. We welcome you to join our free 24 hour on-line support community with its nearly 3 million postings and grow with us as we learn to live better lives in the shadow of this disorder. For more information or to register, please click here. www.bpdfamily.com

Can it be Borderline Personality if There is No Cutting or Substance Abuse?

Borderline Personality Disorder (BPD) is widely associated with self harming, suicidal ideation, substance abuse, and difficulty holding employment or staying in school. However there are many people with clinical BPD or BPD traits that are not self destructive and are very productive in school and the workplace. The later are often missed by family or physicians as having BPD traits - but are seen as difficult or "characterless" people. When this happens, the family and clinical responses can exacerbate the problems rather than help.

To support a difficult loved one and to make appropriate family decisions it is important to understand what is affecting your family member - are they mentally ill or are they just troubled? BPDFamily.com is a support group for family and friends to explore issues like this.

20 percent of all psychiatric inpatients have BPD, as do 10 percent of all mental health outpatients according to the American Psychiatric Association.  Their characteristics of low functioning borderlines include:

1. They acknowledge they have some behavior problems (not necessarily BPD, however)

2. They cope with pain through self-destructive behavior, such as self-injury and actions that put them in harm’s way. The term for this is “acting in”

3. They (often desperately) seek help from the mental health system. Some are hospitalized for their own safety. They may often become very attached to their professional caregivers

4. They have a difficult time with daily functioning and may even be disabled. This is called “low functioning”

5. If they have overlapping (“comorbid) other disorders, they tend to be the kind that require intensive professional treatment, such as Bipolar, Clinical Depression, or an Eating Disorder

6. Family members’ greatest challenges are keeping their loved one alive and functioning. Other concerns might be their inability to, earn their own living and adequately parent their child.

In a discussion on BPDFamily.com, Randi Kreger, co-author of Stop Walking on Eggshells, says the situation with high functioning borderlines will look more like this:

"1. Denial is their primary characteristic. They disavow having any problems and see no need to change. Relationship difficulties, they say, are everyone else’s fault. If family members suggests they may have BPD, they almost always accuse the other person of having it instead. (This is why I strongly advise non-BPs to leave this disclosure to a trained professional)

2. They cope with their pain by raging outward, blaming and accusing family members for real or imagined problems (“acting out”)

3. They refuse to seek help from the mental health system unless someone threatens to end the relationship. If they do go, they usually don’t intend to work on their own issues. In couples therapy, their goal is often to convince the therapist that they are being victimized

4. They may hide their low self-esteem behind a brash, confident pose that hides their inner turmoil. They usually function quite well at work and only display aggressive behavior toward those close to them (high functioning). But the black hole in the gut and their intense self-loathing are still there. It’s just buried deeper

5. If they also have other mental disorders, they’re ones that also allow for high functioning such as Narcissistic Personality Disorder (NPD) or Antisocial Personality Disorder (APD). (These mostly appear concurrently in men—especially APD)

6. Family members’ greatest challenges include coping with verbal abuse, protecting children, trying to get their family member to seel treatment, and maintaining their self-esteem and sense of reality. Partners, especially, are in relationships with Cluster Two BPs. "

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BPDFamily.com provides support, education, tools, and perspective to individuals with a loved one affected by Borderline Personality Disorder. BPFamily is a non-profit, co-op of nearly 75,000 volunteer members and alumni formed in 1998. We welcome you to join our free 24 hour on-line support community with its nearly 3 million postings and grow with us as we learn to live better lives in the shadow of this disorder. For more information or to register, please click here. www.bpdfamily.com