AAPEL

Summary of borderline personality disorder (*)
Meme page en Francais / Same page in french
Synthesis of characteristics and behaviors frequently present by people suffering from this disease
Although all have more or less problems managing emotions "emotional dysregulation", relationships and their impulsive characteristic, other behaviours such as for self-harm and suicide only present in the most affected
Information
Documentation 
It is a true and studied disease, not a myth neither a psychiatrist "fancy", nor a "garbage" diagnosis, it must thus be taken very seriously.  This disease is,frequent and affects approximately 3% of the population and would be indicated in about 10 to 14% of "mental illnesses" - The right to be sick..
- Right to diagnosis and information..
- Official definition..
- Disorder or illness ?..
- Not a myth, data..
- Lady Di..

- Phew ! Not alone ! and..
- Bullshit !..
- "Skeptical"..
- DSM-IV..

In the mental health scale, it is a serious illness lying between neurosis and psychosis ("broad" psychoanalytical definition ) - Medical article..
- Other article..
- Seriousness(TARAAPD)..
- Interviews of specialists..
- Schizophenia and bpd..
Almost 90% of the patients suffering from a Borderline disorder are also diagnosed with another personality disorder or a serious psychosis.  For example Schizotypal, histrionic,ou,dependent disorder - Personality disorders..
- Schizotypal..
- Dependent..
- Avoidant..
- Histrionic..
- Statistics..
The error of diagnosis, or rather an incomplete diagnosis seems, sadly, current, it seems by a lack of training of the psychiatrists and therapists to recent progress in this domain.  The problem is that for example prescribing only neuroleptics long term for a Borderline patient seems "almost criminal". In general that does nothing but deteriorate or mask their condition (although there are exceptions).  Undergoing "traditional" psychotherapy often ends in failure and can sometimes be more dangerous if the patient is not "ready" to deal with their past (related to their over-sensitiveness) - Other disorder ?..
- Bipolar Disorder ?..
- Depression ?..
- Dysthymia ?..
- Attention deficit ?..
- Aspergers ?..
- Generalised anxiety ?..
- Post traumatic stress ?..

- Warning signs..
- I had it "all"..
- Who to consult
- Medication..
- Therapy..
- Neuroleptics..

Borderline patients have a problem controlling their emotions, they suffer particularly from frequent, intense and unpredictable,sudden changes of mood (mood swings up and down). It’s like you’re in the back seat of the car and your emotions are driving. The impulsive,behaviors are a strong facet - Emotions..
- Emotions, why ?..

- Impulsivity, danger !..
- "Without" reason..
- Mood Swings..
- Impulses..

Borderlines are born with an innate biological tendency to react more intensely to lower levels of stress than others and to take longer to recover. They peak "higher" emotionally with less provocation and take longer to come down - Patients interviews..
The patients suffer a lot in this situation, they are fully aware of their problem (their "difference") even if they are unable to explain it and even less able to solve it, it doesn't matter if they show their suffering or not. (Someone who puts on a front to others is aware about their problems) - Life not lived..
- I'm not the only one..
- Alone in the dark crying..
- Suffering..
The patients are at a disadvantage in their relationships, unable to have"normal" human relationships. They sometimes give a misleading appearance to not feel the whole range of human emotions, in fact it would be rather than they feel too much - Compassion..
Rage, inappropriate anger or tears are common behaviors to all Borderline, throughout the scale.  The patient can suddenly change from an "angel" into a "monster" without seeming to care. - I'm bad..
- Dr Jekyll & Mr.Hyde..
- Anger..
- Tears and crying..

Their life is very often full of anxiety and sometimes even panic attacks.  Between defeat, suffering and the unknown, they sometimes choose defeat and renouncement.  They often have problems concentrating. Of course, they can "function" normally but under stress, they become exhausted
- I'm always anxious..
- Panic..
- Renouncement..
- Insomnia..
- I lose my way in all directions and I'm "functioning" with stress..
They suffer from dysphoria, period during which they are "negative", have unpleasant feelings but also a chronic sense of emptiness, loneliness but also with decompensation
These patients are able to control their emotional flow "when it is needed", in order avoid going to a psychiatric institution.
- Dysphoria stories..
- Alone in the dark, crying..
- Happy, unhappy..
- Not with everybody..

- PMS and dysphoria..
- Adolescence traits..
- Hygiene and water (data)..
- Dysphoria..
  (opposite of euphoria)
- Decompensation..

They are terrified by the idea of abandonment but are at the same time unable to prevent their disease from destroying their relationships - Lost the man I loved..
Since Borderline people are emotionaly hypersensitive, imagine what the consequences of abandonment or heartache is like for them. 
It would seem that their way of dealing with abandonment varies with different patients
- Some will be often very alone, undoubtedly because they try to avoid their emotions.  "Best" way of being never abandoned. 
- Others will create a cocoon around themselves that includes for example a spouse or their parents. 
- And others will consistently move from one partner to another in order to avoid feeling abandoned. More often than not, they will be the ones to finish the relationship.
- Facing the abandonment..
- Alone in the dark, crying..
- I protect myself..
The patient does not like him or herself and cannot trust others.  A patient declared "I Couldn't Trust Him to Love Me Enough, and I Couldn't Trust Him If He Loved Me Too Much". They have a large , love / hate ambivalence. 
They are often on the defensive and "function" reactively (they cannot read between the lines) and this leas to paranoia
- Literal meaning..
- Paranoia no responsibility.
- Between love and hate..
- Trust and confidence..
- Does she love me or not ?..
- I'd always hate myself..
- Splitting all good all bad..
Questions a Borderline might ask.  "Who am I, what's wrong with me, why am I always alone, why does nobody care (worry) about me, why does nobody understand me, why nobody love me, how could anyone love me " - Love, me ?!..
- Alone, who am I ?..
Some Borderline patients oscillate between adult,and disturbed childish behavior (dissociative?). They have black and white thinking.  X or Y is either "all good" or "all bad" and there is no in between. - Free will to the adult ?..
- Dissociative..
- Splitting B&W thinking..
The patients are often very disorganised and subsequently may make a mountain
out of a molehill. There is often the same "mess" going on in their heards as in their everyday life. 
(Some hide this fear by a "precarious" over-organisation)
- Making a mountain out of a molehill..
We don't become borderline during adulthood even if it is at this period that the symptoms can become acute.  The disease draws its roots from very early childhood when the construction of the child's personality is blocked by external factors (symptoms close to the post traumatic stress disorder which can occur at the adulthood) - Faq: how ?..
- Clinical studies..

- Post traumatic stress..

This disease is "particular" because it is also biological based with genetic predispositions.  The patients have chemical deficiencies. Memory and vision may be impaired. Epileptic attack, hear trauma, childhood abuse or simply a genetic disposition could trigger the onset of the disease - Clinical studies..
- Memory and vision..
- Epilepsy and borderline ?..
- From mother to daughter ?.
- Medication..
- Somatization..

- Epilepsy..


It's also benn shown that the patient can't recover without help. It is not just a question of will. It is not possible without medication and suitable therapy.  Support is essential, especially when it is known that suicide is also a common and significant characteristic of this disorder
- I'm afraid of medications..
- Impulsive suicide..
- Medications..
- Therapies..

- Suicide (data)..
- MariIyn monroe..


There is a cure for this illness in the sense that all the the symptoms can come out
It's worth saying this since it is not the case of all the personality disorders and even less of other psychiatric illnesses.  The treatment consists of specific drugs (e.g. antidepressants Prozac) but also an specialised therapy to restore normal functioning to the brain 
(In France only a psychiatrist has the right to prescribe drugs and to give therapy. Two people are sometimes necessary, a doctor and a therapist)
- Myths..
- Cure ?..
- Cure ? (2)..
- Suffering and delivery..

- Medication..
- Antidepressants..
- Therapies..
- Hospitalization..
- Who consult..

The adult part of  the Borderline patient appears fine but is "temporary", a façade, a role, an illusion.  Many patients and close relations think that to really communicate with the Borderline patient, it is necessary to speak to their child and not to the adult
This is not to say that they are simple-minded, they most certainly are not 
It is its disease which affects their behaviours, NOT their "nature"
- The "false" adult ?..
- Free will to the "adult"..
- Not with everyone..
It's also been shown that Borderline patients are rather intelligent people even if they often think that they are "retarded persons", "morons" despite a university degree. 
They often have a very low self-esteem (externalised or not)
On the whole, we can say that they do not like themselves
- Patient interviews..
Not "one" but "a lot of"
There is a whole range of people with BPD - From "high functioning" to "low functioning".
  • Those who are "high functioning" are able to fool everyone, to dupe people closest to them, because from the outside, nothing seems to indicate they are suffering of a disorder. They are able to have a family, children, hobbies, hold down a rewarding job, ...
  • Those who are "low functioning", at the other side of the scale are unable to control their impulses. Suicide and self-injury are common, either as dangerous behaviors or "hurt themselves to stop the suffering"
The self-destructive behaviours may be: Shoplifting, Bulimia - an eating disorder, Alcohol or Substance abuse, Drug-taking, Gambling, Domestic violence, Self-harm, Suicide, Sex addiction, road rage,... Treating "only" the behaviors is however a waste of time and effort
- Adolescence traits..
- Alarm signs..
- Degrees in the illness..
- Patients interviews..
- Impulsive suicide..

- Alcohol..
- Anorexia - bulimia..
- Domestic violence..
- Drug..
- Gambling..
- Road rage..
- Self-injury..
- Sex addiction..
- Shoplifting..
- Spending..
- Substance abuse..
- Suicide..
- Trichotillomania..

There are also two categories, each patient is more or less in one of the categories or both.  It is also possible to fluctuate between them according to the moment.
  • The "exteriorising" "acting-out" use direct anger towards others to calm their inner rage, to calm their suffering.  Even if generally after a demonstration of anger, they hate to be like this.
  • The "interiorising" also called "the quiet borderline" act in the same way but anger inwards, towards themselves. They self-inflict their angers be it psychological or physical.  The suffering of "the quiet borderline" is even more terrible and much less known about because it invisible to the people around them. 

  • The danger is when a patient who is in the habit of acting out, gradually becomes  a quiet borderline.  In this event his friends and familiy think "we can leave him in peace" because they believe "he is much better".  But the real suffering of the Borderline has not got better, but exactly the opposite
- Acting in, acting out..
- Quiet borderline..
- Alarm signs..
- Lying suits..
- I'm bad..
- Suffering..
A patient who is "High functioning" and "a quiet borderline" is able to mislead 100% of those around - Degrees of the illness..
High functioning Borderlines may rage only in front of their significant other. In fact many keep it so well hidden that Non's are not believed when they tell friends and family what is happening. Job instability may or may not be present in high functioning borderlines, but is usually found in low functioning - Warning signs..
Another common characteristic is lying and denial
The patient has a great ability to make others believe that all is ok, which may be interpreted as manipulation. No doubt, if those closest to them had actually “seen” the problem, then the borderline might not be in such a situation today.
They can use a distortion campaign.  Effectively, they try to convince people that it is not themselves who are ill, but in fact those around them. (i.e. the “non-Borderlines”).
Borderlines lie, it is one of the common characteristics, but BPD people are not pathological liars. They use lies "selectively", to protect themselves, not in order to hurt others
- Iie, data..
- I'm a lyer..
- Manipulation..
- Lies which suits everybody around..

- Not with everybody..
- Resist help and truth..
- No, he / she is happy!..
- "Bullshit"..
- I'm not Borderline !..
- Denial..
- BP Distortion campaign..

The "non's" may also lie in order to prevent them from acting-out
Of course, this  is the worst thing to do, this doesn't help them to overcome their problems nor to take care of themselves. The non's may also lie because they don't want to face up the reality of what is really going on
- "lying non's"..
- Lies to suit everyone..
- How to tell him / her ?..
The Borderline patients should not feel shame, they can talk to their friends, to their parents, their family. 
There is definitely nothing to be ashamed of in being sickAre you ashamed of having the 'flu or cancer ?  Their behaviors are largely the fruit of their disease
- Shame, mockery..
- "They are unbearable"..
- My fault ?..
- Lady Di.Marilyn..
- How to announce, to exist ?..
- 2 parents it's better..
- Gained from patient..
They should not be blamed.  They are not "bad" "malicious", "without heart", "egocentric people", they are not "bad tempered". Implying that "that they only do something when it suits them" is equally completely wrong, naive and unfair.  They require empathy and compassion. People around the Borderline are also victims of this extremely painful disease - Not blame him..
- Treat us like people..
- I'm bad..

- Compassion..
- Empathy..

The borderline patient has also a lot of qualities even if the disorder can prevent them to be expressed. I call this positive view, "emophany" ("emophane"TM) - Emophane..
It not necessary to look for reasons why and say "it's my fault" because it is pointless. What matters is support and help for the person who suffers from a borderline disorder. The most important is the treatment for the cure. When the treatment "works", the patient, the therapist and those closest to the patient will realise it is worth the effort of seeing through to the end - My fault ?..
- Medication..
- Therapies..
- Who consult..
- The Lucky borderline..
To learn more - Movies..
- Books..
- Personality scale..
- BPD Interviews..
- Close interviews..
- Specialists interviews..
Explanation page for young people..
Questions / Answers - Faq
If you want to comment, give your story, if you agree or disagree ? 
- Am I borderline ?..
- Comments, contact..
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If you think that some affirmations are false, that some important factors are missing to understand the disease, don't hesitate to contact us

AAPEL - Back to BPD Borderline page
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Warning:
All the information in this site is aimed at helping people understand a "rather particular" and puzzling kind of disease
But more especially, to support everyone affected by it, sick or not.  In any case, it is ESSENTIAL to see a therapist who specialises in this field they can confirm or give an alternative diagnosis
The name of what you’ve got doesn’t matter so much, getting the right treatment for the right patient does
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last update august 2007
Copyright AAPELTM federation - All rights reserved
Author, Alain Tortosa, psychotherapist, founder president of the Aapel
Non profit organization

borderlinepersonalitydisorder - bpd - boderline

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(*) This synthesis is the AAPEL synthesis - All what we enumerate was said by specialists or patients - Essentially a summary, a synthesis can be only reducing but that helps to understand.  Each human being is single and a borderline patient is not an exception to the rule.  It is why certain will recognize themself in certain definitions and some others in others... If you wish to give your point of view, do not hesitate to contact us
ordeline