Borderline Personality Disorder Criteria and me

According to the DSM IV, below are the criteria for Borderline Personality Disorder (in bold). Below each criteria is how if it relates to me, if at all.

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

When I was first diagnosed, I didn't think I fit this particular criteria. After some therapy however, I realized I did. In relationships, if the other person said or did something I didn't like, no matter how small, its as if a switch would flip and I would turn into a jerk. I would ignore them or say hurtful things. My therapist pointed out that the reason for this was that I was in fact afraid of them abandoning me. By acting like this, it was a defense mechanism of sorts. I would get out of the relationship before they had a chance to, even if that wasn't even there intention.

2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

This was the big one for me. Aside from being (unhappily) married for 5 years, I haven't had a single relationship last more than a year and a half. Most would last a few months at best. Just as the criterion suggests, the idealization and devaluation was a vicious cycle. When I first meet a girl, I put her on a high and often unreasonable pedestal. After the smallest argument, I get disappointed, thinking that that they don't care for me, or are selfish, resulting in an abrupt change in attitude that often moves too far in the other direction. This cycle has repeated itself for as long as I can remember.

3. identity disturbance: markedly and persistently unstable self-image or sense of self.

This is another area which I have a problem with. I frequently feel that I have little self-worth and that my self concept depends mainly on the attitudes and behaviors of people close to me. If they seem loving and attentive, I feel good about myself. Criticisms however, cause anxiety and feelings of worthlessness. I also often feel unsure of who I really am, what values I believe in, even what career I should pursue. Other peoples opinions of me are much more important to me than my own.

4. impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

Unfortunately, I fit this as well. Most notably excessive spending, drinking, promiscuity and binge eating. This usually occurs when I feel anxious or empty inside. Afterwards I feel a temporary "high", which is gone shortly thereafter and I'm back where I started.

5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

Not so much in this area, thankfully. There was a suicide attempt the day I quit my job however. I took 8 Trileptals and 4 Lexapros. I knew it wasn't enough to kill me, but enough to send me to the hospital. My therapist described this as a "cry for help". The fact that I have 2 kids that love and depend on me is probably the biggest factor in why I am still alive at this point.

6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

Check. My emotions tend to fluctuate from good to bad for reasons that are sometimes obvious, but at other times for seemingly unknown reasons. I seem to get very upset over criticisms or dissagreements that others take in stride. This triggers waves of anxiety,sadnes,anger and at times, desperation. During these "emotional storms" I often turn to alcohol or lash out in anger or rage. I'm at the point where I can often control these, but their are still times when I can't. After these periods, its like a switch is turned and I'm fine and back to "normal".

7. chronic feelings of emptiness

I often feel empty or hollow. This sometimes leads to feeling lonely or bored. I feel dissatisfied with how things in my life are going or with the people around me. When I am in a relationship and these feelings arise, they would often lead to having affairs. This would temporarily relieve the feeling of emptiness, but without a doubt, the feeling would return, along with a feeling of guilt and shame.

8. inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

I don't get to the point where physical fights occur, but am often argumentative, quick tempered and sarcastic. The slightest exchange can result in an outburst. Sometimes in the midst of my rage, I realize that I'm overreacting, but seem unable to control the feelings that are sweeping over me.

9. transient, stress-related paranoid ideation or severe dissociative symptoms

Not so much in this area. I don't think I've ever been paranoid or had occasions when I didn't remember saying or doing something.

There you have it, BPD criteria and how it relates to me. Tomorrow, I'll discuss possible causes for this disorder.