In Brief
- Borderline personality disorder (BPD), a disorder characterized by pervasive instability in mood, relationships and behavior, is more common among Americans than either bipolar disorder or schizophrenia.
- BPD patients are not deliberate attention seekers. Instead recent studies reveal that their behavior stems from an unusual sensitivity to subtle facial expressions and extreme difficulty controlling their emotions.
- Psychotherapy for BPD is now enabling patients to overcome an illness that has long been viewed as a life sentence.
Four years ago Amanda Wang, then 27 years old, was at a rehearsal dinner for a close friend. At the start of the evening, she felt content, eager to enjoy the wedding festivities. But shortly after she sat down to dinner, she was struck by “a tidal wave” of negative emotions. Her mind began to race with disturbing thoughts about her own marriage, which was unstable, and feelings of self-loathing. Suddenly, Wang says, it was as if someone had draped a heavy cloth over her, suffocating her and cutting her off from the conversation. Overcome by anxiety and dread, she excused herself from the dinner table and escaped to the bathroom. Desperate to dull her feelings, she removed her belt, tied it around her neck and pulled it tight to stop herself from breathing. She performed this act several times, until the pain offered her some relief from her emotions. After about 10 minutes, she returned to the table, feeling much better.
At the time, Wang felt she was the only person in the world who battled such extreme mood swings—being content one moment and nearly suicidal the next—and who harmed herself to cope with them. “Self-harm was one of the things that I did to myself to stop feeling crazy, to stop all the arguments in my head, the edginess and anxiety,” she says.
This article was originally published with the title When Passion Is the Enemy.
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21 Comments
Add CommentThis sounds like me. Fluoxetine has given me some (a lot) of stability, but sometimes it doesn't work that well. I would feel fine, walk down the hall to the bedroom and feel just as if an animal had jumped on my back. It was awful and my wife would say that a different person had walked back into the room. I did not try self harm per se, but did try suicide and would go without food for two or three days. I'd like to know more.
Reply | Report Abuse | Link to thisI doubt this 'extreme' case is as common as the article suggests. What is common is though, is over-emotionalism and not just in Americans, and we will remain this way for as long as we 'choose' to remain uneducated about their origin. Emotions originate from the deeper instinctual habit passions we share with all animals. But unlike their brain our visual cortex can activate these instinctual neurotransmitters for imagined nonsensical, non-actual reasons. As long as our 'early' education systems refuse to examine the nature of the instinctual animal passions inherent in us and for as long as our cultures keep sanctifying every surface expressions of them (emotions) good or bad, humanity will remain a moody suffering species.
Reply | Report Abuse | Link to thisIf you're looking for more info about BPD, you can go to my website, www.BPDCentral.com. I focus on info for family members. There is also www.BPDDemystified.com and www.NEABPD.org.
Reply | Report Abuse | Link to thisI wonder if you have read the article and examined the evidence. How do you account for the brain scans if the disorder doesn't exist?
Reply | Report Abuse | Link to thisThank you for the wonderful article. My 19 year old daughter suffers with this disorder and your article described her very accurately. She is currently in her 6th month of DBT therapy and slowly making progress. All help and information and insights are greatly appreciated.
Reply | Report Abuse | Link to thisThank you for helping to bring BPD into the mainstream-- this is a remarkably common condition that receives very little attention in the media. For more information on BPD visit http://bpd.about.com
Reply | Report Abuse | Link to thisThe article "When Passion Is The Enemy" by Molly Knight Raskin is a well researched and accurate account of the devastating brain disease classified as borderline personality disorder. The personal story of Amanda Wang mirrors the symptoms endured by millions of Americans. As board members of the National Education Alliance for Borderline Personality Disorder, www.borderlinepersonalitydisorder.com, we urge Scientific American to allow this fine piece to be made available to the public without charge.
Reply | Report Abuse | Link to thisCongratulations to Scientific American, Ms. Raskin and Ms. Wang.
Sincerely, James and Diane Hall Family Educators for the National Alliance on Mental Illness (NAMI) and NEA-BPD
The article "When Passion Is The Enemy" expertly written by Molly Knight Raskin, is an accurate and well researched chronicle of borderline personality disorder. The courageous personal story of Amanda Wang mirrors the devastating symptoms of millilons of Americans. As board members of the National Education Alliance for Borderline Personality Disorder (NEA-BPD), www.borderlinepersonalitydisorder.com, we would urge Scientific American to allow this article to be fully available to the public without charge.
Reply | Report Abuse | Link to thisCongratulations to Scientific American, Ms. Raskin, and Ms. Wang!
Sincerely, Jim and Diane Hall Family Educators for the
National Alliance on Mental Illness and NEA-BPD
Hi, I'm the Amanda that is featured in this article. Just want to thank Molly Raskin for shedding a spotlight to this sorely misunderstood disorder. People sometimes say that those with mental illness just need to "buckle down and try harder." What has helped me the most, however, is receiving the proper, evidence-based treatment (as mentioned in the article). I believe this is perhaps one of the most effective things a person diagnosed with BPD can do.
Reply | Report Abuse | Link to thisI've realized that the more I understand, learn, collaborate and participate in my treatment, the less likely I will relapse. Learning about my diagnosis was half the battle. My journey continues on. It sure hasn't been easy, but I am thankful for the incredible support I have received on my way.
Like the Halls mentioned in a previous post, it would be of great service for Scientific American Mind to share the entire article free of charge. People need to understand that this is a very real illness and begin to recognize the symptoms before a it reaches a crisis point. With studies showing a suicide rate that is 400 times the national average, we need all the help we can get to make this a priority health issue.
With gratitude,
Amanda Wang
Producer
The Fight Within Us: A Documentary by RethinkBPD
http://thefightwithinus.com
PS: You can read my follow-up post to this article at http://bit.ly/aB8Lzm and while you're at it, check out NEABPD here: http://bit.ly/aWOeQ2.
This is a wonderful, fact-filled article on BPD--an illness I've struggled with for 40 years without seeing information readily available to the public before this article. I hope and pray you will make this article free to be read by the public, given the dearth of information out there. Those with this deadly illness are so starved for accurate and meaningful information and your well-written piece was spot-on!
Reply | Report Abuse | Link to thisHi Amanda, thanks for being brave enough to share your story with others. I have had the same symptoms of being fine one minute and suicidal the next and have the same diagnosis. However, I was treated effectively years before DBT was developed. The technique? The therapist treated me like a human being and with caring and compassion, something mental health professionals all too frequently fail to do, as I found out from my experiences with other professionals both before I saw her and after she left.
Reply | Report Abuse | Link to thisHi Amanda, thanks for being brave enough to share your story with the world. I also have a BPD diagnosis and have suffered the same symptoms of being fine one minute and suicidal the next. I was, however, treated effectively years before DBT was developed. The technique? The therapist treated me as a human being and with caring and compassion, something mental health professionals all too often fail to do, as I found out by my experience with some other therapists and mental health staff besides her.
Reply | Report Abuse | Link to thisI am a clinical psychologist and I am interested in individuals who have been diagnosed with BPD and treated with DBT. I am interested in hearing how helpful (or not) DBT was for you, as well as the duration and frequency of DBT sesssions, if you are comfortable sharing such. Thank you in advance for share your personal expereince!
Reply | Report Abuse | Link to thisI have this and have known for about 8 years. It is not merely over emotionalism as it affects cognition and memory. Like Depression it can affect your physical state as well. Understanding it does not fix it or even make it less problematic. Like many, I do not respond well to medications and am almost always living in fear of my own brain. My whole family, except my adult son, and many friends have abandoned me because of this disease and believe I do it for attention. People consider it acceptable to bully the mentally ill so that adds to the problem. I am very educated and that does not help either. I have been in therapy and on meds for years and years and none has helped and some of the therapy has made me worse for forcing me to relive trauma over and over.
Reply | Report Abuse | Link to thisI have taken to telling people who have difficult understanding what happens when the brain malfunctions that it is more of an altered state of consciousness than a bad mood. Unless you have experienced an altered state you cannot understand it and should just believe the ill person instead of pestering them to justify their behaviour.
I was in a DBT program and it was starting to help. My therapist had promised to stay at least a year and I had to as well. It is part of the program so that the ill person feels safe. Well, mine quit after 3 months for a better job. She knows as well as I do that BPD includes a huge fear of rejection.
The problem with DBT is it costs a great deal as it is so intensive and has both therapy and training to help cope better and minimize the lapses from sanity. The therapists have to be specially trained so they do not trigger the patient and can help them back if they do go off. I believe that DBT would work for Depression and Anxiety but the gov't will never fund that much for the mentally vulnerable. At the heart of DBT is compassion not judgement. I wish I could do it the right way with a committed therapist who did stay a year. I am only alive because I won't abandon my son the way my birth mother and adopted mother did me. If it were not for the compassion of my son I could never have made it this far as all it has been is blame and accusations from the rest of my family.
This disorder or cluster of them ruined my life but mostly it was the lack of help and being stigmatized. I was punished very heavily as a child and teenager for mood swings. Diagnosis as an adult did not change the attitudes. If anything it was worse. My family also pushed out a younger cousin who was mentally ill like her mother.
My current pshrink has decided not to treat me anymore because she is making me worse. She is not looking for anything else for me though she promised she would at the beginning. After decades of varied mental health care professionals it is now my view that none of them want to work with someone they cannot fix quickly. There are no programs for the mentally ill who remain ill. There are no programs to help the chronically ill cope. There may be private ones but few have the money for that. I did not used to be very angry, more like despairing and hopeless. When I could no longer work and had no income to do anything at all I also found out my doctor was dumping me without any help. This is when the BPD went from hysterical sadness to rage. When hope died. I have started over so many times that I have a multiple page resume. I am now too old to pick up the pieces and start over. When my belief in my ability to start again died so did something in me. My life was stolen by BPD and arrogant and nasty mental health workers. Would you send a person with BPD to a Freudian Analyst who sleeps most of the time? My managing pshrink did this and laughed when I told him the guy was sleeping. There is no hidden cause here; it is all on the surface. Freud?!?!?!
Reply | Report Abuse | Link to thisI would like to see psychiatrists have to recertify every couple of years as the findings are coming out faster than they are picking up on it. I put my hope in neurology and wish the psychiatrists would get with it. Psychiatry is not a science even though they say they are scientists. It is a social science that makes use of out dated hard science. My pshrink is a Freudian and did not like it when I went on a rant about him withholding the knowledge he had that parents sexually assault their kids. He did not want to ruin his career. And there in a nutshell is the problem. I think psychology and medicine are callings. I think Psychiatry is a career path.
Better than being a narcissist.
Reply | Report Abuse | Link to thisTo a2103159's comment-- and for anyone that would blindly agree. I suffered for more than 20 years with BPD undiagnosed. Year after year of agonizing unhealthy relationships, self loathing, thoughts of suicide, unrealistic fears of social exposure, antidepressant cocktails, mood stabilizers, therapy for PTSD, Dysthymia and depression. All the while, never feeling any of it fit me. Nothing helped me feel normal or valid. Never being able to release that deep fearful breath. Something else was going on that was different. I felt like an alien from another planet dropped here to suffer until I could just expire to escape. It wasn't until I had missed nearly a year of work and been 'passed off' by my psychiatrist (who was either at the end of his rope or suspected the disorder) to the University of Iowa staff where I was correctly diagnosed. With proper treatment, support, and most importantly, knowledge I have been able to make a much healthier and happy life. I no longer feel 'broken' all the time and have tools that I use on my own to stabilize my thoughts and reactions. It is still difficult at times, but if it weren't for this diagnosis and the skills that DBT and the University's STEPS program teach I would most likely have lost my job, my home, my children and possibly my life. BPD is real and those of us that suffer from it want nothing more out of life than to be as 'normal' and content as we view the rest of the world around us. Shame on you for your narrow minded and self serving blather.
Reply | Report Abuse | Link to thisquincygtg, I participated in the U of I STEPS program which was three months of 3x weekly group sessions and still practice those skills all the time. It was a wonderful program that taught me to come to terms with BPD, understand it and work on it. It is a group setting that does NOT focus directly on the individual so that we learn to break the cycle of self focus that is so detrimental and difficult for one on one therapy. I also found that low dose Prozac was a wonderful adjunct to the program. Just enough to do the job and I was able to go off it within a year. These programs are about learning how to stop the cycling and empower us to change our own lives. Truly a blessing when someone with BPD wants peace in their chaos.
Reply | Report Abuse | Link to thisThank you so much ofr this fantastic article! I have BPD and as Amanda stated the more you learn about your illness, the more likely you are to be able to gain better control over your emotions. The physical evidence helps to validate the difficulties we go through and some of the reasons. I think it is so important to raise awareness of BPD so that other people can begin to understand just how real and hard life is for someone with BPD.
Reply | Report Abuse | Link to thisI also agree that it would be a massive service if this article could be shared free of charge. It has helped me and I have shared it with a couple of friends who also have BPD. It does have the capability of potentially saving someone's life. I know that sounds like an exaggeration, but it isn't! Thank you so much Amanda for sharing your story!
In Rasking's article, she states, "Because those affected display a disparate and variable set of symptoms, even trained mental health professionals can miss the diagnosis or attribute the behaviors to some other cause." I think is is crucial to point out that when someone appears to have a dual diagnosis, substance abuse ALWAYS takes precedence over a suspected personality disorder. What I mean by that is, BPD would NOT be diagnosed until the patient is clean and sober for a certain period of time. If the symptoms of BPD persist (and the patient is in treatment--not just "dry"), then the diagnosis can be made. But it is unethical to diagnose a patient with BPD if s/he is using drugs/alcohol.
Reply | Report Abuse | Link to thisSounds more like psychopathy than BPD...
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