BPD and Recession ?

[Twylight]

I have noticed that a lot of people with BPD are in their 20's

They were children of the eighties and Thatcherism.

I am curious if there is a link between BPD and the suffering of their parents - due to unemploment and misery ?

 

[Apotheosis]

Quite probably - A purely biological basis to 'mental illness' has never been proved. In fact all the research shows just the opposite. That the true causes are environmental - stress, trauma, social circumstances, inter-personal relationships, exasperated by multiple possible factors including substance abuse issues, nutrition; ect ect ect; & most likely a combination of many factors; as part of a continuum. That is not to say that there are not biological components. But it is far from clear as to whether the 'abnormal' biology are simply nuances, or secondary to other factors.

It is simply not known what exactly is going in 'mental illness', not enough is known about the workings of the Brain or the interplay between genetic factors; influencing brain function; & how these possibly combine to influence 'illness'. Even if a clear picture can be found of the exact nature of these things; it still does not prove cause. The biology cannot be divorced from environment.

 

[quality factor]

I have noticed that a lot of people with BPD are in their 20's

They were children of the eighties and Thatcherism.

I am curious if there is a link between BPD and the suffering of their parents - due to unemploment and misery ?

I am 56,I was dx with BPD twelve months ago, after a changed dx of Bipolar which I had been stuggling with since my early twenties.
BPD is a relatively new illness recognised in DSM, so more people are having that dx given to them in recent years. I don't think you can particularly blame Thatcherism or any other particular social/political climate.
Psychatrists do not know the true cause of psychiatric illness, it could be due to environmental or biological influences or a culmination of both.
Likewise, many psychiatrists' asked if they've found a cure for psychiatric illness usually have to admit that they have not.
QF.

 

[ms_P]

I find it curious that BPD is the only mental health disorder aside from schizophrenia that, with brain imaging techniques, shows brain abnormalities.

The nature vs nurture debate will continue for a long time, I think.

 

[Apotheosis]

I find it curious that BPD is the only mental health disorder aside from schizophrenia that, with brain imaging techniques, shows brain abnormalities.

In such studies it is very difficult to conduct an impartial study. Firstly; & importantly; anti-psychotics & other psychiatric medication is known to have the common potential to shrink the brain & cause other brain abnormalities. This is proven. These drugs work on altering brain function - often drastically.

Any test must be impartial & study at least 3 groups - Medicated. Also those in long term recovery having never been medicated, & having received comprehensive 'alternative' support (such as from Diabasis, Soteria House, & other similar projects). & Thirdly non medicated & non recovered. I am not aware of any studies that categorically prove any brain abnormalities are present as a result of Schizophrenia, nor Bi-Polar - as a direct result of those conditions. It has, as far as I know, never been proved that these conditions are purely biological in origin, or 'an organic brain disease' in nature.

I have had brain scans - they showed no abnormality of any kind. I know others who have been severely ill; who have showed nothing on brain scans.

Imaging techniques are still not that accurate or detailed, although progress is being made.

There is no biological or objective test for Schizophrenia or Bi-Polar.

 

[Twylight]

it doesn't seem to matter how much I learn about psychosis it always remains just that little bit ' Sinister '.

 

[ms_P]

In such studies it is very difficult to conduct an impartial study. Firstly; & importantly; anti-psychotics & other psychiatric medication is known to have the common potential to shrink the brain & cause other brain abnormalities. This is proven. These drugs work on altering brain function - often drastically.

Any test must be impartial & study at least 3 groups - Medicated. Also those in long term recovery having never been medicated, & having received comprehensive 'alternative' support (such as from Diabasis, Soteria House, & other similar projects). & Thirdly non medicated & non recovered. I am not aware of any studies that categorically prove any brain abnormalities are present as a result of Schizophrenia, nor Bi-Polar - as a direct result of those conditions. It has, as far as I know, never been proved that these conditions are purely biological in origin, or 'an organic brain disease' in nature.

I have had brain scans - they showed no abnormality of any kind. I know others who have been severely ill; who have showed nothing on brain scans.

Imaging techniques are still not that accurate or detailed, although progress is being made.

There is no biological or objective test for Schizophrenia or Bi-Polar.

I was thinking along the lines of the Hypothalamus and Thalamus showing marked abnormalities in size & function in people with Borderline Personality Disorder.
How they got that way is the question.

 

[Apotheosis]

I was thinking along the lines of the Hypothalamus and Thalamus showing marked abnormalities in size & function in people with Borderline Personality Disorder.
How they got that way is the question.

I am aware that the Hypothalamus is one of the main areas targeted by anti-psychotics.

?

I like your new Avatar.

 

[quality factor]

There is recent documentation on Borderline Personality Disorder which may be of interest.
There is advice on the prevalence of brief episodes of psychotic states from those of us who suffer from BPD.

http://www.nice.org.uk/Guidance/CG78

 

[918]

Antipsychotics and other psychotropic medications do not shrink brain and do not drastically change the brain function. They cheifly act on neurotransmitters (brain chemicals) and mostly (apart from side effects such as tardive dyskinesia) their effects are reversible. All other effects are reversible on stopping the medication.
On a different subject - environmental factors are more important in personality disorders. Multiple changes of care taker and abuse in childhood are particularly common in persons with BPD.
Regards,
918

 

[ms_P]

Antipsychotics and other psychotropic medications do not shrink brain and do not drastically change the brain function. They cheifly act on neurotransmitters (brain chemicals) and mostly (apart from side effects such as tardive dyskinesia) their effects are reversible. All other effects are reversible on stopping the medication.
On a different subject - environmental factors are more important in personality disorders. Multiple changes of care taker and abuse in childhood are particularly common in persons with BPD.
Regards,
918

I agree from experience about the abuse. Also, the having multiple care takers may be an interesting point. I spent more or less the first 3 - 4 years of my life in various hospitals and clinics. I remember quite a bit. All the strangers all the time, poking and prodding. My best friend was a rocking horse I was allowed on when I could sit up long enough.

 

[quality factor]

There is current discussion as to whether BPD should even be classed as a Personality Disorder in favour of Mood Disorder, or be in a class of it's own.
QF.

 

[*Sapphire*]

This article explains Marsha Linehans view on what are the causes of Borderline Personality Disorder.

It was taken from Source: Linehan, Marsha M. Skills Training Manual for Treating Borderline Personality Disorder, New York: The Guilford Press, 1993.

http://borderline-personality.suite101.com/article.cfm/causes_of_borderline_personality_disorder_bpd

I have been diagnosed with BPD and have experienced the reasons why Marsha Linehan invested her time and energies into researching a comprehensive treatment for those suffering with BPD.

"Much controversy surrounds the diagnosis of Borderline Personality Disorder (BPD). In some circles, it is considered to be the most overdiagnosed condition in the DSM-IV, a label that gets attached to the clients who do not get well, whose problems seem intractable and whose relationships with their therapists are full of conflict and negative feelings at both ends. Many social workers and psychologists refuse to treat clients who have been diagnosed with BPD. One of the more renowned psychologists who do not, who actually welcome borderlines in clinical practice, is Dr. Marsha Linehan. Dr. Linehan has developed a comprehensive model of BPD that includes a possible etiology for the condition, a persuasive argument for why its sufferers become so entrenched in their behavioral patterns, and a suggested treatment approach. She chose to call this model Dialectical Behavior Therapy or DBT, and its practitioners have been greeted with success where so many others have failed."

An overview of DBT is detailed on this site;

http://www.dbtselfhelp.com/html/linehan_dbt.html

I am now under-going DBT treatment (which she developed) and on the whole it has helped me control my behaviours. However throughout my treatment I have criticised the fact that it does not deal with the root causes of my problems, and has not stopped me from having the urges to engage in harmful behaviours however has helped stop me from indulging in them. However I do recognise that when I started the treatment I was informed that the treatment was not about resolving the underlying issues but to deal with the present and to teach me skills to cope. Hence part of the treatment is called "skills training". What I do like about it is that I am allowed to call my therapist on a mobile between the hours of nine am to seven pm because the treatment I am undertaking understands that most crisis' do not happen in the groups or in your therapy session but in real life, (however times vary from therapist to therapist within the group because Marsha states that the therapist must also take into account how much they can also reasonably cope with).
This has been an invaluable aspect of the treatment for me, and now i am towards the end I hardly ever, if at all call, because now I am able to imagine what the therapist may say, and use the resources made available to me in the training to cope.

However although some people seem to appear to need no further treatment, I do think that it is the responsibility of the therapist/mental health workers involved in your treatment to seek out further therapy that deals with the underlying/root causes of your problems when DBT finishes. Marsha Linehan states that DBT is to help the client/patient to learn skills to prevent them from engaging in parasuicidal behaviors or ambiguity that could have a negative impact on deep going therapy. Because she states that, I get the feeling that she does believe that the underlying problem should not be ignored at a later stage. I am worried that an under-funded/poorly run health authority, may see someone who is no longer engaging in damaging behaviours as "cured" and therefore leave them living what I would deem a tortuous life of merely COPING with their impulses rather than CURING them.

If you have heard of/been in DBT or other treatments for borderline I would be most interested in your point of view.

 

[quality factor]

I have not been fortunate enough to have been offered DBT to help me with my problems.
My CPN seems to be doing her best in the time that she has available to her to give me constant support, she is constantly reminding me to ring her.
We are able to talk through problems that have arisen, once a week or once a fortnight at best.
She has told me it is going to take 'a long time',to get anywhere near recovery. She will not commit to how long a 'long time' could be.
I am 56 years old, I was given the BPD dx 3 years ago.
Basically I feel like there is no hope for me to unlearn 40 years of learned behaviour.
I feel that my mood affects my behaviour more than anything.
There are two or three major aspects of the criteria for BPD in DSM, that I feel I do not meet.
I am therefore, not totally convinced that I am true BPD and have had a great deal of problem in accepting the dx.
I would jump at the chance to be fortunate enough to be offered DBT, but as usual in Mental Health Services it's down to funding.

QF.

 

[*Sapphire*]

I have not been fortunate enough to have been offered DBT to help me with my problems.
My CPN seems to be doing her best in the time that she has available to her to give me constant support, she is constantly reminding me to ring her.
We are able to talk through problems that have arisen, once a week or once a fortnight at best.
She has told me it is going to take 'a long time',to get anywhere near recovery. She will not commit to how long a 'long time' could be.
I am 56 years old, I was given the BPD dx 3 years ago.
Basically I feel like there is no hope for me to unlearn 40 years of learned behaviour.
I feel that my mood affects my behaviour more than anything.
There are two or three major aspects of the criteria for BPD in DSM, that I feel I do not meet.
I am therefore, not totally convinced that I am true BPD and have had a great deal of problem in accepting the dx.
I would jump at the chance to be fortunate enough to be offered DBT, but as usual in Mental Health Services it's down to funding.

QF.

Hi I'm sorry to hear that there doesn't seem to be treatment in your area. I found out last week that I only got onto the treatment because I was seeing another therapist at the time at an eating disorder centre, who used to work with another therapist who happened to be the lead consultant for DBT in my area, and knew she was setting it up for the first time within a few months of me finishing my eating disorder treatment, so gave me a direct referral/reccomendation. I consider myself very lucky on that basis, proves that in mental health it is not what you know but who you know.

It is so good that your CPN has said that you can call her for support, that kind of support is invaluable, and is so reactive to your needs.

Mind do have alot of information about DBT;

http://www.mind.org.uk/Information/Factsheets/Treatments+and+drugs/Dialectical+behaviour+therapy.htm

and although your CPN may be doing her best, if you really want to try DBT and you think it will really help you i see no harm in calling your local health authority to see if they run groups/will run groups and seeing if you can create a demand for it in your area. One of the criteria for the group is the willingness of the client to attend the programme and embrace the skills, you would surely be in someway by proving this by enquiring about it. But then I am an eternal optimist and refuse to be sidelined by their excuses of funding etc! MIND say that since 1995 over 175 groups have been set up in the UK and my one was only set up last year, which was rolled out from a successfully run group in London, hopefully other counties/Wales etc will follow suit soon.

With regards to you saying that you do not feel that you can undo many years of behavior, all I can see is that concern was echoed by other users in my group, and towards the end, many of them are making substantial changes to the way they are approaching/dealing with things. The skills training is repeated twice. Our groups have lasted in total 18 months, it is not a quick fix by any stretch. And one of the criterias of the group is that you actively practice the skills and report back your successes/failures.

Hey I'm not saying it's perfect by any stretch of the imagination and i don't want you to think i am an evangelist about it! However if you really want it, i would start calling/email your local authorities, cos who knows where it may lead, and you won't lose anything by doing it!