More About Epilepsy and BPD

I previously posted about some theories that there may be a link between having epilepsy in one's family and having borderline personality disorder (BPD).

Recently a very wise person who has been diagnosed with BPD and is recovering from it brought up the possible BPD-epilepsy connection with me.  This person pointed me to the website of Dr. Leland M. Heller.

According to Dr. Heller, "The most severe BPD symptoms are likely a form of epilepsy and include 'dissociation' (unreality, body parts going numb, deja vu, etc.)..."

Of interest to me was the page where Dr. Heller stated,

Epilepsy means nerve cells firing inappropriately and out of control. Some individuals have a genetically unstable neurological system that can cause epilepsy in different areas.  This instability in the instinctual "trapped, cornered, wounded animal" response causes the BPD. Some other common disorders are likely epileptic in origin including bipolar disorder...

Dr. Heller also addresses the possible BPD-epilepsy connection here.

I Will Always Care

I told someone, "The only way I will ever again feel safe in your presence is if you return to seeing a mental health professional on a regular basis." Should this person ever visit this blog, I want something to be understood.

I said that not because I do not care about you, but exactly because I do.  You can go on looking very confident and outwardly successful to everyone else and, as you well know, I have never had any objections to that.  But it's simply not enough; you are due for so much more and so much better.  What you deserve is that lasting happiness that Aristotle called eudaemonia -- Greek for "good spirits."  It refers to an ability to feel at peace within the confines of your own psyche, to be comfortable in your own skin and in the body that Nature gave you, to accept yourself and see in yourself the charm and beauty and compassion that others have seen in you on those occasions when you let them.  To know that there is nothing unnatural or uncomfortable about one day having children and starting a family of your own.  No, starting a family is not any kind of duty or moral obligation; it is simply something very rewarding, an enterprise grander and more challenging than any business scheme I could cook up. So much happiness is possible to you, and just begging to be allowed entry into your life.  And, as you are cognizant, that happiness reaching you is incumbent upon the hard and disciplined choice to accept it.

Contrary to your fears, no one sees you as some specimen to be put in a laboratory, poked or prodded.  You are never on some stage to be judged harshly by anyone.  And no matter how strangely you may look or dress, no one is staring at you; people are much too consumed by their own worries or insecurities to project negative thoughts upon you.  No one plots against you, no one conspires against you, no one is trying to outsmart you, no one wants to use you. On the contrary, everyone believes in your greatness as a person and is rooting for you to win at life. 

A return to psychiatric care does not have to be a prison sentence.  Nor must it feel like one.  In Hawaii, it would be you -- and no one else -- who would ultimately be in control.  You could fire any mental health professional who did not meet your standards of competence and care.  As far as American mental health professionals are concerned, it is the patient who is the boss.  Getting the care that you need is a form of self-determination and self-empowerment.  Far from submitting to the dictates of anyone else, receiving quality care is a form of psychological liberation, no less important than political and economic freedom.  I want you to be happy.  But far more important than that is that I want you to want you to be happy.

You told me that I cannot force any of this upon you, and of course that is true.  I was the one who first told you, "I cannot persuade anyone to do anything.  I can only encourage you to persuade yourself to do something."  That applies here.  I force no one's hand.  I wish happiness for you.  And I unabashedly plea that you put at least as much priority as I do upon the joys and sense of serenity just waiting to be experienced. 

Whatever you do, I will always give a damn, irrepressibly.   I have no regrets about knowing you; I only have gratitude for it and I face no qualms in expressing that.  Just as you have every right to your own choices, I have a right to mine.  Of course I can move on and put the emphasis on my writing projects.  My doing so will never mean that I have forgotten anything.  I will continue to remember and to care.  That is my own prerogative.  :'-)

Identity Disturbances

Among the nine criteria for diagnosing Borderline Personality Disorder, another is the presence of "identity disturbances."  As Psych Central phrases it,

There are sudden and dramatic shifts in self-image, characterized by shifting goals, values and vocational aspirations. There may be sudden changes in opinions and plans about career, sexual identity, values and types of friends. These individuals may suddenly change from the role of a needy supplicant for help to a righteous avenger of past mistreatment. Although they usually have a self-image that is based on being bad or evil, individuals with borderline personality disorder may at times have feelings that they do not exist at all. Such experiences usually occur in situations in which the individual feels a lack of a meaningful relationship, nurturing and support.

I don't thinks Psych Central means that a BPD sufferer's entire outward persona will completely shift from minute to minute or day to day (although some mood swings can be like that).  Rather, it's more along the lines of someone "searching for identity" the way a high-schooler would.  One would can have certain career goals in mind and have a certain type of fashion for some months or some years.  Then some stressful triggering event can cause this person to immediately switch all of this around so that the clothing choices and career goal will be completely different.  Those who do not have BPD can also sometimes make sudden changes.  However, those with BPD often make sudden changes in manner that those around them finding more jarring and confusing.  

A helpful article on this subject is found here.

As recovered Borderline Rachel Reiland has pointed out, sometimes this identity confusion can manifest in the BPD sufferer wearing a sort of mask, trying to always appear confident and friendly to mask a gnawing self-doubt and extreme predisposition to being bothered by what other people say.

Someone suffering from BPD identity disturbances will not have an integrated, consistent personality, but instead have a highly fragmented personality, switching back and forth. The true self will emerge when one feels safe. However, once one feels threatened in some way, the impervious false self emerges as a form of "protection." Sadly, this "confident" false self happens to wall off the person from true emotional bonds, thus becoming a maladaptive obstacle to finding true lasting happiness. :'-(

Some psychologists can mistake this phenomenon for Multiple Personality Disorder. However, there is an important difference. When someone with Multiple Personalities switches from one personality to another, the switch is unconscious; the person doesn't know it is happening. By contrast, the Borderline with a disturbed, "fragmented" personality does have some conscious awareness of when she or he is changing personalities as the result of some emotional trigger. Again, Rachel Reiland explains that.

The identity confusion can even come in the form of changes in perceived sexual orientation.

But you are not cursed to permanently suffer with this. A return to psychiatric care can be of enormous help with the proper diagnosis and committed mental health professionals. Please take your happiness very seriously. :'-)

Wearing a Mask of Confidence on the Outside, Feeling the Opposite on the Inside

The blog Beyond the Borderline Personality presents this interesting excerpt from an article in Scientific American Mind (the article itself is not fully Web-accessible):

BPD is also characterized by a disturbing, but fascinating, dual nature: when people with the disorder are not experiencing flagrant symptoms, they often appear highly functional. “You could meet a patient with BPD in a social setting and not have an inkling that the patient had a major psychiatric disorder,” says psychiatrist Glen O. Gabbard of the Baylor College of Medicine. 

On the bottom of that page, there are many insightful comments from sufferers of BPD and/or Bipolar Disorder who  discuss how they appear very confident and composed in public -- such as, say, boasting about being some great real-estate investor -- but are tormented by insecurity on the inside:

*"in many ways I appear 100% [fine in public] but it's just an act..I can only keep up the appearance for so long before I snap..even when I snap I can usually manage to contain it somewhat.."

* " I understand the facade all too well, but it's only a facade. So many times I feel I could fall apart at any moment. I try not to let people on to that little tid bit, but I certainly know what you're talking about."

* From the blog writer herself:  "This is actually one of the reasons my Roommate was not convinced I'm Borderline because when she first moved in with me she'd never seen me dissolve from one minute to the next. I'm so good at portraying a fairy tale version of myself that no one quite catches on"

Also, there is a sad follow-up to my previous post mentioning Amy Winehouse's tragic death. The Daily Star reports that a family member of Amy Winehouse has made the educated guess that Ms. Winehouse suffered from BPD symptoms. Unfortunately for Ms. Winehouse, this would not and cannot be corroborated by a mental health professional. As one article elaborates,

According to the [Daily] Star, a family member said that the Grammy award-winning singer may have suffered from Borderline Personality Disorder. "It was never diagnosed, because unfortunately she would never agree to a proper diagnosis," the Daily Star quoted a family member as saying. "I'm not an expert, but from what I've read on Borderline Personality Disorder it kind of fitted with her."

Meanwhile, Winehouse’s father, 61-year-old Mitch Winehouse, told the Star he wished Amy would have sought counseling. 

If you are experiencing inner pain like that described in the quotations above, then -- even if your symptoms are not as severe as Ms. Winehouse's -- it would be prudent to make sure that you are currently receiving professional help on a regular basis. No one should have to experience such consistent pain. Your true, inner happiness -- not your outward public success -- is what is most important, and there are people in your life who care about you. :'-)