Not Everything Is Fleeting. Some Feelings Are Deep. The Fact It Isn’t Close To Me, That I Can Understand.

The present study examined the utility of meaning to differentiate between depression and grief in a sample of suicide survivors (N = 555). Three regression models were tested, each with a different measure of meaning predicting depression and grief. Across three models, meaning was negatively associated with depression but positively associated with grief. Additionally, grief and depression were negatively correlated across all models. Results support a conceptual distinction between grief and depression, with the presence or absence of meaning in life as a key distinguishing factor between the two in a population with a relatively high risk for pathological grieving.

"ill never leave you" liar liar liar liar liar liar liar liar liar liar

The Miseducation of Cameron Post (Desiree Akhavan, 2018)

I refuse to let my major depressive episodes and my schizophrenia take control of my life. I have a lot of fight in me. I am on the right meds and am trying to find some one-on-one and group therapy to go to. I’ve always been a fighter, though, figuratively and literally at times.

FBI Vault Files on Serial Killers

Andrew Cunanan (3 parts)

The Atlanta Child Murders (24 parts)

Herbert Baumeister (164 pages)

Ted Bundy (3 parts)

Jeffrey Dahmer (19 parts)

John Wayne Gacy (1 part)

Jack the Ripper (1 part)

Charles Manson (1 part)

The Zodiac Killer (6 parts)

The Borderline Personality Disorder Checklist

This is a checklist to help one understand Borderline Personality Disorder. One may use it to self-diagnose or as a worksheet to present to a doctor or therapist  or other medical professional and better communicate symptoms they are experiencing. All information is taken from the DSM-5.

Section I Must check TWO or more of the following:

I have identity problems, including: I have an unstable sense of identity, I have poor self-esteem and excessive self-criticism, and I often experience dissociation when I am under stress.

I am unstable in my goals, aspirations, values, and/or career plans.

I have a heightened sense of empathy and am hypersensitive to the feelings and needs of my peers, although my perceptions are often biased towards negative attributes.

There is a lot of instability in my relationships, in that I am needy, mistrustful, and anxious.

__ / 4 Total

Section II Must check TWO or more of the following:

I have cognition problems and difficulty retaining information and remembering people and events.

I have affectivity problems and difficulty controlling the range and intensity of my emotional responses.

I have problems with interpersonal functioning and being aware of my own actions and feelings and how they affect others.

I have difficulty controlling my impulses.

__ / 4

Section III Must check ONE or more of the following:

I am very impulsive and often act on things without planning.

I engage in dangerous, risky, and/or potentially self-damaging activities with no concern to my personal limitations.

I am easily angered.

__ / 3 Total

Must have at least FOUR checks TOTAL by the end of this section, including ones from previous section (If you checked two above, you only need two here, for example):

My emotions are incredibly unstable, and I change moods often (sometimes within minutes), feeling things more intensely than others seem to.

I experience intense feelings of nervousness, tenseness, panic, and/or anxiety. I have fears of the future and of falling apart or losing control.

I get separation insecurity and fear abandonment.

I am frequently depressed and feel hopeless and have a difficult time recovering from such moods.

__ / 7 Total

Section IV Must check FIVE or more of the following:

I have a fear of abandonment and do my best to avoid it.

I switch between idealizing and devaluing the people in my life. My relationships are often unstable and intense.

I have an unstable sense of self and often question my identity.

I am impulsive.

I have attempted suicide and/or I self-harm.

I have frequent mood swings.

I often feel empty or depressed and have doubts about my future.

I am hot-tempered.

When stressed, I am paranoid and/or I experience dissociation.

__ / 9 Total

Section V Must check ALL of the following:

My symptoms impair my personality and social functioning 

My symptoms are consistent across a broad range of personal and social situations.

My symptoms have lasted a while and started in early adulthood or earlier.

My symptoms are not caused by medication, drug use, or another medical condition.

-

At this point, if you have checked the minimum, you may qualify for a diagnosis of Borderline Personality Disorder. The next section is a compiled list of symptoms, behaviors, thought patterns, etc. often found in borderline patients.

If you did NOT meet the minimum, check out Major Depressive Disorder, General Anxiety Disorder, Post-Traumatic Stress Disorder, Bipolar Disorder, or Obsessive-Compulsive Disorder. If you checked ALL of Sections II and V but still did not meet the minimum in other sections, look into other personality disorders, especially other Cluster B’s.

-

Section VI Common Symptoms and Behaviors associated: 

I have disordered eating patterns.

I am sometimes obsessive.

I sometimes get intrusive thoughts which I am unable to ignore.

I become attached easily.

I often “bait” people in order to start a conflict.

I have trouble sleeping, or I sleep too much.

I have a child-like curiosity.

I am dependent on others.

I sometimes mimic or mirror others.

I have nightmares.

I have difficulty processing information.

My appearance changes often.

I have an extreme need for acceptance.

I have a natural rejection of people in authority.

I constantly feel like I need to prove myself over and over again.

I very much live in the moment, to the point where past actions don’t matter. How I judge others (and myself) depends entirely on what is happening right now.

I isolate myself, even when I need social interaction.

I am often defensive.

I have anxiety/panic attacks.

I experience memory lapses.

I consider myself a perfectionist.

I react very strongly to mundane experiences.

I have a difficult time making decisions.

I have difficulty completing tasks.

I often feel misunderstood, mistreated, or victimized.

When I am upset, I am unable to calm down without help.

I castrophicize my problems and see the smallest things as the end of the world.

I often see my problems as unsolvable and hopeless to fix.

I hold grudges.

I alternate between seeing others as completely for them or against me.

I have a hard time recalling someone’s love for me when they’re not around.

I change my opinions depending on whom I’m with.

Sometimes the slightest provocation will make me feel abandoned.

I feel distrustful and suspicious a great deal of time.

I rush into relationships based on an idea of a person rather than the person themselves.

__ / 35

How do you expect me to be nice when I feel like dying

All it takes is one small trigger. And I'm in a shit mood for awhile. And I have no idea how to change that. Is it even possible to change that in BPD? How do you stop the all over body inside and out feeling of a horrible mood shift after you've been triggered? It takes me a huge time out, meltdown, and hours long sleep just to snap out of it but I don't have time for that always.

Neuroscience of BPD

Lately I’ve been hearing that BPD isn’t a real mental illness because nothing is actually wrong with our brains and so, naturally, that means we’re using BPD as an excuse for our mood instability and impulsive behavior.

Guess what, naysayers? You were COMPLETELY right and totally called us out on our nefarious scheme!! We did, in fact, all convene at a super secret BPD convention of sorts and plotted to infiltrate the psychiatric field.

Haha, no. With the help of alix660 and porcelaindissonance I’ve learned a lot about the neuroscience behind BPD. And, while much more needs to be done in terms of BPD research, I did find strong evidence that BPD does have biological causes. You know. Just like an actual mental illness.

So here’s what we found, sorted by brain structure:

Amygdala: This brain structure is very heavily involved in emotional regulation and responses, particularly negative emotions. An fMRI study of BPD patients while being subjective to distressing visual stimuli found that our amydalas were significantly more reactive than those of control patients. This means that either the signals in our amgydalas are much more intense, or they continuing firing in our brains, preventing us from shutting down our emotional responses. Or perhaps it’s both, because that’s fun.

Another thing to note is that the amygdala receives tons of visual information, sent by the thalamus. The thalamus circumvents emotional processing in the prefrontal cortex (where we would consciously process how to regulate our emotions) and thus is involved in automatic, subconscious emotional processing. This is probably why our mood swings are so fast, unpredictable, and uncontrollable. It’s a knee-jerk reaction to even the tiniest triggers we come across.  (Herpetz, et al.)

Amygdala volume is significantly reduced in BPD patients as well. (van Elst, et al.)

Hippocampus: This structure is involved in formation and retention of long-term memories, as well as autobiographical memories. Not only is hippocampal volume reduced in PTSD and MDD, it is also reduced in BPD. (van Elst, et al.)

I know from my studies that the reason for hippocampal volume reduction in PTSD and MDD comes from prolonged activation of the stress response. When we go into “fight or flight” mode, several physiological changes take place: our immune system shuts down, digestion stops, etc. But most importantly, when we enter “fight or flight,” glucose, which is necessary for cell metabolism, is redirected from the hippocampus and to your muscles. If you’re faced by a life-challenging thing, like a pack of velociraptors, you don’t want to think about it. You want to run, and you want to run fast. This is biologically adaptive in the short-term and in prey species… but not so with humans, because we can have this reaction to long-term, non-threatening stressors. So in long-term distress—like MDD, PTSD, and BPD—our hippocampus is starved of energy and atrophies. Result? We have absolutely terrible memory.

Prefrontal cortex: This is where we do our conscious thinking. More specifically, the medial prefrontal cortex, which is involved in processing emotional memories, is more active in the BPD brain. Essentially, this means we have difficulty mediating our conscious emotional responses.

In the ventrolateral prefrontal cortex, BPD brains also show abnormally high reactivity to aversive stimuli. This part of the cortex directly connects to our good friend the amygdala, and thus has some level of control over emotion-driven responses. (Herpetz, et al.)

In the anterior cingulate cortex, which is involved in feelings of apathy and emptiness, we see a significant reduction in volume in the BPD brain. The ACC is linked to self-harm and pain sensation. (van Elst, et al.)

In the orbitofrontal cortex, we also see volume reduction in BPD. The OFC is responsible for irritability, impulsivity, and instability, which are our favorite things.

Fusiform gyrus: Found in the temporal lobe, the fusiform gyrus is the facial recognition center of the brain. And—you guessed it—it’s also shown to be hyperactive in the BPD brain. Which makes sense when you think about it: we are EXTREMELY sensitive to even the slightest changes in the facial expressions of other people. If you appear disinterested, annoyed, angry, or otherwise upset, that’s an immediate trigger. (Herpetz, et al.)

Taken together, this means that the limbic circuits (emotional regulation) and the prefrontal cortex (executive control) are uniquely involved in BPD, resulting in a hyperarousal-dyscontrol syndrome. As of right now, no other psychiatric illness has this combination of reduced brain structure volumes and hyperactivity in certain regions. (van Elst, et al.)

Bonus!!!

Serotonin: Most of us know serotonin as a crucial neurotransmitter involved in major depressive disorder. But in BPD, studies show that reduced serotonin activity is found in several locations in the brain, including the cingulate cortex, which is critical in processing incoming emotional cues. Reduced serotonin impairs inhibition of aggressive behaviors, both directed at others (like outbursts) and directed at the self (like self-harm and self-hatred). Genes involved in serotonin can easily be studied. (Skodol, et al.)

Sources:

Skodol, et al. “The Borderline Diagnosis II: Biology, Genetics, and Clinical Course”

Herpetz, et al. “Evidence of Abnormal Amygdala Functioning in Borderline Personality Disorder: A Functional MRI Study”

van Elst, et al. “Frontolimbic Brain Abnormalities in Patients with Borderline Personality Disorder: A Volumetric Magnetic Resonance Imaging Study”

PS I did read several other articles that corroborated these findings, so it’s not like these are the only sources of evidence I found that point to the biological nature of BPD.

When👏can👏I👏die?