I Hate You—Don't Leave Me by Jerold J. Kreisman Read Free Book Online

threatening suicide, hyperactive, or experiencing wide and rapid mood swings, the borderline may appear bipolar, but the borderline’s mood variations are more transient (lasting hours, rather than days or weeks), and more often reactive to environmental stimuli. 3
BPD and ADHD
    Individuals with ADHD are subjected to a constant scramble of flashing cognitions. Like borderlines, they often experience wild mood changes, racing thoughts, impulsivity, anger outbursts, impatience, and low frustration tolerance; have a history of drug or alcohol abuse (self-medicating) and torturous relationships; and are bored easily. Indeed, many borderline personality characteristics correspond to the “typical ADHD temperament,” such as frequent novelty-seeking (searching for excitement) coupled with low reward dependence (lack of concern for immediate consequences). 4 Not surprisingly, several studies have noted correlations between these diagnoses. Some prospective studies have noted that children diagnosed with ADHD frequently develop a personality disorder, especially BPD, as they get older. Retrospective researchers have determined that adults with the diagnosis of BPD often fit a childhood diagnosis of ADHD. 5 , 6 , 7 Whether one illness causes the other, whether they frequently travel together, or, possibly, if they are merely related manifestations of the same disorder remains for intriguing further investigation. Interestingly, one study demonstrated that treatment of ADHD symptoms also ameliorated BPD symptoms in patients diagnosed with both disorders. 8
BPD and Pain
    Borderlines have been demonstrated to reflect paradoxical reactions to pain. Many studies have shown a significantly decreased sensitivity to acute pain, particularly when self-inflicted (see “Self-Destruction” on page 45). However, borderlines exhibit greater sensitivity to chronic pain. This “pain paradox” appears unique to borderlines and has not been satisfactorily explained. Some posit that acute pain, especially when self-inflicted, satisfies certain psychological needs for the patient and is associated with changes in electrical brain activity and perhaps quick release of endogenous opioids, the body’s own narcotics. However, ongoing pain, experienced outside the borderline’s control, may result in less internal analgesic protection and cause more anxiety. 9 , 10
BPD and Somatization Disorder
    The borderline may focus on his physical ills, complaining loudly and dramatically to medical personnel and acquaintances, in order to maintain dependency relationships with them. He may be considered merely a hypochondriac, while the underlying understanding of his problems is completely ignored. Somatization disorder is a condition defined by the patient’s multiple physical complaints (including pain, gastric, neurological, and sexual symptoms), unexplained by any known medical condition. In hypochondriasis the patient is convinced he has a terrible disease despite a negative medical evaluation.
BPD and Dissociative Disorders
    Dissociative disorders include such phenomena as amnesia, feelings of unreality about oneself ( depersonalization ) or about the environment ( derealization ). The most extreme form of dissociation is dissociative identity disorder (DID), previously referred to as “multiple personality.” Almost 75 percent of individuals with BPD experience some dissociative phenomena. 11 The prevalence of BPD in those suffering from the most severe form of dissociation, DID, as a primary diagnosis is even greater. 12 Both disorders share common symptoms—impulsivity, anger outbursts, disturbed relationships, severe mood changes, and a propensity for self-mutilation. There is frequently a childhood history of mistreatment, abuse, or neglect.
BPD and Post-Traumatic Stress Disorder
    Post-traumatic stress disorder (PTSD) is a complex of symptoms that follows an extraordinarily severe traumatic event, such as a