BPD and Medication

A counselor friend this week asked me the following question:  If there is no medication for Borderline Personality Disorder why are so many on medications?  Pretty valid question.

No medications have been approved by the U.S. Food and Drug Administration to treat borderline personality disorder. Only a few studies show that medications are necessary or effective for people with this illness. However, many people with borderline personality disorder are treated with medications in addition to psychotherapy. While medications do not cure BPD, some medications may be helpful in managing specific symptoms. For some people, medications can help reduce symptoms such as anxiety, depression, or aggression. Often, people are treated with several medications at the same time, but there is little evidence that this practice is necessary or effective. source

I have meet many people with BPD who have another diagnosis (or 5); Anxiety disorders, depression, PTSD, etc.  So for some people they are receiving medication for a separate disorder, which sometimes has overlapping symptoms.  For those of you who follow me on Twitter you know my issue with being people misdiagnosed with a plethora of other diagnosis, that gets added to each year when BPD is the only one.  Putting that aside I also think some people with BPD (especially those whom are newly diagnosed) are given Benzodiazaphines (I will save my opinion on that for another rant) to cope with the anxiety caused my BPD.

I work full-time in a prison, the female inmates are in a 6-month program, I find that month 1 everyone is knocking on my door about medications, someones their mental illness is valid often it is not (mostly due to drug use.)  Month 2-3 some mental health issues come to surface, as the program is intensive 20-hour a week therapy and people are now dealing with things they have stuffed for so long and they have a decent amount of clean time.  Right now my group is in month 3, what started as 11 on medication (out of 21) is now 5.  I asked the group why it has dwindled down significantly in 90 days.  The answers not surprising; 'we now have cog skills, I started journaling, grounding techniques, coping skills, I take to my bunkie about it.'  Many of these women are using skills over medication.*

So maybe medication is not available to you (Big Pharma will be another rant as well,) or maybe you are on medication and looking to gain more coping skills- here is a list of modes to get well for BPD:

• Dialetcical Behavioral Therapy Self-study material
• EMDR mostly used to handle trauma
• EFT (tapping)
• MBT used more in UK (Thanks to anon comment for the info)
• Social Support. Talk to others who may understand what you are going through. 
• Behavioral Activation. Engage in an activity that might take your mind off the stressful situation for a little while. 
• Relaxation Exercises. Practice a relaxation exercise, such as deep breathing or progressive muscle relaxation.
• Grounding. Practice grounding exercises that are designed to keep you "grounded" in the present moment, rather than caught up in replaying events in your head, worrying about the future or zoning out. 
• Mindfulness Meditation. Practice mindfulness meditation, which helps you to observe and describe your experiences without judging or rejecting them. 
• Active Problem-Solving. Consider the problem at hand: Is there a way to solve the problem directly? (source for 5-10)

*I am not saying medication may not be necessary for some

BPD Community Pinterest

I love Pinterest and I find myself spending more and more time sharing inspirational quotes I find on there.  So, I decided to create a Pinterest Community page.  E-mail, comment here or DM on Twitter with your e-mail address and you can view, share and add your own pins.  

As an FYI I had to set it up as a business account, otherwise it would sync with my personal account (and only so many people can look at Corgi boards!) 

I won't be doing any kind of "screening" before someone posts on there, so if you see anything triggering or inappropriate let me know and I will be quick to delete and if necessary un-invite someone.

BPD Community

Blog Roll

Just wanted to make a short post to bring attention to the blog roll on the right. New blog coming soon on romantic relationships and BPD.

Hope you are enjoying the winter (or summer depending on where you are!)

Mental Illness and Self Identity

Since the book contest has been going on for a week (congrats winners!) I have not been blogging, but now my ideas are running amok so it's time to put down on paper what's swirling around my mind.

I have been getting a lot of questions about the new changes to the BPD diagnosis in the DSM5 coming out in May 2013, which was just finalized this weekend.  The new diagnostic criteria for BPD in my opinion is vague and covers too many people.   But what if looking at the current criteria, and after years of therapy, DBT, CBT, therapy, heck even EMDR therapy you now meet 1 or 2 of the criteria when 5 or more criteria equals a Borderline Personality Diagnosis?  Well, first off you no longer have a BPD diagnosis (per the DSM IV-r) but does this make you "cured?"

"Recovery may seem like an illusory concept. We still know very little about what this process is like for people with severe mental illness. Yet many recent intervention studies have in fact measured elements of recovery, even though the recovery process went unmentioned. Recovery is a multidimensional concept: there is no single measure of recovery, but many different measures that estimate various aspects of it. The recovery vision expands our concept of service outcome to include such dimensions as self-esteem, adjustment to disability, empowerment, and self-determination. However, it is the concept of recovery, and not the many ways to measure it, that ties the various components of the field into a single vision. For service providers, recovery from mental illness is a vision commensurate with researchers’ vision of curing and preventing mental illness. Recovery is a simple yet powerful vision  (Anthony, 1991.)"

I have worked with many people whom were diagnosed with a mental illness, and though therapy, groups and sometimes medications, were doing better; holding down jobs, attending college, making friends and felt like they were lost for a while, "I have been Bipolar for so long who am I now?"  I think this mindset can be especially true for some with BPD, since the therapy is so intensive and the community is so tight-knit.

Take for instance a client I worked with whom had Bipolar disorder with psychotic symptoms; he had been attending NAMI groups for years, most of his friends were from the mental health clinic I worked at, his calendar was filled with Bipolar workshops, meetings, and events he had been attending for years.  After years of therapy and medication he was still attending these events and at some point I told him he was the poster child for "Bipolar Success."  He was confused by this term "success," he asked, "am I cured?"  I opened the DSM IV-r and read through the criteria for his current diagnosis- he meet 2, when 5 was needed.  After I assured him that he was not going to be dropped from services due to this (oh, insurance woes,) we spoke about if he should continue to spend 20 hours a week surrounded by those with a mental illness he no longer has? Should he drop all his friends? Was it appropriate to discuss at NAMI meetings issues surrounding a mental illness he no longer has? Should he tell people?

After a 50 minute session and a follow up phone call (he was "freaking out!") we decided his plan of action; it is okay to continue the relationships he has created, he can be a role model for others regarding what recovery looks like; attending NAMI meetings-okay BUT new doors are now open he didn't think were when he was diagnosed before; college classes, a healthy relationship (he was too embarrassed prior to have one,) and  full-time employment over collecting disability.  He was (understandably) so attached to his identity that he didn't know who he was without it.

I understand this isn't the case for all people with Mental Illness, as some hide their mental illness from others, are not properly diagnosed and some even avoid the reality of their illness.

Here is a great list of people's stories regarding their mental illness recovery Connections: Stories of Recovery from Mental Illness:

"Today, LeRoy doesn't see any doctor for therapy. He sees his doctor simply to refill his prescription when needed. His treated Delusional Schizophrenia affects him as much as treated diabetes or high blood pressure would. He takes responsibility for it, and life goes on.  "I take my pill at bedtime. I haven't really had any side effects," he says.  But perhaps there has been a side effect his job. As a survivor of a mental illness, LeRoy realized he now has a responsibility not only for his own recovery, but for the healing of others. So he's made a career of it. LeRoy helps other people with mental illnesses, called clients, as they walk their own road to recovery.  He says he may be making less money than he set out to earn, but he's helping more people than he ever thought he could.   In addition to mentoring and supporting people with mental illnesses, LeRoy tries to teach the public about mental health issues. He speaks to churches, schools, and practically any group or individual who wants to hear about the bravery of those who battle mental illness.  It's easy for LeRoy to talk about bravery, because it's bravery that helps him accept himself, accept his diagnosis, and go forward.  "You can't deal with your mental illness until you can agree with yourself that, 'Hey, I have a mental illness so I need to be responsible and take care of it.' "  He's brave. He's responsible. He's taken care of it. LeRoy Simmons is a survivor, (pg. 13.)"

 I would love feedback from anyone who no longer meets the criteria for BPD regarding how they got recovery and how (if at all) their identify was wrapped up in their diagnosis.

Book Contest Winners!

*The e-books were e-mailed out today and the other 2 books were ordered and will arrive shortly*

I am happy to announce the winners, whom  all have been notified.  I received 53 entries and had 12 winners in total- twice as much as November's contest.  Some of you entered here and on twitter and a few daily.  Below are the winners.  If you won Buddha and the Borderline or Gift of Imperfection please e-mail (alicia.paz.ma(at)gmail.com) or DM on twitter your physical address so I can have it shipped to you via Amazon.  I will send the e-books and 2 other books out once I get everyone's e-mail and physical addresses- hopefully Monday.) I abbreviated all names listed below for privacy.

Stop Sabotaging: 31 Day DBT Challenge to Change Your Life

• Stephanie J (Blogger)
• Jennifer C (Blogger)
• Paul K (Twitter)
• Tee B (Twitter/Blogger)
• Befuddled N (Twitter)
• The Guy... (Twitter)
• HeavensP (Blogger)
• Rhonda (Blogger)
• Cass (Blogger
• Dltd (Blogger)

The Buddha and the Borderline

• MsStitch (Twitter)

The Gift of Imperfection

• Stephanie E (Twitter/Blogger)