Q. I am a 59-year-old gay male, who has been recently diagnosed with BPD. I was epileptic in adolescence, resulting from a head injury when I fell off an 8′ porch when I was about 3. I was on Phenobarbital for several years. The seizures disappeared when I was about 14. Soon after that I began having “rage attacks” in the fifth and sixth grades. I have 7 of the classic 8 conditions for BPD.
My interpersonal relationships have been horrific throughout my life. I live with a person who has put up with the behavior for 27 years. Within in the last 3 years, however, I have been having 3 separate affairs. But I manage to “dynamite” them in order to end them, and then go through all the abandonment steps…. My life is a mess!
My current “affair” has lasted for a year, but it is also on the skids. I’ve raged it to death! The difference this time is, however, that the significant other is a therapist himself. Within the last two or three months, he has begun questioning whether I might not be a BPD. He has never acted as my therapist, but just as a loving friend.
I see a therapist (psychologist) regularly at Kaiser Permanente. At Kaiser, however, they will not prescribe drugs for me. I realize that meds will not do away with the core problems (epilepsy being only one of them), but I think it will put me in a more functioning mode for getting on with what is left of my life.
A. Don’t assume medication won’t have a profound effect. It can – particularly if you learn how to check your moods hourly and treat rages early and preferably before they happen.
I believe the BPD is epilepsy – brain cells firing inappropriately and out of control. This causes the core symptoms of inappropriate moodiness, chronic anger, emptiness, boredom (although removed from DSM IV), emotional pain (feeling like your best friend died all the time) and stress symptoms: dysphoria (anxiety, rage, depression, despair), dissociation (deja vu, unreality, looking through another’s eyes), misinterpretation of motives – usually leading to paranoia (I call it the “cornered animal response”) and occasionally hallucinations.
Those biological problems combined with behaviors, traumas, etc. that have caused you problems are the issue (along with any other diagnoses you have). First things first: get the diagnoses correct, then get on the right meds (including the right sequence). Once doing better then you must learn to like and love yourself and to think like a successful person.
Don’t fall into the trap of believing that your life will stay miserable because of things that have happened in the past. That’s not true unless you choose to make it true.