- Do borderlines always have all the symptoms?
QUESTION:
Dear Dr. Heller,
Hello, I was looking at your website, and had a few questions that were not covered. If someone has BPD, will they exhibit all of the symptoms, like cutting themselves, and suicide, or can the exhibit a milder form of this disorder?
I guess what I am getting at is I was involved in a relationship with a person, who had shown some of the signs of BPD, more so the milder symptoms, saying they love one day the not having anything to do with you the next day. I understand that is a broad description of the events that take place with this disorder, but I guess I was wondering if there are a milder version of this disorder, and maybe a some places to collect more information about it.
ANSWER:
One only needs to have 5/9 criteria consistently, causing significant problems to have the diagnosis. Most borderlines don’t self-mutilate.
I believe the BPD is due to damage in the brain’s “trapped, cornered, wounded animal” instinctual response, located primarily within the limbic system. An instability in that area causes unprovoked mood swings, chronic low level anger, emptiness, boredom and emotional pain (like one’s best friend died) . Under stress they experience an epileptic phenomenon (nerve cells firing inappropriately and out of control) called “dysphoria” (anxiety, rage, depression and despair). If the seizure spreads to the temporal lobes dissociative symptoms such as deja vu and unreality can result.
Borderlines generally find some activities that temporarily stop the dysphoria, such as binge eating, binge spending, reckless driving, etc. Some find cutting the skin in a linear manner also stops the horrible dysphoria (anxiety, rage, depression and despair), just like scratching insect bites stops the horrible itching.
Mild versus severe is difficult to define. It really depends on how the symptoms are interfering with life and affecting others. There is a considerable range of variability in how symptoms manifest.
