Dr. Leland Heller Discusses BPD

"...Epilepsy was once thought to be a psychiatric problem, until the underlying neurological abnormalities were understood. Researchers have uncovered medical and neurological abnormalities in borderlines. Many symptoms are likely due to malfunction in the brain's limbic system. In my opinion, the borderline personality disorder is primarily a medical problem. It can now be treated.

The Borderline Experience

Imagine you are faced with a minor stress - a flat tire, a clogged-up sink, or a trivial disagreement with your spouse, friend, lover, child, etc. Instead of finding an acceptable solution, your mind seems to panic. A sense of unease develops, possibly causing discomfort in the stomach or chest. Feelings of anxiety complicate the increasing sense of uneasiness and restlessness. This is followed by progressively worsening anger - eventually becoming a rage so strong it overwhelms you - even though you realize it's excessive. Over the next few minutes to hours, other negative sensations creep in - including memories of past hurts - until you are experiencing virtually every bad emotion a human can feel.

You feel trapped and vulnerable. Your psychological defenses are overwhelmed by unbearable emotional pain. You feel depressed. You find yourself unable to cope as your mind and body are now in a full scale panic. You lose proper perception of reality - jumping to erroneous conclusions in a futile effort to make sense of what's happening. As the pain continues to intensify the nervous system creates bizarre sensations such as emptiness, numbness, and unreality. You become incapable of rational thinking as the panic continues to worsen.

Your mind now desperately tries to find a way out of the pain and searches for solutions. It recalls past activities that have made you feel better. Once a method is found, your mind frantically forces you to pursue that activity to a self-destructive excess - finally resulting in a biochemical rescue. Brain chemicals are released that stop the pain and let you feel 'normal' again.

But how can you ever feel normal again knowing that such a horrible experience will return? How can you feel normal again when your self-destructive and inappropriate behaviors are witnessed by family, friends, employers and/or co-workers? How can you feel normal again when those behaviors result in financial, interpersonal, physical, or legal trouble?

For those not afflicted with the Borderline Disorder this is a nightmare we hope never happens to us. Borderlines experience it over and over - especially when confronted with stress. While individual borderlines may feel some symptoms differently, the horrible feelings described in the first paragraph (called 'dysphoria') intrude frequently into a borderline's life.

Borderlines will do almost anything to make dysphoria go away. Most impulsiveness and self-destructiveness is an effort to relieve dysphoria. Some borderlines, especially those suffering very severely, will literally cut their bodies during dysphoria. The self-mutilation is itself painless (the cuts don't hurt), yet it relieves the dysphoria.

Borderlines also suffer from intense, frequent and unpredictable mood swings that can cause 'dysphoria' even without stress. The mood swings cripple a borderline's efforts to live a happy, successful life. Borderlines are victims of an incredibly painful illness...

Like victims of epilepsy, muscular dystrophy, and neurofibromatosis (the 'Elephant Man's' disease), victims of borderline neither asked for, deserved or caused their affliction. The symptoms can be so unpleasant to those interacting with borderlines that feelings of compassion and understanding may be difficult or impossible to feel. Borderlines desperately want to be loved, but their illness makes them at times seem unlovable. They are terrified of being abandoned, yet are powerless to keep the illness from destroying relationships.

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