Sunday 14 November 2010

A Capitalist Take On Mental Health

This is an article by a member of the Socialist Party of England and Wales. They are talking about how they believe capitalism influences mental health problems and treatment, and the answer to the problems they believe capitalism poses. This is not necessarily our view, it is just one of many views of BPD worth discussing in order to learn more and understand more.

At Socialism 2010 I went to the session on Mental Health and Capitalism and I asked if I could feed back from it. This is a summation of the talk and discussions we had.

The speaker, Steve Bell, a mental health nurse and a Unison Service Group Executive, explained that he felt that mental illness is actually a sane reaction to the craziness of capitalism. Mental health problems are a natural reaction to stresses in our lives.

Everyone has stresses in their lives, but not everyone goes on to suffer mental health problems because of this. However, one in four people do experience some sort of mental illness during their lives. The sorts of stresses people have include neurological trauma pre-birth, during birth and in the vital months after birth, childhood abuse of any kind, bullying, existential and identity concerns during puberty and for women, often, pregnancy. 

There are also the stresses that are more explicitly linked to capitalism. Housing concerns, work stress, being downtrodden by management, long hours, banal jobs, underpayment, difficulty finding a job, lack of job security, lack of free time, lack of money to enjoy social activities, lack of sufficient childcare and education for one’s children... and all the other problems we often discuss. These stresses are increasing, especially in the current climate, and so too is the prevalence of mental health problems.

What a person with mental health problems essentially suffers is the reliving of these stresses over and over again every second of the day. Their body is shot by the stress and their mind is battered. The links between the mental and physical aspects of mental illness are shown in the cognitive behavioural model. In it, there is a triangle of factors that affect or are affected by mental ill health. They are behaviour, thoughts and feelings. For example, behaving in a negative way reinforces the person’s idea that they are a bad person, and this in turn makes them feel depressed. Feeling depressed they end up behaving negatively again. This makes them feel worse and thus reinforces their idea that they are hopeless. The cycle goes on, but can be broken.

The treatment of such illnesses is often a subject of heated debate by those on the left, with the ‘Big Pharma’ and all medication often being seen as entirely negative, and the anti-psychiatry movement resenting even the diagnosis of such problems as a way of labelling someone incurably ill. None of this, however, is a balanced reaction to the real problems. Medication IS effective in helping those with mental health problems. It tackles the ‘feelings’ bit of the cognitive-behavioural model – thus calming and stabilising the patient enough to be open and responsive to therapy. Talking therapy can then challenge the thought and behaviour patterns, and all together the medication and therapy can help to dramatically reduce the impact of the mental health problem on the person’s life, or, even, to cure it.

However, there is a problem with medication and the ‘Big Pharma’. And there is a point to be taken from the anti-psychiatry movement who resent labels that seem to give people a hopeless diagnosis of a seemingly perennial disease. There are two factors to this. The first is the link between pharmaceutical companies and the mental health practitioners. The companies want the practitioner to prescribe more and more drugs. 

Mental health problems are encouraged by the market to be treated with ‘medication, medication, medication!’ If one drug doesn’t quite work, they’ll throw another one in to balance the side effect, and then another for the side effects of that if necessary too. Most mental health patients are over-medicated. At the other end of the problem is the lack of therapy being offered by the NHS. Without therapy a diagnosis may seem like a life-sentence. Without therapy mental health problems can be seen as a weakness that someone has been labelled with forever. The anti-psychiatry movement no doubt gain momentum from the fact that the status quo is not to offer therapy. Therapy is expensive to the NHS and can take years to be effective to the state of a patient being considered ‘cured’ of their mental illness. In fact, when you ask a GP for counselling or therapy, they will no doubt refer you to a charity who is doing the government’s work for them, or to a private therapy company that the government is funding to do the job of the NHS for less. 

Of course, without the stresses of a capitalist society, there would be a lot less mentally ill people needing such services. Without imperialist wars there would not be another generation of ‘shell-shocked’ soldiers with PTSD. There would be suitable homes for all. Jobs for all. A good wage. A good and free education. Crime would no doubt have fallen. Drug abuse would be lower. However we cannot hold up socialism as a plaster to the wound – it would be an insult to those currently suffering. We cannot say ‘join the party, bring in the revolution, then you’ll be ok!’ Instead our demands and efforts need to be transitional.

We need to protest, lobby, petition, inform and even strike for the good of the mentally ill. Cuts to the NHS and to disability benefits can hit the mentally ill the hardest. Cuts to services such as talking therapies will see more over-medicated but under-therapised patients who see no future ahead. The mentally ill will fall foul of ‘fit to work’ initiatives due to nonspecialist practitioners seeing no visible symptoms of their problem and thus declaring they must seek work or their benefits be ceased. We need to fight the closure of acute mental health wards. We need to resist the privatisation of mental health services. We need to stand by the NHS workers when they strike. We need to fight against cuts to DLA and ESA. That way we can truly stand by the mentally ill and fight capitalism together as one.

Is there a link between politics and mental health? Is capitalism really the enemy or is socialism a far greater threat to health and the health service?  

Thursday 21 October 2010

Mind and Soul

Is belief in God a big part of your journey with BPD? Have you found that your religious beliefs have comforted you through the tough times? Or has your faith community let you down, not knowing how to treat someone who is mentally ill? Perhaps you have been told that your disorder is a result of sin, or demons? Maybe you see your symptoms in a spiritual light, and the the fluctuations of energies that you experience as a manifestation of a higher power? 

Here, Paul tells his story of childhood sexual abuse, Borderline Personality Disorder and christianity. If you want to know more about a christian mental health perspective, visit Mind and Soul, a website exploring christianity and mental health.


I was sexually abused as a child. It went on for approximately six years. It had a very big effect on me. I found it very confusing. My parents provided a stable home environment and cared about me. Like many people, communication between my self and my parents was not very good. My parents did not know I was being sexually abused. I told them about it when I was an adult. They both believed me when I told them which I found very helpful. I did not feel able to tell anyone about it at the time. The person abusing me told me that if I told anyone I "would go to Hell", which was quite a deterrent to a ten year old.

As I grew up I had this "big secret", about an adult having sex with me, which I felt I could not tell anyone about. I started to have very strong feelings and troublesome thoughts about the whole situation. I felt very guilty about what was going on. I felt very ashamed of my self. I felt very angry. I felt deeply resentful towards my abuser. I also had confusing and contradictory feelings, for example sometimes I liked the attention and some bits of the sex. This would confuse me further. The person abusing me seemed to really enjoy the power they could have over me. They would repeatedly tell me how wrong this activity was and stop it, for a few days, and then they would start it all up again. This repeated acceptance and rejection over and over again really 'did my head in'. This went on for years. I also had increasingly high levels of anxiety and a constant fear of being found out. I started to hate my self and struggle with suicidal, violent and self-destructive thoughts and impulses.

During this time I appeared fairly normal to the outside world. My grades fluctuated a lot. When I got to thirteen I discovered alcohol and some drugs and gambling. I found if I did these excessively and impulsively then the really bad mixture of thoughts and feelings in my head would go away for a short while, only they always came back and my repetitive excesses caused me and those around me increasing problems.

I ended up spending four months in a rehab for alcohol dependency when I was nineteen. I joined A. A., did their 12 step program and stayed sober for five years. I tried two years of psychotherapy. I went to university and got a first class honours degree and started teaching at university. However I still felt very hurt and troubled inside and struggled with suicidal thoughts.

Nothing seemed to solve my inner turmoil. I returned to drink and drugs, and became addicted to amphetamines. Sometimes I stopped drink and drugs for weeks or months but found my problems stayed the same. I had difficulty forming relationships as they caused me great anxiety and I found it difficult to manage my feelings such as resentments, fear, low mood, violent thoughts, loneliness, envy, shame and guilt. I spent the next four years in and out of the psychiatric hospital in Bradford. I lived a very self destructive lifestyle. I was given lots of medication and diagnosed with bi-polar disorder, then psychotic depression and finally with "Borderline Personality Disorder". No one explained what this meant. Sometimes I took overdoses or cut my self. I felt utter despair.
Then I overheard someone called Barry telling someone that Jesus had died to set them free from all their wrongs and had risen from the dead so they could be 'born again' into a 'new life'.

I suddenly thought, "it's true" and I knew I needed to be 'born again'. I then joined a church. The best thing was that I was accepted into a home group and the people really seemed to care about my well being and believed I could get better. I felt I belonged somewhere instead of being an outsider. I worked through the 12-1/2 Steps to Spiritual Health, outlined in a book the vicar (Howard Astin) had written. This was just basic Christian practice: I admitted that I did not have the power on my own to sort out the serious set of problem habits I had. I asked Jesus to be the Boss ("Lord") of my life from now on. Barry prayed for me to be filled with the Holy Spirit, this gave me the power to live out this new way of life. I then admitted every thing I had ever done wrong in my life, wrote it down and shared it in confidence with two other Christians who I had come to trust (Barry and John). I admitted all the problem habits I had formed in reaction to being abused (self hatred, addictions etc.), I then turned away from my previous way of life and believed God had forgiven me. I also shared all the hurtful and damaging things that had been done to me with these two men and forgave anyone who had hurt me, including the person who had sexually abused me. This was a great relief. I then was prayed for to be healed of the hurts of the past. I do not think I could have been healed without admitting my wrongs, turning away from them and forgiving the wrongs of others towards me.

I then have spent the next seven years living out my salvation and growing and maturing in line with God's word (the Bible). I got and continue to get a lot of support from my church. I started dating for the first time in ten years and have since married my wife who is a great blessing and loving support to me. I also have two step children. I came off benefits and am now in full time employment working with clients who have a "Personality Disorder" diagnosis like I had. I enjoy life and feel fulfilled. God has been very good to me and I want to share some of his love with others. Jesus promised that he had come to give us new life to the full, and he has. Along the way have been many struggles as I have had to submit to God's will and not my own. I love 'the new way of the Spirit' and am glad the power of the evil one was broken by the power of Jesus' resurrection from the dead. I was 'dead' in my spirit but rose again with Jesus! Praise be to God, who has the power to transform people's lives.

Monday 18 October 2010

BPD Survey

American charity, Love Is The Cure, are running a survey at the moment and need as many people with BPD as possible to take it in order to get the best results. There is a link to their website in our side bar and the results will be made known in due time.


www.kwiksurveys.com/?s=HHOMNO_9e65258


Thank you ever so much for helping us to help them.

Thursday 7 October 2010

BPD Relationships - I Hate You, Don't Leave Me

Unstable and intense interpersonal relationships are taken by some to define the life of the borderline. Those with BPD swing from extremes of ideation to devaluation, or, in simpler terms, are renowned for pushing away those they are desperate to draw close to. But are relationships always doomed to fiery burnouts for those with the disorder?


Many psychiatrists see that a stable, loving relationship can be the catalyst to a 'cure' for someone with BPD. A partner who can't be pushed away, won't let words said in fear of loss make them actually lose them, and won't believe that things will never get better can be the stability and unchanging rock that a borderline needs. Extremity can be tempered by a calm presence and irrationality needs a rational, listening ear to be comforted, confronted and changed.


For many, such a stable relationship has never materialised. They learn instead that if they push hard enough, one time they will push too far. They see that they can at least control the pain by being the one to bring it, rather than waiting for the other person to do the seemingly imminent breaking up of the relationship. They see that their fears of losing those they love become realities time and time again. They become closed off to the idea of love when love could be the cure.


This highlights yet another reason why greater awareness and understanding of BPD is needed. When the person that a borderline is in a relationship with truly understands why they are behaving as they are, it is much easier for them to rationalise it, not be pushed away by it, and even challenge it and comfort the concerns causing the person to behave in such a way in the first place. But whilst there is still ignorance about the disorder and while people still believe that once a borderline is always a borderline, the sufferer will be reinforced in their sense that they are and can be their own worst enemy.

Monday 4 October 2010

"A Famous Fictional Example Could Spread Awareness" - Anakin Skywalker Has BPD?

Eric Bui, French psychologist and psychiatrist, proposed that psychiatric help could have prevented the emergence of Darth Vader.

"I believe that psychotherapy would have helped Anakin and might have prevented him from turning to the dark side," Bui said. "Using the dark side of the Force could be considered as similar to drug use: It feels really good when you use it, it alters your consciousness and you know you shouldn’t do it."

Is psychotherapy what is needed to stop more people turning from a troubled Borderline Anakin into a broken and destructive Darth Vader? Or does the parallel drawn with Star Wars only further stigma that those with BPD are the baddies of society, going from showing six of the diagnostic criteria for the illness to a total breakdown and swing to the Dark Side?


[Bui and colleagues] have used the "Star Wars" example to teach their students for the past few years, and noted that such a famous fictional example could spread awareness.


It is certainly true that celebrities being open about diagnosis with a mental disorder does help raise awareness for that disorder. However along with the hightened awareness does not always come heightened understanding. Seeing the extreme behaviour of celebrities with bipolar, for example, doesn't lead to a balanced understanding of how bipolar affects the majority of people. Thus, when we search to herald news like this a victory for BPD awareness, we must temper it with a call for greater understanding too.


Read the rest of the article here and make up your mind.

Is Anakin Borderline?
If so, can we use this to help us fight stigma?
Or, should we dismiss such diagnoses of fictional characters as irrelevant and unhelpful? 

 

Monday 27 September 2010

All About Me - A LiveJournaler's Experience Of BPD

We firmly believe that the best way of raising awareness and understanding of BPD is through each individual's story. Whether it be the experiences of a sufferer or of their carer, the varying but converging stories help us understand ourselves better, and help those who are unfamiliar with the diagnosis have a greater idea of just what BPD means - not as a diagnostic criteria, but as a real, life-bending illness.

We're asking that if you visit this website and have a story to tell, don't stay silent. Email us the story at BPDaware@hotmail.co.uk and we'll showcase it right here - anonymously if you wish. Your story can make the difference. Your story is our greatest weapon. 


Here's what I know about me, personally, as a BPD sufferer. Some may be relevant to the disease, some may not. However, I hope this list will help pinpoint some of the causes of the disease, from a biological standpoint.
  • I experience severe and frequent mood swings
  • I am a self-injurer
  • I am frequently suicidal
  • I have attempted suicide on more than one occasion
  • I have been described as manipulative
  • I have been described as fishing for compliments
  • I am awful with money
  • I have difficulty trusting others
  • I am overweight
  • Sleep significantly affects my mood
  • Eating can affect my mood
  • I am near-sighted
  • Music affects my mood
  • I experience "personality shifts" (My patterns of behavior change based on who I am with.)
  • My moods can change significantly based on who I am around
  • I have anxiety issues
  • I have social phobia issues
  • I have abandonment issues
  • I have trust issues
  • I change my hair color frequently
  • I make many decisions based on the moment
  • I hate big changes in my life
  • I am messy
  • I have been described as lazy
  • I have a rich and variety fantasy life
  • My dreams are vivid and I prefer my dream life to my waking life
  • Meditation has helped me some in the past
  • Medication has not helped me very much in the past
  • I need personal therapy on a weekly basis just to vent my feelings
  • I dislike and distrust group therapy
  • I prefer being cold to being hot
  • I smoke
  • I drink caffeine
  • I drink alcohol occasionally, although I fear addiction and avoid it mostly. Plus, it screws with my sleep and I don't like that.
  • Speaking of sleep, the amount of sleep I need varies greatly as does the quality of my sleep.
  • I like to start things, but rarely finish them.
  • I am a sugar addict
  • I am a fidgeter
  • I have severe menstrual cramps
  • I am allergic to cats and pollen
  • I think out loud sometimes
  • I talk to myself
  • When faced with a challenge that I find too insurmountable, I tend to shut down emotionally and physically.
  • I have astigmatism
  • I love to read
  • I can't stand drama, although I fear I cause it
  • I am always wondering what other people think about me
  • I always assume people are thinking negative things about me
  • I often assume fault automatically and have been accused of apologizing too much
  • I crave security

    By BPDCure at LiveJournal



Saturday 25 September 2010

The Mystery of Borderline Personality Disorder

We have chosen to share this article from the US Time magazine with you because it showcases perfectly and succinctly some of the statistics along with some of the misunderstandings that BPD Aware are campaigning for a greater awareness and knowledge of. The statistics found in here, along with many more, can be found under the 'BPD Stats' tab near the top of the page. A full response to some of the stigmatic ideas presented here is found under the 'BPD Stigma' tab, and will help you make your way through the truths and trivia found in this article. Explore and enjoy.

By John Cloud, Seattle. 08/01/2009. Time.
With a final paragraph by BPD Aware.
Doctors used to have poetic names for diseases. A physician would speak of consumption because the illness seemed to eat you from within. Now we just use the name of the bacterium that causes the illness: tuberculosis. Psychology, though, remains a profession practiced partly as science and partly as linguistic art. Because our knowledge of the mind's afflictions remains so limited, psychologists — even when writing in academic publications — still deploy metaphors to understand difficult disorders. And possibly the most difficult of all to fathom — and thus one of the most creatively named — is the mysterious-sounding borderline personality disorder (BPD). University of Washington psychologist Marsha Linehan, one of the world's leading experts on BPD, describes it this way: "Borderline individuals are the psychological equivalent of third-degree-burn patients. They simply have, so to speak, no emotional skin. Even the slightest touch or movement can create immense suffering." 

Borderlines are the patients psychologists fear most. As many as 75% hurt themselves, and approximately 10% commit suicide — an extraordinarily high suicide rate (by comparison, the suicide rate for mood disorders is about 6%). Borderline patients seem to have no internal governor; they are capable of deep love and profound rage almost simultaneously. They are powerfully connected to the people close to them and terrified by the possibility of losing them — yet attack those people so unexpectedly that they often ensure the very abandonment they fear. When they want to hold, they claw instead. Many therapists have no clue how to treat borderlines. And yet diagnosis of the condition appears to be on the rise.

A 2008 study of nearly 35,000 adults in the Journal of Clinical Psychiatry found that 5.9% — which would translate into 18 million Americans — had been given a BPD diagnosis. As recently as 2000, the American Psychiatric Association believed that only 2% had BPD. (In contrast, clinicians diagnose bipolar disorder and schizophrenia in about 1% of the population.) BPD has long been regarded as an illness disproportionately affecting women, but the latest research shows no difference in prevalence rates for men and women. Regardless of gender, people in their 20s are at higher risk for BPD than those older or younger.

What defines borderline personality disorder — and makes it so explosive — is the sufferers' inability to calibrate their feelings and behavior. When faced with an event that makes them depressed or angry, they often become inconsolable or enraged. Such problems may be exacerbated by impulsive behaviors: overeating or substance abuse; suicide attempts; intentional self-injury. (The methods of self-harm that borderlines choose can be gruesomely creative. One psychologist told me of a woman who used fingernail clippers to pull off slivers of her skin.)
No one knows exactly what causes BPD, but the familiar nature-nurture combination of genetic and environmental misfortune is the likely culprit. Linehan has found that some borderline individuals come from homes where they were abused, some from stifling families in which children were told to go to their room if they had to cry, and some from normal families that buckled under the stress of an economic or health-care crisis and failed to provide kids with adequate validation and emotional coaching. "The child does not learn how to understand, label, regulate or tolerate emotional responses, and instead learns to oscillate between emotional inhibition and extreme emotional lability," Linehan and her colleagues write in a paper to be published in a leading journal, Psychological Bulletin.

Those with borderline disorder usually appear as criminals in the media. In the past decade, hundreds of stories in major newspapers have recounted violent crimes committed by those said to have the disorder. A typical example from last year was the lurid tale of an Ontario man labeled borderline who used a screwdriver to gouge out his wife's right eye. (She lived; he got 14 years.)

There are several theories about why the number of borderline diagnoses may be rising. A parsimonious explanation is that because of advances in treating common mood problems like short-term depression, more health-care resources are available to identify difficult disorders like BPD. Another explanation is hopeful: BPD treatment has improved dramatically in the past few years. Until recently, a diagnosis of borderline personality disorder was seen as a "death sentence," as Dr. Kenneth Silk of the University of Michigan wrote in the April 2008 issue of the American Journal of Psychiatry. Clinicians often avoided naming the illness and instead told patients they had a less stigmatizing disorder.

Therapeutic advances have changed the landscape. Since 1991, as Dr. Joel Paris points out in his 2008 book, Treatment of Borderline Personality Disorder, researchers have conducted at least 17 randomized trials of various psychotherapies for borderline illness, and most have shown encouraging results. According to a big Harvard project called the McLean Study of Adult Development, 88% of those who received a diagnosis of BPD no longer meet the criteria for the disorder a decade after starting treatment. Most show some improvement within a year.

Still, the rise in borderline diagnoses may illustrate something about our particular historical moment. Culturally speaking, every age has its signature crack-up illness. In the 1950s, an era of postwar trauma, nuclear fear and the self-medicating three-martini lunch, it was anxiety. (In 1956, 1 in 50 Americans was regularly taking mood-numbing tranquilizers like Miltown — a chemical blunderbuss compared with today's sleep aids and antianxiety meds.) During the '60s and '70s, an age of suspicion and Watergate, schizophrenics of the One Flew Over the Cuckoo's Nest sort captured the imagination — mental patients as paranoid heroes. Many mental institutions were emptied at the end of this period. In the '90s, after serotonin-manipulating drugs were released and so many patients were listening to Prozac, thousands of news stories suggested, incorrectly, that the problem of chronic depression had been finally solved. Whether driven by scary headlines, popular movies or just pharmacological faddishness, the decade and the disorder do tend to find each other.

So, is borderline the illness of our age? When so many of us are clawing to keep homes and paychecks, might we have become more sensitized to other kinds of desperation? In a world so uncertain, maybe it's natural to lose one's emotional skin. It's too soon to tell if that's the case, but BPD does have at least one thing in common with the recession. As Dr. Allen Frances, a former chair of the Duke psychiatry department, has written, "Everyone talks about [BPD], but it usually seems that no one knows quite what to do about it."


The conclusion that everyone talks about BPD but no one knows quite what to do about it is the problem that BPD Aware intend to focus upon. There is a faction of society who chatter about the illness, but even those who have heard of it don't understand it. The rest of the population just have not heard of it. They know of the illnesses that affect 1% of the population, but this one, which affects twice as many, is entirely alien to them. Because 75% of those with BPD self-harm, this symptom of the emotional chaos is often seen as the illness itself. Thus, it is true that a majority of the population have come across BPD, they just don't know that that's what it is! Psychiatrists simultaneously don't know how to treat BPD yet are diagnosing it more and more. Despite this, there is hope. Those who are diagnosed and receive treatment are getting better - 88% seemingly 'cured' within a decade. It must be remembered that BPD is not a death sentence. There can be healing and an 'emotional skin' can be grown with the right health plan and support.