Is BPD really just an addiction?

[Skippy]

Is this all about addictions?

After reading WO Eggshells (2X), reading many posts (52 hours on this site), and looking at the practicality of the relationship, it's hard to come to a conclusion that these relationships can be very rewarding in the long run. Mine is a high functioning BPD with any self destructive (mutilation, etc) behaviors.

It seems, at best, that:

1) you need to be able to, periodically and without warning, be able to make evasive maneuvers to avoid major dramas;

2) you need to react to challenges with a wholly unnatural reaction (hide / mask feelings or deny them)... .

3) you need to keep morphing as your BPD partner will find new and different ways to push their behavioral disorder on you... .including acting behind your back. They are very creative this way... .they have to be... the need the "supply"... .and then the clincher... .

4) if you're successful, they very well might will leave you for a better source of supply.

I had the chance to really test it all. 

In my most recent encounters, I approached her with everything I learned from reading and with the calm and maturity I have... .only to watch her create a huge relationship threatening drama from thin air... .I was effective at dodging her normal actions... .but that frustrated her until she finally declared that I "stepped over the line" .  My "crime" was a situation that was so minor and so trivial it's laughable.

They are not bound by fairness, by reasonableness, by your feelings, by their children's feelings, by reality... .its all up for grabs it needed to get supply. 

They are addicted to it. 

Does this make sense? (please have at it!)

[jreilly]

Erin Pizzy in her book "The Violent Pronce Individual" makes the same observation about the women she saw in her shelters.  Her observation was that the generally the women who screamed the loudest about male abuse were in fact the women who consistently sought out violent men to interact with.  Erin said these women were "addicted to violence" and were educating their children to follow the same path.  Her contrast were the women who fell into violent relationships, realized it and got out to move on with life.  Her case study were the 5,000 families she gave shelter to over the years she was allowed to run shelters, before the gender politics took over and all men were seen as the perps and all women were the victims. 

[TaloninTx]

This is just my opinion so take it with a grain of salt... .

I'd say "yes... .and no." The addiction is there to fill an emotional hole that they are unable to deal with as a rational person but it's just so much more complicated than "they're addicted." I think the addiction is just a symptom of the real problem which can be a tangle to unravel. Everything I've read so far says that clinically dealing with BPDs is horrendous difficult where as dealing with addiction in general is pretty common place and treatable.

I don't think you should try to rationalize your BPperson to being an "emotional addict." It's only one side to a multi-faceted problem.

[snaillady2]

In the realm of medicine and science, addiction has a very precise definition, which I will attempt to describe here.  Addiction is a biological, organic concept where the person has a measurable physiological response to withdrawal of the addicted substance.  Addictions of all forms have been shown to have measurable effect upon the mesolimbic dopamine system, with withdrawal symptoms stemming from the inbalance in this system which resulted from the addiction.  There is considerable debate in the field of addiction that pre-existing deficits in the mesolimbic dopaminergic system may make one more susceptible to addiction (an "addictive" personality), but biological characterization of this has not been performed at this time. (sorry for the science-speak, I've been editing a paper recently).

In my opinion, BPD patients do not appear to exhibit physiologically relevant responses in response to withdrawal of emotional stimuli such as that which skipping back performed.  Psychological responses, yes. Physiological responses, no.  To my knowledge, there is no evidence of mesolimbic dopaminergic involvement in BPD, although studies of this type would be complicated due to cofactors often associated with BPD, such as drug/alcohol addiction, mania, and depression, which also effect the mesolimbic dopamine system.

At this time, BPD is classified as an Axis II disorder, personality disorder, not disease. As per the guidelines of the DSM, this suggests that there is a psychological, rather than physiological condition which leads to development of BPD.  There is no physiological evidence that BPD itself is a disease.  The evidence that BPDs, while helped by drugs, are not CURED by drug/biochemical intervention, but rather through intensive behavioral and cognitive therapy also supports the hypothesis that BPD is more principally a psychological, rather than physiological disorder.

Can BPDs exhibit symptoms of dependence?  Yes.  Could there be a genetic component to BPD?  Yes.  Does that make it a physiologically dependent disorder? That depends.  A genetic component can make one more susceptible to development, but in the absence of the trigger, it could also lie dormant. 

As we learn more about the neurological sequelae associated with psychiatric disorders, it is quite possible that personality disorders will be reorganized into Axis I disorders, but at this time that is not the case.  Successful identification of neurological targets effected by BPD and relief of symptoms through biochemical treatments would enable reclassification into something more akin to an axis one disorder, such as ADHD, schizophrenia and bipolar, which were previously thought to be more psychologically-based.  Or another example is the identification of neurological deficits associated with autism.  While we still do not have drugs that successfully treat the disorder, we have identified neurological/biological components that are consistently associated with the disease, thus it's "reclassification" from a personality disorder (often attributed to the mothers actions) to a biological disorder.

Hope this clarifies some,

--Snails