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THE PSYCHOLOGY OF PERSONALITY DISORDERS
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Author Topic: DIFFERENCES|COMORBIDITY: Borderline PD and PTSD  (Read 39760 times)
LavaMeetsSea
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« Reply #10 on: September 09, 2007, 06:15:51 AM »

The amygdala is the part of the brain that regulates fight, flight, and freeze responses.  The hippocampus affects things like memory; it's why traumatic memories are often so darn different than regular ones, so intense and emotional, sometimes fragmented so you get the smells, sounds, body sensations, as a war veteran you probably already know.  Anyway, there's a bunch of research being done by Drs like van der Kolk and Herman, and they can actually see major differences in the way those parts of the brain function after trauma like combat, rape, torture, that sorta thing.
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LavaMeetsSea
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« Reply #11 on: September 09, 2007, 06:40:07 PM »

Hugs if ok, Shay.  I recommend reading "Trauma and Recovery" by Judith Herman; it's got research on Holocaust survivors, political prisoners, rape and incest survivors, war veterans, and a chapter on the history of shell-shock.  I need a medical dictionary to get through any of Bessel van der Kolk's stuff, but he's the one doing most of the physical/biological tests, so if you've got that kind of patience, he's a pretty good read too.
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NewLifeforHGG
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« Reply #12 on: September 09, 2007, 09:59:57 PM »

I notice that a lot of people with BPD will discuss the PTSD all day long but as a sufferer of PTSD I can say that I am nothing like my ex, his mother, my father or others I have known with BPD. I can have friendships, respect boundaries, have a minimal fear of abandonment and don't cause chaos wherever I go. I don't lash out, I don't feel empty and I am not abusive. I empathize with others.

I do get a numb feeling going at times, or can be fearful about safety sometimes but I have overcome most of it.

Having PTSD is very different than having BPD.
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LavaMeetsSea
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« Reply #13 on: September 15, 2007, 08:03:53 AM »

PTSD... it can manifest in many ways, but usually there's the flight, the fight, and the freeze.  When an experience triggering that much adrenaline prolongs, repeats, or is extreme enough, those reactions don't end with the experience itself.  Traumatic memory is different, more intrusive, more sensory, more state-dependent, which means you tend to feel it as intensely (or close) in memory as you did the first time around - maybe even more, if you were in shock or denial.  One of my triggers, for example, is hearing a police or ambulance siren.  I completely loose focus, my heart starts pounding, I have to remind myself to breathe, and I can count on not remembering a thing that was said to me if it was at work, in class, therapy, whatever, until that siren is gone.  I'm not reacting to what's really happening in the moment - I'm reacting to something that happened years ago.  Only it doesn't feel that way when I hear a siren.

Often my reaction is OVERLY empathetic... though if I dig deeper, I find it's really about identifying with the victim in a situation and I'm just vicariously trying to re-enact and somehow master the situation.  I've burst into tears just seeing someone with a nosebleed. 

On the other extreme, I do this thing where I step back and instead of feeling my life, it's like I'm watching a movie of it.  Short-term, it's calming and I too am really together in a crisis.  Long-term, it's made it difficult to inhabit my body, know what I'm feeling, and take comfort from the people around me.  Sometimes I can't shake that feeling, and the world seems garishly absurd, like I'm living in ToonTown at Disneyland, flat, disproportionate, unsubstantial.  When my depression was at it's heights, there were days when simply lifting a toothbrush felt like a Herculean task beyond my abilities.  I'd long for sleep, and not be able to.

PTSD is NOT pleasant, and I too went from refusing OTC meds to taking anti-depressants.  For me it's a quality-of-life issue, and a recognition of the lasting biological ramifications of trauma.  Still, I think talk-therapy is where most of the real lasting work is done.  The meds are like a crutch that helps you be mobile while the wound is healing.  Eventually though, you want to be able to get around without them.  You can't really do that unless it's cleaned out and set properly.  I guess what I'm trying to say is that there is no pill that'll get you out of bawling about it in front of someone else; it seems to be the only way to lessen the intensity, frequency, and duration of those %^&* flashbacks.

I think the easiest differences to spot between PTSD and BPD are relational, though.  I went to a support group for sex abuse survivors for a year.  We all had PTSD symptoms, and most of us eventually outgrew the group.  We maintain the friendships though, and most of us use the techniques we learned and have all gotten (at least a little) better.  My BPD Mom and sister were not at my wedding.  Four of my old support group friends were, even though I'd moved.  One of them did my hair and make-up, something I trusted her to do because she knew intuitively to be slow when touching my face.  There is NO WAY I'd ever trust someone with BPD with a curling iron near my skull.  Been there, done that.  Someone with PTSD (no personality disorder)?  They understand the value of gentleness.
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eastmeetswest
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« Reply #14 on: September 24, 2007, 09:12:19 PM »

One very big difference between PTSD and BPD is that PTSD can have onset at anytime in one's life.  There is often adult onset.  War, trauma, living with someone who has BPD can all lead to PTSD.  It occurs when the body is placed in a physical place where the mind is not ready to go.  It can occur in an instant, meaning a one-time event or over a period of events or exposures to traumatic events.

BPD occurs during childhood/growing up.
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Mollyd
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« Reply #15 on: September 24, 2007, 09:20:24 PM »

I agree with the first part of what eastmeetswest wrote, but not the second.

There are some people with BPD who have no history of trauma and abuse in their childhood; pointing to a biological component to the disorder. 

I'd add PTSD is in the Anxiety cluster of mental health conditions.  It's like hyper-drive after a life threatening (or perceived life threatening) event.

There is an overlap of symptoms in PTSD and BPD, but there is also an overlap between BPD and bi-polar.  BPD, as it's currently defined, is a class of personality disorders, meaning it's the symptom set that is inflexible (not just happening as a reaction to a perceived cue of danger), and pervasive (meaning it crosses into many aspects of life- work, relationships, sense of self, etc.).  It's a way one views and interacts with the world.
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Mollyd
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« Reply #16 on: September 25, 2007, 09:10:06 AM »

I think there is a popular thought that both BPD and ptsd have their roots in abuse and trauma, but that is not necessarily so.

PTSD - is a patterned anxiety response to an event or series of events.  BPD, as it's currently conceptualized, is a disorder of the personality - an inflexible and pervasive way of interacting and perceiving the world - that involves cognition, affect, and interpersonal relationships. There is a high incidence of reported abuse in people who've been dx'ed with BPD, but, again, not all people with BPD have an abuse history.  Both BPD and ptsd have a biological component - not meaning they are inherited, but meaning there is brain activity involved, so the brain matters.

BPD is traditionally viewed as not being a diagnosis in children, although there are some teens/older children who might show the symptoms (some or all of them).  The reasoning for the hesitation in diagnosing children/teens is that their personality isn't fully formed.  To say one has an inflexible personality with pervasive traits - when the personality isn't fully formed is problematic.  

BPD doesn't show itself in a similar way to autism, which can be seen clearly in early childhood.  BPD is more comfortably approached as a diagnosis when people are in earlier adult life, where coping strategies, patterns of thinking, behavior and emotional reactivity can be viewed.

However, all that said - my personal belief is that with some people you can see some traits in the teen years, and with most people you really can't safely consider a pd until adulthood.

I think it's important to figure out (as I wrote in another thread) the reason one is making the distinction. Therapists have different needs to make the distinction of PTSD and BPD than perhaps a family member.   From a clinical staNPDoint, BPD and ptsd are different - thus how one would be treated is different.  That's not to say there isn't significant overlaps, but the tx for someone who had a tragic accident would look different than the treatment for someone whose been repeatedly hospitalized for self harming.  And, someone with BPD might very well have issues of trauma and abuse that would need to be addressed in the context of pstd ...

Molly
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eastmeetswest
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« Reply #17 on: September 26, 2007, 11:53:13 AM »

Well, I read some lit at the site for vets - I think they are cutting edge and there are some/quite a few variables that may allow for PTSD to become more likely but likewise as many studies show that there is no cause/effect in the general pop.  It can emerge in anyone under the unfortunate confluence of conditions.  However, there are some characs that make it more likely to emerge in an individual - some were leaving the household at an early age (didn't have to be for a bad reason), folks with other anxiety disorders, depr, or PDs are more likely to get it.

Hence for many, it isn't a sleeping tiger.  It is a result of severe trauma, or ongoing incredible inconsistent stress for long period of time.  Take one normal adult - shaken, not stirred, repeatedly and you can create quite a concoction.
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discohornet
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« Reply #18 on: March 23, 2008, 09:51:54 AM »

Post Traumatic Stress Disorder.

It is basically a heightened state of chronic stress you experience after something bad happened to you.

For some people it can be getting shot at in war. For some people it can be abuse from someone they love.

There are good treatments out there for it. Try going to google and type in PTSD treatment if you think you may have it. I'm guessing almost ALL of us here do to one extent or another.

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johnkane
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« Reply #19 on: January 12, 2009, 02:24:08 PM »



The effects of ptsd article:

www.aaets.org/article158.htm
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