Borderline Personality Disorder

At the point when Jack Bingham was 14, he was unable to go out in light of the fact that he thought the indoor air was tainted at head level. So he strolled right to the washroom. More awful, he was unable to pee without showering. Floated by his stress over tainted air, he here and there held off peeing for 24 hours until he could securely get to the restroom, where he would shower for eight hours in a row.

Other times, he felt impurities coming in through gadgets, so he didn’t sit in front of the television. He remained under the roof fan to shake and hack away the tainting. At the point when he wasn’t reluctant to go to class, he utilized Lysol wipes to consistently clean his seat on the transport before he could sit. He lost a great deal of rest and sat around on account of his impulses. On the off chance that he attempted to oppose them, everything that did was make them last multiple times longer when he finally surrendered.

Bingham experienced the outrageous over-the-top urgent issue (OCD), a mental condition portrayed by wild fixations (repeating prominent musings), bringing about uneasiness and impulses (tedious practices used to lighten nervousness brought about by the fixations). The commonness of OCD is assessed at 1% or around 3.1 million individuals in the USA. He likewise experienced substance use issues (SUD) and marginal character problems (BPD)— otherwise known as depressed character issues (EUPD)— described without anyone else picture issues, trouble overseeing feelings and conduct, and an example of unsteady connections.

Bingham explains the obsessive aspect: “OCD causes a lot of anxiety, panic, and fear to the point where you’ll act on compulsive behaviour even though you know it’s irrational just to get relief. It’s like using (drugs) just to not be dope sick. You’re not getting high when you’re doing your compulsion; you’re just not in hell. But eventually, that whole pattern becomes hell.” He turned to drugs to escape. But when addiction set in, the drugs no longer helped. So he turned to stereotype addictive behaviours (like stealing) while also managing compulsions. It all came to a head when he attempted suicide.

Numerous doctors told him, “There’s nothing we can do. We can try different therapies but you’re always going to have a certain degree of OCD.” Salvation came through his mom’s therapist friend, with whom he shared a secret that may have been the cause of his OCD—sexual trauma at eight years old. She was able to bring him to a moment of clarity with a single sentence: “All of this insanity and fear is a lie created by the mind of a child.” It took six months of not giving in to compulsions before he got better. “The obsession doesn’t go right away just like getting sober. But as time goes on and you fight that obsession, it does leave you,” assures Bingham, who has written a book about his multiple disorders.

Why Borderline Personality Disorder and Obsessive-Compulsive Disorder Sufferers Are Susceptible to Addiction

They are more prone because of emotional sensitivity and hyper-vigilance to issues like abhorrence of germs, abandonment, loneliness, and emptiness. Substance use is a means to create a dissociative sensation, so patients are separated from whatever they loathe, including themselves.

Environmental and social factors, such as stress, peer pressure, and negative interactions, are the usual triggers of substance use. This continued indulgence typically ends up in addiction, which encourages maladaptive behaviour and functioning.

Personality disorder psychologist Dr. Daniel Fox says that approximately 78% of those with BPD also have SUD. This doesn’t mean that everyone with BPD abuses substances and that everybody who has SUD has BPD. Alcohol/drug use is a short-term reward because after the high, patients experience symptoms again, making them want to reuse, reinforcing a vicious cycle. When BPD, OCD, and SUD overlap, therapy is more challenging, but all are treatable.

Borderline Personality Disorder Characteristics

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), criteria for Borderline Personality Disorder include:

• identity disturbance—influences patients to adopt many identities, often leading to a misdiagnosis of dissociative identity disorder (DID), formerly multiple personality disorder.
• impairment in interpersonal functioning with either empathy (obliviousness to others’ feelings) or intimacy (intense, unstable, and conflicted relationships)

BPD patients also have these pathological personality traits:

• Negative affectivity—fear of rejection, anxiety, frequent mood changes, feeling down, suicidal thoughts and behaviour
• Disinhibition—impulsivity and risk-taking
• Antagonism—inappropriate, intense display of anger

Comorbidity Statistics

Apart from mental health disorders, the obsessive-compulsive disorder also commonly occurs with physiological diseases like fibromyalgia and irritable bowel syndrome. According to a 2013 article by Biskind and Paris, the average for comorbidity with a borderline personality disorder is four mental health disorders and two personality disorders. Comorbidity is the reason BPD is often perceived as treatment-resistant. So careful diagnosis and precise treatment planning are of utmost importance.

Disorders That Co-occur with Borderline Personality Disorder

88% anxiety

75% depression

50% PTSD

40% panic disorders

55-60% SUDs

15% eating disorders

25% ADHD

What Causes Obsessive-Compulsive Disorder and Borderline Personality Disorder?

Factors blamed for causing these conditions include both genetics and the environment. No research, however, has shown that stress or negative parental interaction during childhood causes OCD. The most common BPD triggers are relationship torment or interpersonal distress.

Treatment options

Integrated Treatment

Cohesive mental care and addiction therapy for two or more mental health conditions or SUDs. This is more effective than treating each diagnosis separately. Clinical psychologist Dr. Ramani Durvasula of California State University recommends treating co-occurring mental illnesses simultaneously, while Fox is adamant about treating addictions first to break the cycle.

Medications

According to the Mayo Clinic, psychiatric medications used to treat OCD control compulsions and obsessive thoughts by increasing serotonin levels in the brain (low in OCD patients). Serotonin is a ‘happy hormone’ that regulates anxiety, happiness, and mood. The most commonly used mood stabilizers effective for BPD are antiepileptic drugs. Lithium is effective in treating BPD anger and irritation. These drugs are habit-forming, so doctors’ guidelines should be strictly followed.

Natural Supplements

Natural supplements recommended for OCD include milk thistle, said to have similar effects to that of the antidepressant Prozac. Magnesium and zinc also boost levels of serotonin. Foods to avoid include caffeine, energy drinks, alcohol, anything processed, and trans/saturated fats.

Glutamate

This amino acid in protein-rich foods has been found to cause psychological distress. Also produced by the body, it’s vital for metabolism and brain function. A 2016 study by Holton and Kotter found that lowering glutamate from the diet alleviates OCD symptoms.

Exercise

Working out promotes the release of endorphins, a “feel good” neurochemicals that zap stress.

Behavioural Therapy

• Cognitive Behaviour Therapy—modifies harmful beliefs and maladaptive behaviours. Effective for SUDs, anxiety, and mood disorders.
• Dialectical Behaviour Therapy—reduces self-harm behaviours. Most effective for BPD.
• Contingency Management (aka Motivational Incentives)—reward-based treatments.
• Assertive Community Treatment—for severe mental illnesses like schizophrenia and co-occurring SUDs.
• Eye Movement Desensitization and Reprocessing—patients relive traumatic experiences while therapists direct eye movements.
• Rational Emotive Behaviour Therapy—helps patients change thoughts and beliefs about addiction.
• Exposure therapy—repeated exposure to a feared situation, object, traumatic event, or memory.

Diagnosing Borderline Personality Disorder and Obsessive-Compulsive Disorder

Don’t Go Solo

It’s critical that people with simultaneously occurring BPD, OCD, and addiction consult mental health professionals to receive appropriate diagnosis and treatment. Those on a budget may contact their local health centre for free or subsidized support.