Borderline Personality Disorder--of interest

Borderline Personality Disorder is a psychiatric diagnosis.  Basically there are three types of psychiatric disorders.  There is a "thought" disorder.  There is a "mood" disorder.  There is the "personality" disorder.

Thought disorders deal with a person's ability to correctly internalize and understand what is happening around them as well as inside them and the relationships between the two.  A thought disorder shows itself in anything from confusion and inability to correctly understand environmental  cues to inability to control thoughts to determine what is reality and what is fantasy.  Thought disorders often have "positive" symptoms which mean that something is added to the person that is not present in most people (some examples are hallucinations or delusions).  Thought disorders often also have "negative" symptoms which means something is taken from the person that is present in most people (for example the ability to show emotions in body language including facial cues and/or the inability to feel emotions).

Mood disorders are a disruption of a persons moods/emotions.  This most often shows itself in depression that is disproportionate to any stimuli or not connected to any stimuli at all and/or lasts for extended periods.  This may also show itself in having extreme heightened excitement (mania) not connected to any environmental stimuli or disproportionate to the stimuli that is present.

Personality Disorders, also sometimes called character disorders, are significantly divergent personalities from the norm.  This refers to the very core of what the person considers to be themselves.   This class of psychiatric disorder is often considered to be the most difficult to treat/change, especially because there is not any medication known to have a positive impact on this type of disorders.

Borderline Personality Disorder indicates a personality that is on the borderline so to speak and crosses over back and forth for what is considered normal.  It often shows itself as difficulty in maintaining relationships although typically the ability to create relationships is not impaired.  It can often be noticed as a person who is unable to determine what makes up themselves (shown as extreme lack of consistency in action, attitude or behavior).  It often also shows in the persons inability to managing their own feelings and/or moods such that they overreact through their behaviors, attitudes or actions.  They often do a variety of actions that are typical and are thought by some to be a concrete symptoms of this disorder: I am speaking of self injurious behavior (i.e. cutting oneself) or frequently threatening and or attempting suicide.  Frequent attempts at manipulation of those around the person and attempts to play one person against another to divert the attention from oneself when things go awry are prevalent as well. 

So having said that as preliminary I ran across this blog that is graphic (swear words, and talk of suicide) that you may want to view as an example of this disorder (almost a text book example) and give you a view of what this feels like for the individual. This is not a person I am in anyway acquainted with myself.  Click here to view.  The comments to this blog are of interest as well. 

Scarcity is an oddity to us.

Let's admit it, we have grown up in a time when we had pretty much as much as we wanted of stuff.  There is plenty of gasoline, that's why we can confidently make trips across the country and expect to be able to get home like we used to do when our kids were young.  Could you imagine making that trip with the concern that you might not be able to find gas and never make it or possibly get there but unsure if you could make it back home? 

We have had plenty of food.  So much food that all of us didn't even have the money to buy it all.  Such that the stores throw it away or give it away to the food pantries for the poor.  There are groups that bring the extra food to apartment complexes where the Elderly live and they give it away to them for free.  Like I said throwing it away is the other option. 

Clothing is available such that some stores charge astronomical amounts for the very same thing that is sold elsewhere much cheaper and still people buy it so they can say that they got it from that store or because it has a certain name brand in one store and another less popular name brand in another store. 

We've grown up with plenty.  Almost whatever we wanted and as much of it as we can handle.   The limitation in the past has always been the money we had.  Those with a job or a more lucrative job could afford it and those without a job or with a lesser paying job couldn't unless of course we went into debt to get it.  But even that eventually would catch up with us and limit us at some point. 



Now we are starting to deal with scarcities of things that cannot be bought regardless.  At my work we have been aware of a certain injectable medication, Haldol, that has been scarcer.  Lots of people with severe psychotic symptoms depend on that medication to allow them to keep their symptoms under control.  We have been aware that the scarcity has started to impact the availability.  It used to be common that people would pick up several doses of this medication and it would be kept at the clinic and they would get several injections from it until they had to pick up a refill months later.  Now they can only pick up one dose at a time.  It used to be that people could depend on their being plenty of the medicine each time they needed a refill.  Now there are times the pharmacy does not have it and cannot get it from their suppliers requiring them to wait days or a week before they can get the medicine.  Consequently they are having longer time periods between injections and their symptoms are not being controlled as efficiently as before.  It used to be that the cost of it was fairly low and the insurance companies paid for it.  Now, due to lack of supply the cost has risen drastically and some insurances refuse to pay the new inflated cost.  Consequently clients must pay a sometimes substantial co-pay where they didn't have to pay any before to get the medicine.  The co-pay turns out to be a substantial amount of their limited income.  So sometimes it isn't purchased and not given and the symptoms run rampant. 

I understand the ingredient that is in shortage for the medication is something that allows the medicine to be injectable.  Not the actually active ingredient that controls the symptoms.  There is no explanation for why this ingredient is scarce.  There is not even a mention of what the ingredient is that is scarce.

I saw an article mentioning this shortage and the ingredient is used in various other medications including medications fighting cancer and so forth.  The article says that this scarcity has led to deaths because the needed medication was unavailable.  The article mentioned that hospitals are having a harder time than other places in getting it and the ingredient comes from foreign suppliers and the United States in general is having a harder time than some foreign countries in getting the medications.

In the case of my work, the injectable is a convenience medication.  It is available and still plentiful in pill form.  However; the reason that people take it in my work is because they are hugely unreliable in taking it in pill form to the point that the injection is needed not for their convenience but for the family, the clinic, and society's convenience to know the people have taken their medication. 

The fact that this feels so odd to have a scarcity of something that formerly was plentiful is what tells me that we have truly been spoiled in our world.  Now I am hearing that other items may become more scarce.  Food items or convenience items that are more on the order of luxury items.  How will our spoiled generation handle these scarcities, especially if they continue scarce over long periods of time and if the number of items in scarcity increase?  We may learn the lessons of generations before us even with money the money to buy in our pocket.  Something to think about.

Why don't they leave out the side-effects?

I was talking with a young man in my office.  He is in his twenties and on medication.  He was complaining about the side-effects of the medication.  He wanted to know why didn't they leave the side-effects out of the medication.  "Why did they put those in?"  He wondered if they were putting the side-effects in the medicine so they could control him or maybe so that they could make him die sooner.  In this case "they" was the government who was giving him money on a monthly basis due to disability.  He figured if he died sooner then the government wouldn't have to pay him so long.  "Why don't they help me find a job I can do instead of put side-effects in my medicine so that I won't draw social security so long?  Then I could work and not have to draw money from the government." 

I tried to explain that medications were made in this case to compensate for a deficiency in certain chemical levels that he had.  The symptoms of the low chemical levels were what brought him to us and the medicine was trying to compensate for that.  If the medicine is successful then the symptoms will lesson or possibly dissipate. 

He was unimpressed and wanted to know why they put in the side-effects.

I explained they made the medication to combat the symptoms and the side-effects were unintentional results that they didn't know would happen or they didn't know yet how to make the medicine so it would work without having those unintentional results. 

Still he was unimpressed.  He seemed not to understand what side-effects meant or maybe he was purposely being a pain in the goiter. 

I was starting to get irritated and that is very rare for me in this setting.  Then it dawned on me what he was really saying.  Sure he doesn't like the side-effects but even more he doesn't like to have to take the medication.  He knows, however; that if he stops taking the medication he will have consequences he likes even less. 

So I started talking about the disappointment he felt in having to take medications.  How it made him feel different than others his age and why it was worth it for him to take the medicine anyway.  Now we were talking about the same thing and we had a good meaningful conversation that may have been helpful to him.

It occurs to me that in life we have a variety of side-effects to things.  Mostly we use the term side-effects to refer to something we didn't expect.  Sometimes we use the phrase to refer to consequences that were going to happen but we didn't know it.  Either way we are often surprised in life by what happens.  Even when our intentions are the best we can be deeply surprised at what results.   

Once I went to the doctor with some ailment.  He prescribed medication.  I had side-effects that I didn't like and would find it very hard to function with.  So he gave me another medicine to cure the side-effect.  Ultimately when all was said and done I decided that I could manage the original ailment better than the risk of side-effects. 

And that is the thing we must weigh in life.  If I do this for the purpose of having this result will I be happy with the consequences or the side-effects?  I may well get the desired result but I may not be too pleased with other side-effects.  We like to know what is going to happen so we can make an informed choice but most often we only know in part and sometimes even that "knowledge" is based on faulty reasoning and we find all kinds of things happening that we didn't expect.

Sometimes in Science Fiction or fantasy stories they approach the question what would happen if we could go back in time and we purposely or inadvertently changed something.  What would happen.  There are lots of good stories about that idea, one of my favorites is Pastwatch: The Redemption of Christopher Columbus by Orson Scott Card.  You might want to try it if you like thought provoking Science Fiction.

Each day we are creating history in our daily lives.  We are determining some of the future now.  And that future will eventually become history.  We need to carefully choose now so that we can stand by what we do regardless of the results or the side-effects and then once again we must take responsibility when things go awry. 

As in the case of medications the side-effects can sometimes be good.  I am aware of a medication that is prescribed at least as often due to the side-effect as it is due to it's initially created intended effect.

Will we live our life and do the best we can and then recognize the good that will come and then correctly evaluate the side-effects or do we think that life should be totally predictable--no side effects added?  I enjoy the opportunities and challenges that come by the unexpected (uh... much of the time).  I hope I can be as positive when things don't turn out in a way that appears desirable. 

What about you?  Do you need to have things work your way to find the joy in life or are you able to find the joy and challenge of the unexpected "side-effects"?