Tag Archives: Cognitive Distortions

Things People Don’t Tell You (or Even Know) about Borderline Personality Disorder

Having borderline personality disorder, I have severe and rapid mood swings. Usually, people with BPD experience chronic, low-grade depression, but it can worsen or spiral down into anxiety, paranoia or anger at the drop of a hat. I have experienced that during severe mood episodes, I have similar experiences that are listed as those common in mood or anxiety episodes for people with depression, bipolar or anxiety disorders. The difference is the episodes are usually more severe but last shorter.

Today, I came across a list of things people don’t tell you (or even know) about depression. I can relate to many of these and could add a few that apply to my BPD moods specifically.

1. Most of the things people tell you, are not going to register with you and/or aren’t helpful at the time. “Just accept that you feel like crap”, “just act happier”, or “it will get better”. When I’m in a BPD mood episode, I usually can’t see beyond this episode and am utterly overcome with emotion. Telling me to “just” accept it or “just” act ahppier will seem totally unhelpful, even though it is particularly the “just” bit that is making it unhelpful. It’s not easy, but acting opposite to emotions and acceptance of one’s emotional state do help.

2. It physically hurts. Particularly depression and anxiety can cause physical symptoms. I often experience a heavy weight on my body when in a depressed state. Intense fatigue is another symptom. Anxiety can come with a lot of physical symptoms, such as a racing heartbeat, chest pains, lightheadedness, etc. When you experience these symptoms for the first time, do see your doctor to make sure it’s indeed anxiety and not a physical health condition.

3. Your relationship with food changes to “it’s complicated”. Many people with BPD also experience eating disorders, usually of the not otherwise specified type, where they alternate between anorexic and bulimic or binge eating episodes. Mood episodes can, as the author of the article I linked to says, also cause you to overeat or forget to eat.

4. Some “friends” will let you down, and that’s okay. Being BPD, we often tend to cling to people and have severe fears of abandonment. However, those friends who let us down during a mood episode, probably aren’t worth our frantic efforts to keep them. Friendships are generally hard for borderlines, so especially when not in a severe mood episode, it may be helfpul to invest in interpersonal skills.

5. You feel like you’re absolutely losing your mind. When in a severe mood episode, I can’t see beyond this episode and usually think it is worse than it is. Even if I do recognize that my symptoms are mood symptoms and I’m not going to die of a physical health condition, I often do feel like I’m going crazy. I could’ve been fine hours or even minutes before, but in such a severe emotional state, all there is, is depression, anxiety or paranoia.

6. Everything will start to annoy you. Even you will start to annoy you. My sensory overreactivity gets a lot worse when I’m in a mood episode. So does my general irritabilty. Unfortunately, irritability in BPD is commonly seen as a behavior problem rather than a mood problem./P>

7. Everyday tasks will feel overwhelming. As I said, most people with BPD experience chronic, low-grade depression. For this reason, everyday tasks feeling overwhelming is not just a symptomom of a severe mood episode for me. It could also be related to autism in my case. However, it is true that, when in a severe mood episode, I find everyday tasks even mroe overwhelming than usual. It is important to keep some level of activity even when in an episode.

8. It’s nearly impossible to tell when it’s “just your BPD talking”. With BPD being a chronic mental health condition, we often get used to our irrational beliefs. They however do become worse when in a dysregulated state. At the same time, it is extremely hard to see beyond this mood to our (still distorted) everyday sense of reality.

9. Moods will wreak havoc on your sleep schedule. When depressed, people often experience disrupted sleep. They may sleep more during the day and less at night. On the other hand, borderlines can have periods of hyperactivity similar to bipolar (hypo)mania, when they seem to need less sleep. Sleeping pills may have opposite effects in BPD, causing agitaton and even aggression.

10. Sometimes, you will not feel anything at all. Feeling nothign at all may be a sign of depression, but it is also common in BPD (“chronic feelings of emptiness” is one of the criteria). I personally don’t feel empty or numb that often, but when I do, it’s often the “calm before the storm” and I run an increased risk of falling into a dysregulated mood episode.

11. Your dreams get weird. Both changing moods and the medications many borderlines take can cause you to start having weird, intense or scary dreams. I felt a wave of recognition when I read this in the article I linked to. When I was admitted to the psychiatric hospital in 2007, the psychiatrist asked whether I had scary dreams. I said “No”, but I did say I had these really weird, intense dreams. They quieted for a while and then came back when I went on an anitpsychotic. PTSD is also common among those with BPD, and one of the symptoms of this is recurrent nightmares about the trauma you endured.

12. Your mood will seem totally “logical”. As I said, it is hard when in a severe mood state to look beyond this state. Your mood will also make you feel like it’s the most normal, or even the only state to be in. Some research shows that depressed people lack healthy but unrealistic optimism. Therefore, your thoughts may seem or even be close to reality, but they aren’t helpful.

13. You won’t be able to think clearly about your future. When I was in my worst mood epsiode, even looking a day ahead seemed impossible. I not only had no hope, but no image of even the short-term future whatsoever.

14. Mood episodes distort your view of the past, too. When I am in a severe mood episode, I can not only not see that it will ever get better, but I exaggerate how long I’ve been in this state. This doesn’t happen consciously or with a purpose, but it’s impossible to look not only beyond this state, but also to the past before this state started.

15. BPD makes you feel like you’re alone. You’re not. I often feel like no-one has similar experiences to mine. Of course, it is true that no-one is in my head so no-one has the same expeirneces, but many people do have similar experiences. You are not alone with BPD.

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Autistic Processing Difference vs. Cognitive Distortion

Today, I experienced a combination of emotional turmoil and sensory overload. Which came first is hard to tell, as I was having oversensitivities already for an hour or so, but the actual reaction, which is either a meltdown or an emotional breakdown, was caused by frustration. Given that both autism and borderline personality disorder come with distress tolerance issues, it is hard knowing which is to blame. It doesn’t really matter, except that the two require different approaches. BPD treatment involves skills training in distress tolerance, learning to shift your idea that you can’t handle frustration to the idea that you prefer not to get furstrated. Autistic distress tolerance issues involve an increased need for routine and time to adapt to a sudden change in that routine.

When sensory overreactivity comes into the equation, it gets more complicated. If this is assumed to be an emotion regulation or distress tolerance issue, people need to learn to accept that sometimes there’s noise they don’t like. When people still didn’t acknowledge my autism, I was often told that it’s other people’s right to make noise, as if I was depriving them of that right with my reaction to overload. In autism, however, noise can be painful, and the right approach is to allow the autistic quiet time away from the overloading stimuli.

Now that I write this, I notice that I’m connoting that the treatment I assuem is perceived to be right tfor BPD is really not that right at all. In fact, I believe that you cannot assume that a problem with distress tolerance is ever true unwillingness to accept that things can’t happen on your terms all the time, which is what is assumed in personality disorders. There are some people who are truly unwilling to take others’ feelings into account, but this si much rarer than the assumption that people are unwilling to take others’ feelings into account. I realize that cognitive distortions are not necessarily willful, and that the thought that you can’t handle any frustration is not the same as the thought that the world revolves around your need for gratification. What I mean to say, however, is that most people, and especially autistic or otherwise neurodiverse people, do not just think they have difficulties. We genuinely do process stimuli differently, and this means that “can’t” is not just a cognitive distortion most of the time. That doesn’t mean that autistics doon’t have cognitive distortions, too. What it means is that you need to take into account autistics’ genuinely different processing style when assessing or treating cognitive distortions. As I was being told for the umpteenth time that my daily living skills deficits are largely due to fear of failure, I begun to wonder whether NTs can truly evr make such a judgment.