I Could Never Explain Why I Cut Myself

Neuroscience of BPD

Lately I’ve been hearing that BPD isn’t a real mental illness because nothing is actually wrong with our brains and so, naturally, that means we’re using BPD as an excuse for our mood instability and impulsive behavior.

Guess what, naysayers? You were COMPLETELY right and totally called us out on our nefarious scheme!! We did, in fact, all convene at a super secret BPD convention of sorts and plotted to infiltrate the psychiatric field.

Haha, no. With the help of alix660 and porcelaindissonance I’ve learned a lot about the neuroscience behind BPD. And, while much more needs to be done in terms of BPD research, I did find strong evidence that BPD does have biological causes. You know. Just like an actual mental illness.

So here’s what we found, sorted by brain structure:

Amygdala: This brain structure is very heavily involved in emotional regulation and responses, particularly negative emotions. An fMRI study of BPD patients while being subjective to distressing visual stimuli found that our amydalas were significantly more reactive than those of control patients. This means that either the signals in our amgydalas are much more intense, or they continuing firing in our brains, preventing us from shutting down our emotional responses. Or perhaps it’s both, because that’s fun.

Another thing to note is that the amygdala receives tons of visual information, sent by the thalamus. The thalamus circumvents emotional processing in the prefrontal cortex (where we would consciously process how to regulate our emotions) and thus is involved in automatic, subconscious emotional processing. This is probably why our mood swings are so fast, unpredictable, and uncontrollable. It’s a knee-jerk reaction to even the tiniest triggers we come across.  (Herpetz, et al.)

Amygdala volume is significantly reduced in BPD patients as well. (van Elst, et al.)

Hippocampus: This structure is involved in formation and retention of long-term memories, as well as autobiographical memories. Not only is hippocampal volume reduced in PTSD and MDD, it is also reduced in BPD. (van Elst, et al.)

I know from my studies that the reason for hippocampal volume reduction in PTSD and MDD comes from prolonged activation of the stress response. When we go into “fight or flight” mode, several physiological changes take place: our immune system shuts down, digestion stops, etc. But most importantly, when we enter “fight or flight,” glucose, which is necessary for cell metabolism, is redirected from the hippocampus and to your muscles. If you’re faced by a life-challenging thing, like a pack of velociraptors, you don’t want to think about it. You want to run, and you want to run fast. This is biologically adaptive in the short-term and in prey species… but not so with humans, because we can have this reaction to long-term, non-threatening stressors. So in long-term distress—like MDD, PTSD, and BPD—our hippocampus is starved of energy and atrophies. Result? We have absolutely terrible memory.

Prefrontal cortex: This is where we do our conscious thinking. More specifically, the medial prefrontal cortex, which is involved in processing emotional memories, is more active in the BPD brain. Essentially, this means we have difficulty mediating our conscious emotional responses.

In the ventrolateral prefrontal cortex, BPD brains also show abnormally high reactivity to aversive stimuli. This part of the cortex directly connects to our good friend the amygdala, and thus has some level of control over emotion-driven responses. (Herpetz, et al.)

In the anterior cingulate cortex, which is involved in feelings of apathy and emptiness, we see a significant reduction in volume in the BPD brain. The ACC is linked to self-harm and pain sensation. (van Elst, et al.)

In the orbitofrontal cortex, we also see volume reduction in BPD. The OFC is responsible for irritability, impulsivity, and instability, which are our favorite things.

Fusiform gyrus: Found in the temporal lobe, the fusiform gyrus is the facial recognition center of the brain. And—you guessed it—it’s also shown to be hyperactive in the BPD brain. Which makes sense when you think about it: we are EXTREMELY sensitive to even the slightest changes in the facial expressions of other people. If you appear disinterested, annoyed, angry, or otherwise upset, that’s an immediate trigger. (Herpetz, et al.)

Taken together, this means that the limbic circuits (emotional regulation) and the prefrontal cortex (executive control) are uniquely involved in BPD, resulting in a hyperarousal-dyscontrol syndrome. As of right now, no other psychiatric illness has this combination of reduced brain structure volumes and hyperactivity in certain regions. (van Elst, et al.)

Bonus!!!

Serotonin: Most of us know serotonin as a crucial neurotransmitter involved in major depressive disorder. But in BPD, studies show that reduced serotonin activity is found in several locations in the brain, including the cingulate cortex, which is critical in processing incoming emotional cues. Reduced serotonin impairs inhibition of aggressive behaviors, both directed at others (like outbursts) and directed at the self (like self-harm and self-hatred). Genes involved in serotonin can easily be studied. (Skodol, et al.)

Sources:

Skodol, et al. “The Borderline Diagnosis II: Biology, Genetics, and Clinical Course”

Herpetz, et al. “Evidence of Abnormal Amygdala Functioning in Borderline Personality Disorder: A Functional MRI Study”

van Elst, et al. “Frontolimbic Brain Abnormalities in Patients with Borderline Personality Disorder: A Volumetric Magnetic Resonance Imaging Study”

PS I did read several other articles that corroborated these findings, so it’s not like these are the only sources of evidence I found that point to the biological nature of BPD.

I want to be covered in bruises and scars

I want to look like the most damaged person you’ve ever fucking seen

Coraline (2009), dir. Henry Selick.

“The ‘O’ in ‘Welcome home’ on the cake has double loops in it. According to Graphology, the double looped lowercase o implies that the person writing it is a liar.”

I don’t even cry anymore

Rest in peace, Billy Drago (1945-2019) 

Thank you for bringing the biggest, baddest villain, the Demon of Fear (and Hope), to life for Charmed fans. 

I refuse to let my major depressive episodes and my schizophrenia take control of my life. I have a lot of fight in me. I am on the right meds and am trying to find some one-on-one and group therapy to go to. I’ve always been a fighter, though, figuratively and literally at times.

Wow just realized how hot and how much i like hearing the sound of 'Yes?' as an answer to name-calling which comes with the speakers' secretly proud of something and knowing that thing is none of his/her/its/their business. Fking hilarious.

A Real Narrative of Borderline

Warning: Triggering, perhaps, to some. A bit of a narrative I wrote recently to help people understand what it can be like living with a disorder that is often signified as ‘bad’. 

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Sometimes I’m scared of myself, because of my disorder. People say ‘commitment’ and I curl in on myself and feel my heart constrict tightly in my chest. Commitment.

“Commitment? There’s no such thing as commitment when you have borderline, it’s even harder when you have antisocial.”

And no, it’s not because I get a need to dump a friend for someone more exciting that snorts cocaine and gets high every minute, nor need to have a quick fling whilst in a relationship. No, it’s because commitment means committing to me, a monster, and in turn, this monster needs to learn to commit to them lest it makes their lives miserable. It means 24/7, 100% effort that you, as nothing but a human, don’t have the mental capacity for.

When it comes to borderline, it’s safe to say I hate it. Everything triggers it, every word, every emotion I don’t understand. I can’t handle anything ‘normally’ and every feeling is exaggerated so much my head feels like it will explode- sometimes, I wish I had a gun so that I could actually make it do so. Then the ‘pressure’ would leave my head.

“I like you.”

Makes me happy, yet I don’t return the sentiment. Am I meant to like you back? I don’t even know if I can feel love. Once upon a time I ignored that statement and went for it, now it’s ingrained in me to go ‘that isn’t fair on them,’ and leave.

“I’m okay if you don’t feel the same.”

Makes me happy, yet I know that it will lead down a dark path. When hasn’t it? When has my borderline been on my side? It hasn’t. It’s no one’s fault, but its fault. It can’t handle emotion and doesn’t know what to do with it besides release it in a fit of rage. It’s 0 or 100, no in-between. For me that is punching a wall, or, on a bad day, playing with fire.

“Break up.”

Is like a double-whammy. It’s soul-crushing because you feel betrayed, even if you don’t really feel betrayed. It’s also a sigh of relief, ‘I don’t need to hurt them anymore. And thus, I will no longer be hurt.’ Some of us don’t’ want to be monsters, in fact, I daresay with borderline, the idea of being monsters tortures us endlessly. There’s this notion that being alone is better, and I think the longer you live with borderline, the more you realize loneliness is the best way to cope with it. You have nothing but you and your dreams and little room to hurt and hurt others, there’s no real people involved – real people you care about.

Friends leave. They don’t stick around except a few really good ones, who are able to see your hate and look past it. Relationships? Forget about them. The minute you make a friend, you start to get attached, and god help you if you like them. If you like them and think they’re cool, or epic, then that’s it. You’re doomed.

So are they.

You don’t want to hurt them, you’re a monster inside, but no matter how you go about it, you will. They like you: so you can swallow that anxiety that the future will fall apart and that you don’t want to lose a friend or cool person who you’re attached to, and you’ll give them what you want. Or: you shatter them and lose a friend anyways. Either way, your friend is gone. The person you cared about is out of the picture. One involves ignoring that you feel like a shithead, the other involves being a shithead, but it may work out better for them later. There’s no winning in borderline. Only losing. Only hurting people. And it’s never them that’s wrong– oh no. It’s always you. And no matter how much you deny it, you’re very aware of it.

So when people ask me what borderline is like I skirt the edges of truth because I know it’s ugly. It’s an ugly disorder, and very few except two people in my life get it. The one person seemed to understand the practicality of emotions, but not nearly as loyal a friend as the other and ended up following his own dubious impulses. I forgave it quickly, because I, although borderline and not antisocial, knew having impulsive behavior was tricky to get rid of – I still find myself punching the wall, or walking along a river at night. The other, a longstanding friend, gets it on a level unlike any other:

1.       The anger: mostly at yourself, and when you’re angry you get so angry you want to blow a hole in the wall, then in your head.

2.       The loyalty: loyal to a fault, so loyal you’d rather suffer and crawl through the dirt for someone than have them abandon you because you like them. That’s the problem, you care too much and feel emotions too much. But at the same time…

3.       Emotionless: that disassociation, where you feel nothing sometimes for days on end, where eventually you become so good at acting you don’t even know what real emotions are. Underneath it all, you care so deeply, but you don’t know why. ‘Why do I care?’ will have your brain feeling like it’s crushed because the question is beyond your comprehension.

“They baffle me,” is how he’d put it, “People ask me what I’m feeling, and I can’t answer. We don’t feel, or we feel too much.”

And then there’s the self-hate.

“Self-hate,” he’d say, “Is what gets us Cluster B’s. On the one hand, this personality is a part of us, it’s who we are…but we see others happy, falling in love, we see them get hurt by some action we did that we don’t get, and we realize …that will never be us. We will never be the good ones because even if we learn to behave properly and act good, in our head, we’re bad news. In my head, I still think ‘I want to punch you in the face.’ It makes you hate yourself when you’re aware you’re bad news, and especially so when you can control it. Then people don’t believe you anymore.”

We all hear the familiar words and phrases from loved ones. Many deny it – what, after all, even is borderline? Or antisocial? Narcissism? Stories and tales that depict the evil characters in books! Plot devices! Consider those as well, who don’t understand it: how can you not feel? Are you insane?

I am insane, at least I feel I am insane. But I still feel that twinge inside, that hurt when you call me as such. You’re side-lining me, making me an outcast for something I have no control over. I didn’t choose this.

Then there’s those who think they’re helping. These phrases vary from “It won’t hurt me if you tell me” to “That’s a bit selfish,” “Hah! That’s a funny thing you said there!” and “That’s evil!”

It is selfish, isn’t it? Imagine being called selfish. Or evil. Or having others find you amusing for your savagery, and the fact that you beat up a guy who looked at you funny.

Imagine being called a word that is immediately connotated with ‘bad’. Imagine being essentially called a bad person for something you can maybe control behaviourally, but can’t erase.

Eventually, you want to give up, run away, and let loose. ‘I’ll cut my hair, get 10 tattoos and have that crazy orgy I never had whilst getting high on cocaine. Because I’m bad anyways, and no one seems to care.’

Having this disorder sometimes feels like a sentence. A very misunderstood sentence that I’m being punished for.

The worst is…

You feel like you deserve it.

i want to be loved in the same amount that i love.