Pathological personality traits in negative affectivity – Depressivity: Thoughts of suicide and suicidal behavior. (DSM5)

Black and others(1) in an extensive look at the data about the relationship between BPD, suicides, and suicide attempts discovered that at least three-quarters of diagnosed BPD patients attempted suicide and approximately ten percent completed it. Those at greatest risk were those with previous suicidal behavior, depressive disorder, and substance abuse. They concluded that repeated attempts are not a call for attention but a genuine wish to die. A study my Brodsky and others(2) divided suicide attempts into two categories. Low lethal attempts were a triggered response to minor incidences, and high lethal attempts were more likely due to impulsiveness and comorbidity with major depression. People in the higher risk group made their first attempt at a younger age, responded more to negative social interactions, and demonstrated more aggression, hostility, and impulsivity.

So what can we take for this data? First of all let’s remind ourselves once again that we are looking at traits rather than a full blown pathological disorder. If we are in this category, that means it has not yet descended into major depression and we can still cope with the stressors in life; however, we also have to admit that we are at risk. Three out of every four of us who have allowed our traits to get out of hand have attempted suicide. We have to recognize that one of those traits is to become overwhelmed to the point that we have a tendency to wish to end it all.

So what should we do about it while we still have the resources to prevent it? Let’s take a look at the three leading triggers: impulsivity, depressive disorder, and substance abuse. First of all impulsivity. The question is – why are we so prone to engage in high risk activity without considering the consequences? The obvious answer is that we do not value our life and we place no value on ourselves. We are willing to risk everything for an emotional high that can take us out of the dread of the life we live. We have to somehow change that. We have to begin to see life as a gift. We have to find a way to get past feeling sorry for ourselves, begin to see the positives, and learn to appreciate the gifts we have and the gifts around us provided my nature and the spirit world of our soul.

If we do not try to fight it, most of us with BPD traits will experience depression. We can fight depression by exchanging hopelessness for hope and helplessness for power. Hope is readily available once we start changing our perspective. When we begin to see ourselves as being capable of loving and being loved, we can then allow others into our lives without fear of abandonment and rejection. These people are out there. All we have to do is make a commitment to go out and find them. We surround ourselves with positive people. We allow positive people to love us. We allow ourselves the sensations of feeling loved.

The third area is substance abuse. We have to face the fact that our mind is fragile but at the same time powerful. We do not need chemical crutches. We acknowledge that others may be able to enjoy drugs but our brain is predispositioned to be profoundly affected leading to drug abuse and psychological and physical dependence. It is a path that we cannot risk walking. We have to look at our brain as being capable of providing all the highs we need just by breathing and becoming conscious of the beauty and the positive energies around us. We find out what makes us tick; we avoid drugs because we know they will lead to depression and suicide; and we diligently seek pleasure in all the right places.

My Five Suggestions for Borderliners

1. Begin to think positively. Every time you experience a negative feeling recognize where it is coming from and reject it knowing that these feeling will eventually lead to disorders and suicide. Do something that makes you feel better or visit someone whom you know cares about you.

2. Turn self-loathing into self-love. Get into the practice of stopping and taking a deep breath whenever you recognize self-hate. Go to a mirror, look yourself in the eye, and repeat “I love you” over and over again until you actually feel it.

3. Avoid impulsive behavior. When you first become aware of that negative powerless feeling stop it immediately before it becomes a compulsion. Talk to yourself, telling yourself all the reasons you should not do it. Make a conscious rational decision not to engage and then immediately seek out a pleasure activity or a person who loves you for some good heart to heart.

4. Avoid all drugs. Remember that all drugs are attractive because they promise release from anxiety and a path to pleasure. Acknowledge the pleasure but realize that they are mind altering drugs and that your mind is not capable of dealing with the consequences. Make a conscious decision to love and protect your beautiful mind. If you want a cold beer on a hot day or a glass of wine with a special meal give yourself the pleasure of having it but know your limits and your reactions. Stay within your limitations. In the case of Mary Jane know that this is indeed a mind altering drug and the only reason you are taking it is to alter your mind. Knowing that your mind is fragile should be enough reason to walk away.

5. If you find yourself slipping out of control, get help. Remind yourself that the path through depression for those of us with BPD will probably lead to suicide and death.

1. Black, Donald W.; Pfohl, Bruce; and Hale, Nancy. Suicidal Behavior in Borderline Personality Disorder: Prevalence, Risk Factors, Prediction, and Prevention. Gilford Press Periodicals. 2005. https://doi.org/10.1521/pedi.18.3.226.35445

2. Brodsky. Beth S.; Groves, Maria A.; Mann, John J.; and Stanley Barbara. Interpersonal Precipitants and Suicide Attempts in Borderline Personality Disorder. Guilford Press Periodicals. 2006

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