Borderline Personality Disorder, Disinhibition, and Suicidal Behavior

img_1394-1(This is the third in the series linking Borderline Personality Disorder (BPD) with Suicidal Behavior. In the first blog, we established the link between BPD and suicidal behavior in general, and in the second blog we looked at the correlation with childhood sexual abuse.)

A study conducted by Brodsky et al [1] involving 214 inpatients diagnosed with BPD, concluded that Impulsivity was the only characteristic of borderline personality disorder that was associated with a higher number of previous suicide attempts. Could it be that impulsivity by itself, leading to risk taking, is the leading cause of suicidal behavior among those diagnosed with BPD? I think not, at least not in isolation.

So why are we splitting hairs when it comes to the causes of suicidal behavior and BPD? We know there is a link with BPD and suicide, and we know there is a link with suicide, impulsivity, and risk taking. Whether or not suicidal thoughts and behaviors are a symptom of BPD or not is not the issue. The issue is that people with BPD  are dying because of their risk taking. This is especially evident in the case of the flirtation with death through street drugs. Why are we doing that? Why are we taking risks with drugs we know are, or may be, laced with fentanyl? Why have we gay and bisexual men engaged in unsafe gay sex when it may have led to AIDS? Why such a disregard for our own lives?

Speaking from personal experience, impulsivity was not my major cause of suicidal thoughts. It was my sense of failure and hopelessness. I never made an attempt on my life but I certainly took risks that I hoped might end it for me. Perhaps, it is the combination of other affects in conjunction with impulsivity, in other words,  a kind of global personality disorder, including impulsivity, that puts us at risk not just for suicidal thoughts but for actual suicidal attempts. Perhaps it is merely not wanting to live our lives anymore because there is too much pain coupled with a desperate sense of helplessness and hopelessness.

So what can we do about it? Therapy should begin not with what has happened in the past, and not the sense of hopelessness in the present.  We have to start with finding something to be thankful for, and what a better place to start than with life itself. We have to stop viewing life through the eyes of our damaged egos and begin to see the possibilities of a life we would love to live that is being offered by our higher self. We have to close our eyes and ears to the message of hopelessness and helplessness and open ourselves up to the message of hope and love from our higher self. We should be focusing on what life can be, not what it was not. We have to learn to dream again and see the possibilities of a life of peace and contentment, a life that we would truly love to live. There is a light at the end of the tunnel; we just have to open the eyes of our higher self to see it.

Here are my five suggestions for bisexuals with BPD:

  1. We can look deep inside ourselves and find that sweet spot at the center of our being, the home of our higher self. We can do this through meditation where we seek out that especial place that is within all of us.
  2. During the day, we just stop the madness for a few minutes and enter into a state of short meditation where we seek the presence of our higher self. It will give us a moment of peace.
  3. If we stay in the moment, our higher self will begin to heal our wounds and dissolve our sorrows. It may be just a quiet knowing, or it may be an emotional charge as old feelings come to the surface and are let go. We do not try to analyse where the feeling comes from; we just acknowledge it and let it go. It’s okay for us men to cry.
  4. We begin to search for and recognize our inner voice. We choose to silence the voice of our mind and welcome the voice of our spirit. It will always say I love you in a thousand different ways.
  5. We recognize that we are in essence love and that love starts with love for our self. We tell ourselves that we are proud that we have survived the pain and we give our self a hug.

[1] Brodsky, Beth S.; Malone, Kevin M.; Ellis, Steven P.; Dulit, Rebecca A.; and Mann, Hohn J..

Characteristics of Borderline Personality Disorder Associated With Suicidal Behavior. Am J Psychiatry 1997; 154:1715–1719)

 

 

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