This is the fifth and last in the series on exploring anxiety dysfunctional traits for Borderline Personality Disorder (BPD) on the DSM 5, and symptom six on the DSM IV. Today we will look at mixed anxiety/depression disorder (MADD).
Although I was unable to find research into a direct link between BPD and MADD, I did find some interesting information and have taken the liberty to employ the blogger’s freedom to draw a few unsubstantiated conclusions. Fava et al in their investigation into the frequency of anxiety disorders in 255 outpatients with depression, concluded that anxiety disorder diagnoses were present in 50.6% of these patients. Moreover, they discovered that an anxiety disorder preceded depression in about sixty five percent of the time. The obvious conclusion is that these two major disorders often occur together and that clinical anxiety usually precedes and may potentially be a significant factor in the onset of depression.
Based on past blogs, I think we can safely extrapolate that people with BPD frequently suffer from MADD symptoms. Because of our fragile egos and our tendency to feel excessive amounts of shame, we are constantly having to deal with anxiety related to the overreaction of the sympathetic system and the hypersensitivity of the reticular system. Because of this constant battlefield in our minds, ninety percent of the time we develop an anxiety disorder. Consequently, this constant battle with anxiety frequently causes a breakdown in the nervous system resulting in clinical depression.
Living with BPD is definitely a difficult path, but it is not hopeless. Neither is living with MADD hopeless; although, it may seem that way when we are in the middle of it. Therefore, I think it is important to recognize our BPD symptoms and predispositions and put safety mechanisms in place before we go MADD.
Here are my five suggestions for bisexuals with, or have the potential for, MADD:
- We hang in there. The depression is just a reaction to a buildup of our anxiety. It is a call to slow the world down and get off the treadmill for a while. We accept out present state of depression, acknowledge that it is a natural outcome of our BPD, and seek professional help. MADD can be complex; therefore, when we go to our family doctor, we go to the top and ask for an appointment with a psychiatrist. A combination of anti-depressants and anti-psychotic medication will restore our chemical imbalance and get us back on track.
- Counselling now can become effective. We seek out a counselor (or stay with our psychiatrist if she is available) and begin the process of coming to terms with our BPD. We explore the original causes of our anxiety and begin to deal with them one at a time.
- We do not let our sexuality be the cause of anxiety. It is one of the best ways of getting rid or stress, anxiety, and anxiety residue. We want it to work for us not against us, so we make sure we have a healthy attitude before and after sex. No blame, no shame.
- If we know we have BPD, we make sure we have a plan in place to prevent common stresses from becoming causes of an anxiety attack and/or another anxiety disorder. This includes a support person or group to help process common issues, a diet to keep our body healthy, and an exercise program to burn off the residue of our anxieties. We can then return to the parasympathetic system and gain relaxation and regeneration.
- We carefully monitor our reticular system. We note when it is becoming engaged. We will usually feel a sense of fear, anger, or shame followed by physical symptoms. We learn to soothe ourselves by breathing exercises and self-talk – there, there – it’s okay – we can handle this.
 Fava, Maurizio; Rankin, Meridith A.; Wright, Emma C. ; Alpert, Jonathan E. Nierenberg, ; Andrew A.; Pava, Joel, and Rosenbaum, Jerrold F.. Anxiety Disorders in Major Depression. Comprehensive Psychiatry· March 2000.