Tag: DSM 5

              In this article we will continue to explore the relationship between borderline personality disorder and bisexuality. As mentioned in a previous article, about one third of patients with BPD are bisexual. We do not have the data on the reverse of that; we do no know how many of us bisexuals also have BPD, but I guess it would be much higher. Today we will look at fears of dependency and loss of autonomy.

Trait Eight – Pathological personality traits in negative affectivity – Separation insecurity: Fears of excessive dependency and complete loss of autonomy. (DSM5)

            In my search of the literature, I found one article that indirectly dealt with fear of dependency and loss of autonomy by alluding to it as part a subtype associated with dependent personality disorder[1]. According to this article, discouraged borderline is marked by noticeable clinginess and a passive follower type of mentality. While on the outside this person might just seem indecisive or weak-willed; they normally experience internal turmoil about their lack of leadership and bitterness toward those whom they feel are controlling them. This type of borderline disorder in a person often leads to self-harm in the form of self-mutilation or even suicide.

            This diagnosis is seen more in women than in men, perhaps due to possible disturbed estrogen levels or part of systematic sexism. However, some research suggests that this tendency affects men and women equally, but women are more likely to seek treatment or to be officially diagnosed as BPD.        

            Descriptors of discouraged borderline includes excessive dependence upon others. They are often compliant and easily swayed by others, even when it goes against their own desires. They have low self-esteem, feel continuously insecurity, and appear to be vulnerable. They may feel hopeless, helpless, powerless, and depressed. There may be a reliance on fantasy or substance abuse as a means to escape.

            The cause is thought to involve many different life factors. These include PTSD, childhood trauma or neglect, a smaller hippocampus or amygdala, genetic predispositions involving genes DRD4 and DAT and chromosome 9, neurobiological factors like estrogen levels, family and social stability levels, and negative social experiences as a child. People with the disorder often have other illnesses including major depression, anxiety disorders, eating disorders, substance abuse, or antisocial personality disorder. People suffering from this BPD trait make up a large chunk of suicides on an annual basis. So if you or someone you know is at risk for suicide because of this trait, it is important that you get help as soon as possible.

            Psychotherapy is the primary method used for managing and treating discouragement BPD. Depression and anxiety are among the two most common conditions that can be treated with medicine while the patient is treated for general BPD with psychotherapy. Antipsychotics might be used to reduce anger or suicidal tendencies as well as impulsivity, psychotic paranoid symptoms, anxiety, and depression. It is important to understand that these medications cannot treat BPD, but that the treatment of concurring conditions can help clear the way for a more successful treatment of BPD through psychotherapy.

            So how does this apply to those of us who are also bisexuals? I do not see it as a direct correlation; however, we can make some interesting comparisons. We usually do not fear losing our autonomy in our heterosexual relationship; in fact, we want to wallow in it. We often depend on them for our sense of security and sanity. In fact, we are afraid of losing it. On the other hand, when it comes to our same-sex relationships, we mostly avoid dependency at all cost. We do not want to become dependent and do not want anyone to become dependent on us. We prefer casual. We mainly want to relate just for the physical pleasures we can get. In other words we seek dependency with our life partner and avoid dependency with same sex friends. What we do fear is dependency of the fix and we fight it because we fear it will ruin our lives.

MY Suggestions

1. Come to terms with your sexuality. It is what it is so you may as well relax and enjoy it. You can realize that your impulses are natural urges of your body and your mind. You are not sick because of your bisexuality. You do not need therapy for your sexual impulses but you may need therapy for your BPD.

2. Be honest with yourself and deal with your fears. Discover the worst case scenario and come to terms with it.

3. If your love relationship with our life-partner is essential to your sense of well-being, try to develop the will and power to do without your same sex experiences (this may be near impossible to some of us).

4. If you wish to continue with a secret life, accept it as it is and go on with our secret life,  but you need to be able to do this without anxiety or fear. You have to be willing to accept and live with the consequences.

5. Most of us cannot live with the stress that comes from feeling that we are being dishonest with our life-partner. If that is the case, we have to be honest with them and tell them about our bisexual desires and needs. Once again, we have to be willing to accept the consequences. If our fears and shame are causing us anxiety and pain, we have to be willing to give up our life-partner in order to live lives free of shame, regret and chronic anxiety. If we continue living with these stresses, they will eventually kill us.

[1] Discouraged Borderline Personality Disorder, Optimum Performance Institute. https://www.optimumperformanceinstitute.com/