u/KuuhakuHaru

I'm not sure if this is an autism thing, but I've never understood other people's fixation on drugs and especially alcohol. They glamourize drinking a lot or not being able to get through a complicated situation (or just socializing) without drinking, and it never registered to me. It's absolutely wild to me how normalized binge-drinking is, as if it is something natural and normal. I myself don't like drinking - I think 99% of alcohol tastes like shit. Not to mention how problematic it is to normalize and glamourize genuine addictions.

So I'm reading a book about self-harm and the author says he doesn't like the labels of personality disorders because they are often more unhelpful and stigmatizing, and because it makes no sense to "diagnose someone's personality". He also says that labels like personality disorders lead people into thinking the root of the problem is the person themselves rather than their social difficulties. Thoughts?

I'd like to know your opinions!

Traditional:

• Abandonment: Frantic efforts to avoid real or imagined abandonment.
• Unstable relationships: A pattern of intense, unstable relationships involving alternating idealization and devaluation.
• Identity disturbance: Markedly unstable self-image or sense of identity.
• Impulsivity: Impulsive behavior in at least two potentially self-damaging areas (e.g., spending, sex, substance use, reckless driving, binge eating).
• Suicidality/self-harm: Recurrent suicidal behavior, gestures, threats, or self-mutilating behavior.
• Affective instability: Significant emotional reactivity, with intense mood shifts that typically last hours and rarely more than a few days.
• Emptiness: Chronic feelings of emptiness.
• Anger: Inappropriate, intense anger or difficulty controlling anger.
• Paranoia/dissociation: Temporary, stress-related paranoid ideation or severe dissociative symptoms.

Hybrid model:

Typical features of Borderline Personality Disorder are instability of self-image, goals, interpersonal relationships, and affects (mood); accompanied by impulsivity, risk-taking behavior, and/or hostility. The characteristic difficulties are apparent in identity, self-direction, empathy, and intimacy, as described below, along with specific maladaptive traits from the domains of Negative Affectivity, Antagonism, and/or Disinhibition.

A. Moderate or greater impairment in personality functioning, manifested by characteristic difficulties in two or more of the following:

1. Identity: Unstable, poorly developed, or considerably impoverished self-image, often associated with excessive self-criticism, chronic feelings of emptiness, and dissociative states under stress.
2. Self-Direction: Instability in goals, aspirations, values, or career plans.
3. Empathy: Compromised ability to recognize the feelings and needs of others, associated with hypersensitivity (e.g., a propensity to feel slighted or insulted); perception of others selectively biased toward negative attributes or vulnerabilities.
4. Intimacy: Intense, conflictual, and unstable relationships; marked by lack of trust, neediness, and preoccupation with real or imagined abandonment; close relationships are often viewed in extremes of idealization and devaluation and alternate between excessive involvement and disengagement.

B. Four or more of the following pathological personality traits, with at least one being Impulsivity, Risk Taking, or Hostility:

1. Emotional Lability (a facet of Negative Affectivity) — Unstable emotional experiences and frequent mood changes; emotions that are easily triggered, intense, and/or disproportionate to events and circumstances.
2. Anxiousness (a facet of Negative Affectivity) — Intense feelings of nervousness, tension, or panic, often in reaction to interpersonal stress; worry about the effects of past unpleasant experiences and negative future possibilities; feeling fearful, apprehensive, or threatened by uncertainty; fears of falling apart or losing control.
3. Separation Insecurity (a facet of Negative Affectivity) — Fears of rejection by—and/or separation from—significant others, associated with fears of excessive dependency and total loss of autonomy.
4. Depressivity (a facet of Negative Affectivity) — Frequent feelings of being down, miserable, and/or hopeless; difficulty recovering from these moods; pessimism about the future; pervasive shame, feelings of low self-worth, suicidal thoughts, and suicidal behavior.
5. Impulsivity (a facet of Disinhibition) — Acting on the spur of the moment in response to immediate stimuli; acting on the basis of momentary impulses without planning or consideration of consequences; difficulty establishing and following plans; a sense of urgency and self-injurious behavior under emotional stress.
6. Risk Taking (a facet of Disinhibition) — Engagement in dangerous, risky, and potentially self-injurious activities without necessity and without consideration of consequences; disregard for one's own limitations and denial of the reality of personal danger.
7. Hostility (a facet of Antagonism) — Persistent or frequent feelings of anger or irritability in response to minor slights or insults.

I see people saying things like "BPD is just autism (or more specifically "female autism")" or "BPD is just CPTSD" like... I know they have a lot of overlaps and often co-occurr (I myself am autistic and BPD, along with Bipolar Disorder), but to say that there is no such thing as BPD and instead it's just CPTSD or autism is just... why? Their symptoms are so distinct... I can't take it...

I KNOW, theoretically, that remission is possible and very common. I've read lots of literature that say that. But I admit I, in my intimate emotional world, have difficulty grasping it. I have difficulty grasping how a personality disorder can have remission, considering it is made of relatively stable and inflexible traits and consists of the person's entire personality rather than being, for example, an episodic mood disorder. With personality disorders, it kind of composes you intrinsically instead of being something that is on you, in my view. I compare it a bit with autism. I KNOW they are different things because autism is a neurodevelopmental disorder which was always there and will always be there, but like... both deeply and pervasively affect your way of being, thinking, feeling, behaving. There's no remission for autism, so how is there for personality disorders?

I'm not trying to be anti-recovery by the way I just genuinely kind of don't get it. Maybe the problem is that I lost hope for myself, because I can't imagine myself being significantly without the symptoms.

I'd like to know your guys' opinions on the new ICD-11's model for personality disorders. Essentially, all categorical labels for specific personality disorders, except for BPD, have been abolished, kind of. They replaced it with a dimensional continuum system, in which personality disorders are categorized as level of impairment/functioning (mild, moderate, or severe) and relevant domains (the domains are Negative Affectivity, Disinhibition, Detachment, Dissociality, and Anankastia), with specified traits of these domains. That way, we get an extremely personalized diagnosis of level of functioning + specific relevant traits, with no overall arching label or common shared symptoms. There is also, however, the specifier of "Borderline Pattern", which is characterized by basically all the 9 traditional criteria for BPD. Therefore, someone with what we know as BPD would be diagnosed as "personality disorder, level of impairment [moderate], Negative Affectivity, Disinhibition and Anankastia domains, Borderline Pattern". While someone with what we know as, say, Antisocial Personality Disorder would be diagnosed simply as "personality disorder, level of impairment [severe], Dissociality and Disinhibition domains", for example.

I personally find this model quite odd. I feel like it kind of dillutes personality disorders a bit too much by completely removing almost all specific labels, which exist because of shared baseline symptoms. It's also often regarded as way too complex for practical clinical practice. I personally prefer the alternative-hybrid model for personality disorder from the DSM-5, which combines features from both the dimensional model (such as spectrum of impairment and basis on domains and traits) and the categorical model (by keeping 6 specific personality disorders: Borderline, Antisocial, Narcissistic, Avoidant, Schizotypal, Obsessive-Compulsive). I feel like that's the best way to do it: describe well-known and established personality disorders through the domains/traits and spectrum framework, instead of replacing them altogether. But I'd like to know your opinions on this.

By the way, I have BPD (as well as other comorbidities). My official diagnosis thorough the ICD-11 would likely be personality disorder, level of impairment moderate, Negative Affectivity, Anankastia and Disinhibition domains (respectively); Borderline Pattern.

Eu e minha mãe caímos num golpe personalizado ontem e eu não sei o que deveria fazer.
A história é longa: meu pai está movendo um processo contra uma empresa de seguros por conta de um problema com o carro dele, só que o carro está no meu nome e, portanto, o processo está no meu nome. Um tempo atrás nós fomos numa audiência com o advogado para a outra parte se defender, mas eles não compareceram, o que deu automaticamente causa ganha. Portanto, agora eu estava pra receber o dinheiro da indenização. Aí aconteceu que ontem uma pessoa me mandou mensagem dizendo ser o advogado, e ele tinha a foto e o nome do advogado corretamente, bem como me mandou um documento com os dados do processo, com meu nome, CPF, e todas as informações certinhas. Ele disse que o dinheiro estava pra sair, mas que pra isso precisávamos fazer uma audiência online naquele momento com um suposto juíz. Eu não tenho muita experiência com essas coisas, então acreditei. Depois outra pessoa afirmando ser o juíz entrou em ligação comigo e pediu que eu filmasse as telas do meu aplicativo do banco. Em nenhum momento eu filmei as telas iniciais com o número da agência ou senha. Eu percebi que ele falava de um jeito estranho, meio informal, que me passou a ideia de que era estranho um juíz falar assim, mas resolvi que era só eu sendo preconceituosa rs. Depois de um tempo ele disse que eu precisaria de outra conta pra receber a segunda parcela do dinheiro para evitar a taxação e os impostos. Com isso eu chamei a minha mãe e com ela foi feito a mesma coisa: filmar as telas dos apps de banco e eles fizeram ela fazer uma transferência de 3.0000 e tantos como forma "do banco identificar a conta". Tem mais detalhes nisso nos quais não vou entrar pra não consumir muito tempo. Eu já tava desconfiando fazia um tempo, e nesse momento, eu mutei a ligação e disse pra minha mãe "eu tô achando isso muito estranho, acho que é golpe". Ele queria que eu confirmasse uma coisa lá pra finalizar as transferências e, quando eu pedi pra ele esperar porque estávamos tendo problemas, ele ficou nervoso, dizendo que não dava pra esperar. Então minha mãe disse "estamos achando que é golpe" e ele ficou notavelmente muito mais nervoso. Nesse momento, desligamos. Daí fizemos o que deveríamos ter feito no começo, que era ligar pro meu pai e confirmar sobre o que estava acontecendo. Como o esperado, meu pai disse que não tinha nada daquele dinheiro sair hoje e que isso era golpe.
Enfim... hoje minha mãe veio chorando pra casa dizendo que vai ter que pagar as transferências que ela fez porque, por causa do jeito como eles fizeram o negócio, o banco não aceitou a contestação. Eles também recomendaram que ela formatasse o celular por conta das filmagens das telas do app do banco. Será que eu deveria fazer o mesmo com o meu, já que também filmei? Lembrando que eu não cheguei a filmar telas de senhas ou outras coisas assim. Informações como meu CPF e meu nome eles já tinham. Não sei o que eu deveria fazer.

I'm fucking tired of hearing that typical discourse of "we're all in the same boat, we all have problems". Yes, it is true that we all have problems, but not all of us have the same types and intensity of them. It is simply a fact that mental disorders greatly affect people in a way that is mostly not experienced by typical people; it is also a fact that some mental disorders are more overly pervasive than others. I think, at least, that understanding that a particular type of suffering is different, and often more intense, than the normal or than other types of sufferings is a key part in validating it. "Sometimes, all I need is for people to understand that they don't understand". I don't mean this as a way to gatekeep suffering - I obviously know everyone suffers -, but as a way to recognize that everyone is different and some people simply have it harder than others in this aspect, even if they might have it easier in others. That is why I hate hearing discourses like "we shouldn't use mental conditions labels because everyone suffers anyway" - well guess what everyone also has a body which experiences pain, discomforts and sensory issues, yet no one is out there saying we should abolish physical illnesses diagnoses because of it. Recognizing that a particular painful - or simply different - pattern exists is essential in its validation and often needs to be done in order to, if desired, change it.

And I hear this type of thing a lot in the Psychology field. I was reading a book about the Alternative Model for Personality Disorders, and I found it really interesting and informative, but also... I think they endorsed a bit too hard this discourse of "we all have some level of personality problems, so we might as well abolish specific personality disorder labels anyway". I don't think that's the solution. I don't think abolishing almost completely the categorical patterns of personality disorders is helpful. I think the traits/domains and functioning spectrum of the AMPD is extremely useful to understand personality disorders and even personality functioning as a whole, but not in a way as to completely delete categorial labels, and rather more as a form to understand these categorical labels more fluidly, as a spectrum, and with more nuanced characteristics - which is why I really like the hybrid-alternative model of the DSM-5 that combines both features of the categorical model with the alternative model.

What I'm saying is, I think this movement that people do, whether formally (through things like abolishing categorical personality disorder labels) or informally (through discourses such as "you shouldn't use labels because everyone suffers anyway") is incredibly invalidating to people who experience markedly different conditions than those the world was built for or that is typical. It's like trying to say that the suffering experienced by people on the Holocaust is the same as the suffering experienced by people stubbing a toe (apologies for the extremist example, I'm just trying to illustrate the point). I'm just so tired of simply not being able to function or exist in a way that is productive or that makes me happy and then hear other people saying that this doesn't matter or matters as much as other people having a slight inconvenience.

Recognizing what you are not is a fundamental part of recognizing what you are. In the same way, recognizing that certain sufferings are not like your suffering is a fundamental part of recognizing both these types of suffering individually. We can't truly see things existing if they aren't contrasted by other experiences. We can't see and validate a type of suffering if we don't see the contrast with other typws of sufferings. What I'm saying is, recognizing that *not* everyone is on the same boat is a fundamental part of seeing everyone's individual boats which all work in a different way, with more or less similarities.

TL;DR: I am exhausted of hearing from people "but other people suffer just like you" or "everyone is equally different so you don't need a label to understand peculiarities about yourself". It's like saying that "everyone is a little bit autistic anyway". I find it all incredibly invalidating. I don't mean to gatekeep suffering, like I said. But it is well-known that a big part of validating someone is, when appropriate, by stating how much you can't understand their lived experience, because their experience is their experience.

So I'd like to know if anyone else does this. Sometimes I'll be talking to someone and then they say something that really hurts me and/or makes me mad. So I'll stop talking to them because I'm too aggravated and I don't see the value on talking to them right now. I give them the silent treatment, basically. But secretly, I'm waiting for them to reach out to me, because I want to know that they've missed me. Then, when they don't, I just get even madder/sadder. But I know that if they do reach out to me while I'm in that state, I'll be confrontative, hostile, and behave aggressively - so I just end up being quiet and ignoring them to avoid opportunities for me to be hostile, becoming quite passive-aggressive instead. It's like a spiral that has no win situation. Is anyone else like that? Is that a common splitting behavior?

I'm curious to know your guys' opinion on something. I'm not diagnosed with an ED myself, so I genuinely don't know about this - but I have a deep curiosity about mental disorders.
A lot is said about how the diet culture and skinny standard produces eating disorders on people. Since the skinny type is worshipped, it makes many people develop eating disorders and purging behaviors, sometimes without even noticing it. But my curiosity is: do you guys feel like, if these cultures and beauty standards didn't exist, eating disorders like those would automatically not exist as well? Or would they still exist, maybe to a lesser prevalence, because there is some kind of biological or innate aspect to them? Are they disorders created exclusively because of culture, or not? I was thinking about that when reflecting about how many disorders are for sure worsened by cultural aspects but, in many cases, not entirely caused by it (in my opinion).

I don't even have the right to want to die. I have a supportive family, friends, good access to treatment, and I'm studying the field I love and have good perspective of following in it. I'm also able to just focus on my studies, without needing to work simultaneously (I wouldn't be able to anyway, at least not without collapsing, because I'm autistic with considerable executive dysfunction). And yet, I have these selfish desires to try to kill myself purely for attention and vanity. I deliberately try to ruin all the good stuff I have. I live in a country where most people live very hectic, heavy lives, and I look at them and all the difficulties they have in their lives and... just come to realize... how fucking selfish, petulant, immature, and terrible I am. I am so privileged, and yet, I think about ending my life or hurting myself severely. I have nothing to be upset about - so much that I create hurt where there is none, getting mad and sad at the smallest things. I genuinely feel like I'm such a spoiled rotten individual, who doesn't value all the good things they have and deliberately do things to hurt those they love, that I ironically deserve to die for it. I don't deserve to want to die - I'm not good enough for that -, and for that, for being such a petulant kid, I deserve to die anyway.

Is it a feature of Borderline Personality Disorder to live in a depressed, slightly dysphoric, or apathetic and empty mood - with a consistently harsh internal critic -, interrupted by episodes of euphoria, intense emotional despair or anger?
To be clear I'm not referring to actual major depression, I'm referring to a baseline mood of flatness or sadness with a harsh self-critic. I have BPD and Bipolar, and I can feel the difference between the depression and mania episodes, the overwhelming emotional crises, and this baseline mood.

I'm autistic and have bipolar and BPD, and right now I'm deliberately off my mood stabilizers because I feel empty and I'm trying to feel something, to combat the boredom (and also because I hate myself and I don't see any value in myself if not actively ill). Does this mean I'm a terrible ungrateful daughter? Am I difficult for not complying with my full treatment?

I genuinely live and "try to get better" exclusively for my family. Deep down, I don't want to get better. I don't want to get better because I see my identity as being deeply intertwined with the fact of being unwell - I don't know myself outside of my illness -, and also because stability leaves me feeling bored, and I have a pretty low tolerance for boredom. I don't see myself as having any intrinsic value. I don't see value in my own survival per se. The only value I see in it is the effect that it has on my family. I don't want to hurt my family, I don't want to disappoint them, so I try to be good. For them. Not for me. Because if I had a choice purely of my own, I would choose to leave myself worsening more and more until this all killed me. I've been thinking of trying to kill myself and the only reason I don't do it (yet) is because I don't want to cause suffering to my family. I know that being my real self causes pain to others, and that's the only reason why I try to suppress it. It's like my relationship with lunch - I absolutely fucking despise lunch and, when I can, I skip it, even if it leaves me very hungry. Literally the ONE and ONLY reason I eat lunch on most days is because my family would make a fuss if I didn't - if I lived on my own, I would never eat lunch at all. And similarly, the only reason why I remotely do things to try and get mentally better is because of my family.
Sometimes, though, this gets tiring. Like a constant homework I have to do. And then, I kind of wish I was living on my own with no connection to my family. Because then I would be able to destroy myself in peace, until it killed me. I

I genuinely live and "try to get better" exclusively for my family. Deep down, I don't want to get better. I don't want to get better because I see my identity as being deeply intertwined with the fact of being unwell - I don't know myself outside of my illness -, and also because stability leaves me feeling bored, and I have a pretty low tolerance for boredom. I don't see myself as having any intrinsic value. I don't see value in my own survival per se. The only value I see in it is the effect that it has on my family. I don't want to hurt my family, I don't want to disappoint them, so I try to be good. For them. Not for me. Because if I had a choice purely of my own, I would choose to leave myself worsening more and more until this all killed me. I've been thinking of trying to kill myself and the only reason I don't do it (yet) is because I don't want to cause suffering to my family. I know that being my real self causes pain to others, and that's the only reason why I try to suppress it. It's like my relationship with lunch - I absolutely fucking despise lunch and, when I can, I skip it, even if it leaves me very hungry. Literally the ONE and ONLY reason I eat lunch on most days is because my family would make a fuss if I didn't - if I lived on my own, I would never eat lunch at all. And similarly, the only reason why I remotely do things to try and get mentally better is because of my family.
Sometimes, though, this gets tiring. Like a constant homework I have to do. And then, I kind of wish I was living on my own with no connection to my family. Because then I would be able to destroy myself in peace, until it killed me.

It's common for me to feel really bothered by a big, overwhelming sense of boredom that leaves me restless and in a low mood. It feels like the type of thing you'd do anything to run away from. My go-to is usually self-harm. Right now, I've been drowning in boredom and I feel like attempting suicide to get rid of it. Here's a part of a text I wrote about it:

"...I sincerely feel like there are only two reasons for me to feel like this. The first, for validation - I crave such an extreme validation that it feels like only the extremest of acts could provide it. It's the only thing that could prove it. And the second: boredom. I'm overwhelmed and bored - I want to run away from what overwhelms me and do something extreme to fix the noredom. I don't mean a daily boredom like the one you feel when you don't have anything to do. I mean an existential boredom, one you feel on the crevices of the deepest parts of your body, leaking around like wasted oil. The shadow on the back of my mind: this emptiness that doesn't let me feel satisfied and grounded even when everything is where it should be. Maybe those are the chronic feelings of emptiness they talk about. The emptiness rises inside me, like a dark sea. No matter what I do - even if I am being able to have fun with my hobbies -, I still feel incomplete. Missing. Off-balance. Like I'm perpetually trying to reach something just out of reach - and like the only way of reaching it is by attempting to die. Crossing the lines between life and death, I'll find the one thing that fills me and kills the boredom. The validation will colour me, the ceasing of the boredom will erase the smudges on me."

Last week I was very intensely triggered, which led me to cut my wrists and thus have to go to the hospital and get stitched up, where I stayed for a day and two nights. I was doing pretty fine before this incident, but ever since, I've been very sad and increasingly thinking about attempting suicide. It's been a week. I'd like to know how long mood swings that were very intense and destructive like these usually last for others with BPD

Ok so I am autistic. And this week I was a victim of a scam on Reddit. Looking back, it was very obvious that it was a scam, but for some reason at the time I just didn't think it through. So I posted a thing on Reddit telling about the scam and I added, just as a little passage to contextualize, "I'm autistic, so I tend to believe what people tell me because of the literacy". And then there were many people criticizing me *extremely* harshly. They just hated that I mentioned I was autistic. Kept telling me "it doesn't make you special". Kept telling me that I was only hiding behind autism to "justify the unjustifiable: that you didn't think, didn't have logic, didn't have critical thinking". Explicitly told me to stop saying I am autistic because that's irrelevant to 99% of discussions, and that I should have my internet access limited because I'm too dumb to use it.

I really do not understand what is this seething hatred people have of someone merely mentioning they're autistic. It's like they hate to be reminded that we exist as what we are amongst them. They hate to see someone autistic being themselves. They want to censor every mention to it as a way to shun it away from society. Like we're not allowed to simply own what we are.

Last week I was very intensely triggered, which led me to cut my wrists and thus have to go to the hospital and get stitched up, where I stayed for a day and two nights. I was doing pretty fine before this incident, but ever since, I've been very sad and increasingly thinking about attempting suicide. It's been a week. I'd like to know how long mood swings that were very intense and destructive like these usually last for others with BPD

I feel like I have nothing in my life to look forward except for an attempt of suicide. I feel like nothing else in my life has a real meaning except for that - my desire to die. I just want to disappear, I want all to stop, I want to take a break. I feel like all I'm doing is waiting for an "excuse" do try/commit suicide. My mind is slowly starting to circle around this one and only matter. And my life isn't even bad - I have a supportive family, friends, I'm studying the field I love and am with a pretty good perspective. Even then, I can't help but feel this emptiness and dissatisfaction with life, with existence, rising inside me like the level of a sea. I feel overwhelmed, rejected and abandoned, replaced, humiliated, guilty, ashamed. I just truly hate myself and it feels... it feels like I want to try to kill myself to see if I can kill this part inside of me that weights me down, that makes me feel so invalidated all the time, that just feels threatened by everything anf everyone. I want to shut up the voices inside of me. And maybe dying, or almost dying, is the only way to do it.
The worst part is, I'm in therapy through DBT and my psychologist is making an effort to construct a safety plan for me and all, connect myself to my values, all those things. But to be very honest... I just don't want help at this point. I don't want to be convinced not to do it. I don't want to be prevented. I just want to have enough courage to finally do it - and whatever happens, happens. I hate that I don't even want to be held onto life through everything that I care about. It's almost like... my suicidal ideation and wishes are a person whom I fell in love with and just want to be able to be together with, even though it's all wrong. I've been sad, but not even that sad. I've undoubtedly been a million times worse before in my life - and even still, the idea of trying to kill myself sings to be like a siren's call.