Mel

The stigma of BPD is not just from cutting though. (Other people do it too and not all BPD people do by any means.) It is because “borderline” has become a quick to apply adjective for someone who is angry at you or just for difficult people that one finds unlikable. It’s quite possible that it is over-diagnosed for females that come to consult a therapist if they are in a stormy mood and under-diagnosed in men because anger in men gets interpreted under other labels. But people who really suffer from BPD have trouble controlling all of their negative emotions in ways hard for “normal” people to imagine.

Self-harm (cutting, slapping, drug use, adrenalin rushes etc.) releases opioids in the brain and can pull a person who suffers from “BPD” out of his unbelievably painful dysphoria (explosive cocktail of rapidly cycling feelings of inadequacy, guilt, overwhelming shame, total despair, irrational fear, intense self-hate, and yes, anger). By directing his acting out inwards, someone with BPD can actually save those around him a lot of grief (as long as these behaviors are hidden or socially acceptable as in dangerous sports, of course). BPD people have the same feelings as others, only their negative feelings, once started, often spiral down at the speed of light, and once they’re in the black hole it can take them days to crawl out. The fact that they do, over and over, get back to the surface where they go on with their lives (i.e. their marriages, their friendships, their jobs, etc.) and in spite of terrible stigma from an uncomprehending and often very quick to judge world, is all to their credit.

The bottom line is that this is a painful emotional dysregulation disorder that affects all kinds of people, which can wreck havoc on the sufferer and his family, until everyone learns to separate the disease from the person. Then suddenly it all doesn’t seem so bad.

with Self-Injury Awareness Day coming, we’ve got a good, solid Factsheet for guys who self-injure – check out http://www.lifesigns.org.uk/publications/

In terms of danger, cuts to the arm are very unlikely to lead to death. Unless someone has a blood clotting disorder, it’s nearly impossible to bleed to death by cutting the arteries in the wrist. That’s not to say that people can’t injure themselves severely by self-harming – it sucks to accidentally cut through a nerve or a tendon. But even so, the vast majority of people who cut, only ever do so superficially and never require medical attention for their wounds. Self-harm by way of poisoning is much more dangerous and can lead to death much more easily than cutting.

There has been research on self-harm as a precursor to suicide. Fox and Hawton’s estimate is between 40 and 100 times as many young people have engaged in self-harm than those who have actually ended their own lives. So the best guess at the number of suicides that are actually self-harm incidences gone wrong is “not many”.

Which isn’t to say that self-harm shouldn’t be treated, but an over-reaction is probably as bad as an under-reaction. Unless that child with a cut needs stitches, there’s no point going to the emergency room – an appointment with their family doctor would usually make more sense. The Young People and Self Harm is about the situation in the UK, but is probably useful reading for anyone with an interest in the subject.