Borderline Personality Disorder Subtypes Part I: The Discouraged Borderline

Brandy never seemed to grow out of her “emo kid” persona. At 23, she is still obsessed with dark, emotionally dense music and sad anime storylines. Her wardrobe is almost entirely black and she is never seen publically without heavily lined eyes—at once making her appear older and more experienced, yet simultaneously childlike and naïve.

Brandy is withdrawn, depressed and often tearful. She likes to say that she is “allergic to herself,” and that everyone else is also. While Brandy has few close friends, she is highly dependent on one she does have—a childhood friend named Scott—and is extremely attached to her mother. Both Scott and Brandy’s mom are used to her chronic episodes of sadness and her habit of closing herself off from time to time.

An intelligent girl, Brandy dropped out of college after only one semester. She’d had a difficult time meeting and sustaining friends and was certain none of her professors liked her. She’d failed too many exams by electing to stay behind in the dorm when she should have been attending classes. She felt hopeless and depressed and returned home. Because Brandy wasn’t choosing to “advance her future,” her father pushed her to find work and move out of the house. He was attempting to encourage independence. But Brandy interpreted her dad’s push as a terrible rejection, and since then, she has refused to speak to him. She sulks around the house and sometimes refuses to leave her room. When it’s just Brandy and her mother, she curls into her mom’s lap just like she did when she was a little girl. She can cry for hours with the older woman holding her.

But Sunday morning, Brandy’s mother made an attempt to help her daughter see that her father actually had her best interests at heart. Doing so backfired. Brandy took her mother’s words to mean that she was siding against her, and feeling betrayed and rejected, she raged uncontrollably for several minutes and then locked herself into her bathroom, saying that she wanted to die. Expressions of rage are rare in Brandy; she normally stews rather than speaks in anger. She became so escalated this time that she had to be hospitalized. Brandy has borderline personality disorder, and falls into the discouraged subtype.

A Mention of Subtypes

Theodore Millon, Ph.D., D.Sc., dean and scientific director for the Institute for Advanced Studies in Personology and Psychopathology, is the author of Disorders of Personality: DSM-IV and Beyond. In his book, Millon describes subtypes under each of the personality disorders, including the most common of them, borderline personality disorder (BPD). While there are characteristic traits belonging to the diagnosis—unstable sense of self, unstable relationships, black-and-white thinking—Millon contends that painting every BPD diagnosed individual with a whitewash of assumed behaviors can lead to misunderstandings about how an individual is personally affected by the disorder or even misdiagnosis—missing the fact of BPD in the first place, an issue which can be dangerous for individuals in need of correct treatment.

Millon lists four subtypes under BPD (each one will be further described in its own blog post). They are the discouraged borderline, the petulant (angry) borderline, the impulsive borderline, and the self-destructive borderline.

Symptoms of the Discouraged Borderline Type

The discouraged borderline type is set apart from the others as being dependent, depressive and avoidant. Some of the symptoms common to this subtype are:

  • Excessive dependence upon others
  • Cycles of withdrawal and aloneness
  • Passive, permissive
  • Recurrent depression including tearful episodes (more common than rage episodes)
  • Anger can feel sudden and surprising to others
  • Paranoia and self-persecution
  • More likely to deprive rather than indulge oneself
  • Victimized, tendency to evoke sympathy
  • Feelings of abandonment can invoke psychotic episodes
  • Feelings of abandonment may trigger desperation and suicidality
  • Irresponsible behavior
  • Uses drugs, alcohol, food, money, or sex for self-soothing
  • Tendency to use fantasy to escape reality
  • Gives away or destroys belongings
  • Suffers from chronic or recurring illness or somatic complaints

The media image as much as the mental health stereotype of a person with borderline personality disorder is of someone far more dangerous and provocative than this description allows. Actress Glen Close’s portrayal in the 1987 film Fatal Attraction has been called upon too many times to describe someone with borderline personality disorder, but this version is only Hollywood, after all, and far too one-sided.

The reality of BPD is a far more layered, more diverse picture. Like Brandy, many sufferers of BPD can be more accurately described as living quietly in their own private hells rather than making the world especially unlivable for others. In order to provide the best and most appropriate treatments to people with BPD, and in order to begin to dismantle the mountain of stigma that exists against them in both the public and the mental healthcare worlds they orbit, understanding the nuances of the diagnosis behooves all of us impacted by it.

 

On October 10th, 2013, posted in: Mental Health by Tags: