New Treatments For BPD an Easy to Understand Detailed Overview (2012-2013) Part 2

Part 1

*2012 Video update Coming Soon!* It will include the latest scientific info from review papers on RCTs on drugs & therapies for BPD (more recent than Wikipedia,which I plan to update after I've finished the video) You can subscribe to my YouTube to know when I've uploaded it http://www.youtube.com/user/ROMI1AAT

But here is a sneak preview while I'm finishing

IPT-BPD

Showed large, statistically significant effects in the reduction of affective instability impulsivity and interpersonal problems.ITP-BPD is a modified version of Interpersonal Psychotherapy (IPT) which is a brief and very structured manual-based therapy that addresses relationship problemsPatients are encouraged to learn interpersonal skills and adapt their behaviour to current roles and situations.

 

Dynamic Deconstructive Psychotherapy (DDP)

is a type of psychodynamic psychotherapy used to treat BPD and other complex behavior problems such as drug dependence,self-harm, eating disorders, recurrent suicide attempts & co-occurring disorders,such as substance use disorders or additional personality disorders.

Weekly 1-hour individual sessions over 12 to 18 months

There were no statistically significant results when compared to a therapy control.Encouraging effects on core BPD & associated pathology were found, showing  that it may help severely ill patients.

 

In Conclusion

Disorder-specific treatments should be used.

Nonspecific treatments that were investigated:Cognitive Behavioural Therapy (CBT), Client-Centered Therapy (CCT), Interpersonal Psychotherapy (IPT) showed no encouraging effects for the treatment of BPD core pathology. The best length of treatment is unclear Based on the available findings, a treatment of 12 to 18 months seems to be appropriate.

Yi-gan san for the treatment of borderline personality disorder: an open-label study.

          Background:

Recent studies indicate that the traditional Chinese herbal medicine yi-gan san (YGS, yokukan-san in Japanese) may be safe and useful in treating behavioral and psychological symptoms in dementia patients. We aimed at evaluating both efficacy and safety of yi-gan san in patients with well-defined BPD.

            Methods:

Twenty female outpatients diagnosed with BPD according to DSM-IV criteria and the revised Diagnostic Interview for Borderlinescompleted a 12-week open-label study with yi-gan san at an average daily dosage of 6.4+/-1.9 g (2.5-7.5 g). Psychometric instruments to assess efficacy included the Brief Psychiatric Rating Scale (BPRS), Hamilton Rating Scales for Depression (HAM-D), Global Assessment of Functioning (GAF), Clinical Global Impression Scale (CGI), and Aggression Questionnaire (AQ).Most psychometric scale scores exhibited a highly significant improvement (total BPRS; BPRS
somatic concern, anxiety, tension,depressive mood, hostility, suspiciousness, motor retardation, uncooperativeness,and excitement subscale; CGI; GAF; AQ) over time.

          Conclusions:

In this open-label pilot study, patients treated with YGS showed statistically significant reduction on self-rated and clinician-rated scales. The present findings suggest that yi-gan san might be effective for the treatment of a number of BPD symptoms, including low mood, impulsivity, and aggression.

http://www.ncbi.nlm.nih.gov/pubmed/17765378

Omega-3 Fatty acid treatment of women with borderline personality disorder: a double-blind, placebo-controlled pilot study.

Abstract
Objective:
The purpose of this study was to compare the efficacy of ethyl-eicosapentaenoic acid (E-EPA) and placebo in the treatment of female subjects with borderline personality disorder.
Method:The authors conducted an 8-week, placebo-controlled, double-blind study of E-EPA in 30 female subjects meeting Revised Diagnostic Interview for Borderlines and DSM-IV criteria for borderline personality disorder.
Results:
Twenty subjects were randomly assigned to 1 g of E-EPA; 10 subjects were given placebo. Ninety percent of those in both groups completed all 8 weeks of the trial. Analyses that used random-effects regression modeling and controlled for baseline severity showed E-EPA to be superior to placebo in diminishing aggression as well as the severity of depressive symptoms.
Conclusions:The results of this study suggest that E-EPA may be a safe and effective form of monotherapy for women with moderately severe borderline personality disorder.
http://www.ncbi.nlm.nih.gov/pubmed/12505817

St John's Wort and 5HTP

Some borderlines have found a combination or 1 to be helpful,no studies have been done unfortunately.You should not take either with other meds especially antidepressants and at too high doses as serious damage can result,you should also not be taking them with alcohol and side effects may occur... Consult your doctor as always when starting any treatment...St John's Wort is not appropriate for severe depression.

I have a condition known as BPD or Borderline Personality Disorder and I have found that taking both SJW and 5-HTP has really helped me by levelling my mood swings, regulating my sleep patterns, reducing the feelings of stress, depression and anger. I've been taking these for well over a year with no side effects, I sometimes miss taking then for a week and I notice that my symptoms start to slowly return but not in a worse way and once I start again, after about a week I feel back to "normal".

Read more: http://wiki.answers.com/Q/Can_you_take_St_Johns_Wort_and_5-HTP_at_the_same_time#ixzz20YouWzFL

 I am now well into my recovery, and exclusively on St. John's Wort. I have been taking SJW by itself for around a year, and also recently tested 1 month of total withdrawl from it. After the test, I confirmed the SJW is having a very positive affect on my life. The only real side-effect I have is photosensitivity, especially to bright flourescent lighting in buildings. Well bright artificial light in general. Sunlight doesn't really bother me so much, but then again I'm usually indoors anyway

A further discussion of it can be found here http://www.psychforums.com/borderline-personality/topic41988.html

Energy Psychology Work 

Not yet proven/studied much,but something to look into.
http://www.psychologytoday.com/blog/resolution-not-conflict/201206/new-treatments-borderline-personality-disorder



Lists of  other treatments may be found here: http://en.wikipedia.org/wiki/Management_of_borderline_personality_disorder

Click to enlarge

Brain Regions are appproximate

I have written a post you might find useful,it contains some information on low cost/free workshops for family & people that suffer from mental illnesses Can't Afford Treatment/Want to Further Research ?

What is Borderline Personality Disorder (BPD)-Dyslimbia ? 2012-2013

What is Borderline Personality Disorder ?

Artist- MargaritaJP

BPD also called Dyslimbia (meaning malfunction of the limbic system) or Emotionally Unstable Personality Disorder is a mental health disorder.People with BPD have unhealthy patterns of perceiving,thinking about & reacting to their environment and events in their life. There is a pattern of instability spread out in various areas such as relationships,self-image (how you see yourself),emotions & impulsivity usually starting during early adulthood (& sometimes adolescence)

Artist -RaeGrimm 

You need 5 or more of the following criteria to be diagnosed with BPD by a professional using the (DSM-IV-TR).

Proven Methods to Increase Mental Health

Why is good social,emotional & psychological health so important?

Image: FreeDigitalPhotos.net

    It reduces:

· risk of emotional and behavioural problems

· violence and crime,

· teenage pregnancy

· drug and alcohol abuse

· it will reduce psychological pain

           

How to Increase Your Mental Health

·         Try to spend your leisure time participating in your community doing something active rather than playing video games/watching TV.

·          If you are religious get involved in your church.

·         Practice mindfulness (focusing on the now without judging)

High Nutrient Recipes for Mental Health

Author-Vi..Cult...Wikimedia
Quinoa

This is my post on recipes for mentall health,a follow up on  Diet for Mental Health Part 1

Quinoa-Vegetable Dish -serves 4  
You will need:
3 white onions cut in small pieces
A few florets of broccoli/cauliflower chopped into small pieces
3 cloves of garlic chopped

The Importance of Relaxation

image from Fir0002/Flagstaffotos

Relaxation can :

• Help speed up psychotherapy
• Decrease depression and anxiety
• Decrease agitation which is a sign of a mood swing that is going to occur.
• Reduce stress hormones which in excess can cause various health problems including heart disease,depression,sleeping problems,headaches,stomach problems...
• Improve your communication skills
• Reduce anger
• Help you find what your deepest personal value is
• Help you deal with a crisis and with impulsivity in a healthy way.

Various Types of Relaxation & Stress-Reduction Techniques

Diet for Mental Health Part 1

Image: FreeDigitalPhotos.net
Berries -good sources of
 antioxidants& nutrients

What You Eat Affects Your Mood!

Inflammation is associated with psychiatric disorders,especially clinical depression.Psycho-social stress and anxiety can start the inflammatory response in the brain,¹⁰ this stress causes oxidation in the brain which  damages parts of the brain including the parts that regulate mood and can result in cells dying.This process increases your chance of depression and uses up nutrients like fatty acids,zinc and magnesium causing more damage to the brain.Antioxidants (lutein,lycopene,zinc,vitaminE,A,C,beta-carotene & selenium) can help as they protect body cells from the damaging effects of oxidation.Omega 3 fatty acids,EPA specifically reduce inflammation.¹¹ 

A diet rich in antioxidants,nutrients and EPA will help your immune system and cells in both the brain to prevent and reduce symptoms of psychiatric illness.

Poor Nutrition is a Risk Factor for Mental Illness ³

BPD,Menstruation & Estrogen

 3 studies were made to see if estrogen had an effect on the symptoms of BPD.They used oral contraceptives in the 3rd study as they contain estrogen.If you have high BPD and started using oral contraceptives your symptoms increased.During times of rapidly changing estrogen levels BPD symptoms increased.

Values Improve Your Life

 Kidsonroof wishes to re-connect modern life with nature
, rediscovering basic values. 

What are Values?

They are the moral principles and beliefs or accepted standards of a person or social group

Why are they important?
They help improve your quality of life,help us deal with stress.Can help us keep motivated when we want to give up.Values can give you a sense of achievement and something to look forward to.

A quick exercise to see what your values are can be found here Identify Your True Values

Can't Afford Treatment/Want To Further Research ?

Image: FreeDigitalPhotos.net

What You Can Do:
Options include: free online CBT,studies,free/low-cost workshops,peer counselling,support groups,surveys,books,websites and self-care.

Impulsivity & Extreme Thoughts

Slowing Down Impulsiveness

When a question or comment upsets you, wait at least five seconds before responding and repeat “calm down” in your mind several times first.

When you feel a strong impulse, remind yourself that taking action at those times usually results in bad outcomes.Use feelings of regret as helpers.
                            

The Way You Say It Is More Important Than The Words

How to communicate effectively:  

1 Gentle eye contact- it increases trustworthiness and encourages future cooperation, a happy gaze will increase emotional trust.

 2.Kind facial expression.If you think about someone you love,or an event that brought you deep joy & satisfaction, a "Mona Lisa" smile will appear on your face & the muscles around your eyes will soften.

 3.Warm tone of voice-slow down and drop your pitch to convey more trust to others.When expressing joy,your voice needs to become increasingly melodic, whereas sadness is spoken with a flat and monotonic voice.  When we are angry, excited, or frightened, we raise the pitch and intensity of our voice, and there’s a

Self-Harm in Mood Disorders

Why Self Harm Feels Good In The Brain
Self harm is present in a wide variety of mental disorders and in many different forms from cutting,burning,hitting and banging your body against hard surfaces to picking your skin ,pulling out your hair and poisoning yourself.

9 Things you probably didn't know about BPD

1) Borderlines are more likely to have a stuffed toy (teddy bear) than people without the diagnosis they also reported more childhood trauma, rated their early caregivers as less supportive, and had more attachment problems as adults.

Teddy bears a BPD's best friend

Image: FreeDigitalPhotos.net

2)BPD patients suffered a significantly greater rate of nightmares, elevated levels of dream anxiety, and disturbed sleep quality than did controls. In the borderline group,
heightened dream anxiety was correlated with higher rates of early traumatic experiences and dissociative symptoms, and impaired sleep quality.

Anger Management

                               Things to avoid

venting
saying things you will regret
throwing objects
self-harming (you are just re-enforcing the self-hate)

16 Things You Can Do

Seek Warmth-take a hot shower,hold a hot water bottle,hold a cup of tea in your hands(but not so warm that its uncomfortable)

Delay-helps arousal decrease

Different Treatments for Schizophrenia

I came across this by accident when researching emotional lability (really bad mood swings)


The Treatment of Schizophrenia with Chinese Medicine
http://www.encognitive.com/files/The%20Treatment%20of%20Schizophrenia%20with%20Chinese%20Medicine_0.pdf

Yi-gan san (traditional Japanese herbal medicine)as adjunctive therapy for treatment-resistant schizophrenia   http://www.ncbi.nlm.nih.gov/pubmed/19471183

Some have had success with a combination of medication with strong vitamins

Symptom & Mood Charting

What?

Basically it is where you will be recording your symptoms & treatments over time.

Why?

It can be difficult to remember especially with a mental illness how you have been doing if your doctor asks and you can get a clearer picture of what has been working for you,your triggers,patterns of how your symptoms may be affected by things such as your menstrual cycle,the seasons,sleep... What treatments are helpful,some triggering patterns, behaviour you may carry out before making suicide attempts,early warning signs

BPD and Mood Disorders

Did you know ?

If you have BPD (borderline personality disorder) chances are very high you will also have a mood disorder (a.k.a affective disorder)

One study found that about 96% of patients with BPD met criteria for a mood disorder. 

•  about 83% of patients with BPD also met criteria for major depressive disorder(aka clinical depression)

• about 39% of patients with BPD also met criteria for dysthymic disorder.

According to NAMI :

Co-morbidity with other disorders:

Major Depressive Disorder                                                --  60 percent

Dysthymia  (chronic, moderate to mild depression)          --  70 percent

Eating Disorders                                                               --  25 percent

Substance Abuse                                                               -- 35 percent

Bipolar Disorder                                                                -- 15 percent

What is Major Depressive Disorder?

New Treatments For BPD an Easy to Understand Detailed Overview (2012-2013) Part 1

(I will try to keep updating this as time goes by & new studies are published...)

*2012 Video update Coming Soon!* It will include the latest scientific info from review papers on RCTs on drugs & therapies for BPD (more recent than Wikipedia,which I plan to update after I've finished the video) You can subscribe to my YouTube to know when I've uploaded it http://www.youtube.com/user/ROMI1AAT
But here is a sneak preview while I'm finishing

Artist-Ferian Moon

We will be looking at Long & Short –Term Treatments like:

DBT (Dialectical Behaviour Therapy)
MBT (Mentalisation Based Treatment) (partial
hospitalization & outpatient)
SFT (Schema-Focused Therapy)
TFP (Transference-Focused Psychotherapy)
STEPPS (Systems Training for Emotional Predicatibility & Problem Solving)
GPM (General Psychiatric Management)
DDT(Dynamic Deconstructive Therapy)
NET (Narrative Exposure Therapy)

DBT-ACES (Accepting the Challenges of Exiting the System)
Drug Treatment,ECT & Alternative Treatments

Suicide

So let me guess you hate your life and want to end it aka die ? Chances are that you have a mental disorder and little information on how to make a successful suicide because if you did you would probably not be searching online.Or you can't access the Peaceful Pill Handbook or Suicide and Attempted Suicide Methods & Consequences by Geo Stone(parts of the book are available free online)

Understanding and Helping a Borderline

Image: FreeDigitalPhotos.net

 During a Crisis

Encourage  them to use crisis skills,see my Crisis Skills Post 

Things I will be discussing today are:(compulsive)self-harm,things to do/say,things to avoid and tips for friends/family of a borderline.

Top 25 Things NOT to Say (or do) to Someone in Crisis

Crisis Skills 1

Feel like its all too much & you want to urgently tear your hair out?
Don't worry this will pass,I've outlined lots of suggestions below to help.



3 things to memorize/write down :

 1) Distract

 2) Relax

 3) Cope

Memory Aid 
Dinosaurs Relax in Coats
or
 Dinosaurs Race Cows
whichever one you like best (or make up your own)

Distract

To distract from urges to self-harm & an anxiety provoking thought.
Hold some ice cubes or splash cold water on your eyes. Use a pipette to let red food coloring

Bad Coping Skills

Note : In certain situations it is best to call the emergency services in your country, if this is one of those emergency situations,take a few deep breaths,call them and try to explain the situation as calmly as possible.

Image: FreeDigitalPhotos.net

Otherwise,hopefully you will find the following tips helpful.

First you need to be willing to identify & change your coping reactions to healthier ones,I know its frightening giving up your safety blanket of things that work for you but they probably have long-term consequences.

May- BPD Awareness Month

Please sign the following petition to help make a difference for the sufferers of this illness
http://www.thepetitionsite.com/1/Advocacy-for-Borderline-Personality-Disorder/

Image: FreeDigitalPhotos.net 

Join NEA.BPD's symbol of hope & wear a ladybug pin.

Thank You