Are You High Functioning and Also Have Symptoms of Borderline Personality Disorder (BPD)?

Meet Marcele. She is a widely published author who has a law degree from an Ivy League school. She has two beautiful daughters and an adoring husband five years her senior. They've been married twenty-six years. She has many close friends and is very involved in charity work.

And then there is Carlos. He is in his late 30's, the perfect picture of health, married for fifteen years, has three beautiful children, and is a highly successful investment banker. He manages fifty-nine employees and billions of dollars of assets for his company, and also coaches his son's soccer team.

And let's also meet Nancy, who comes from a large, close-knit family. She is a therapist with her own practice, in her late twenties, has not yet married, and runs the Boston Marathon each year.

These characters represent some of my clients who also happen to have Borderline Personality Disorder traits.

What?

Hold on. Hold on. Doesn't Borderline mean you are suicidal, wreckless, and can't hold down a relationship to save your life?

Well, yes, sometimes. But not always.

And I think the perception that you have to be homeless and/or institutionalized in order to have BPD is holding a lot of otherwise successful people back from getting help. And also it is causing a boat-load of clinicians to miss the diagnosis -- and cure.

Fortunately,the fifth edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the "bible" clinicians refer to as a guide for mental health diagnostic criteria, to be published in May 2013, is going to more accurately reflect that we have "levels" of personality disorders. According to the American Psychiatric Association's website, the DSM-5 workgroup is proposing a continuum based on levels of self and interpersonal functioning, ranging from no impairment (0) to extreme impairment (4) to assess our levels of performance, or lack-there-of.

So, if there are many individuals out there who "look" perfectly normal, even highly successful, then how is this disorder impacting their lives? Sometimes, even our children are not aware of the suffering brought about by the disorder.Because many of the symptoms are triggered by close relationships, often many of the behaviors and distress only manifest behind closed doors. These symptoms can range from re-curring high-conflict fights with partners to dissociative experiences and impulsive, even criminal activities as the result of the stress of relationship and self-crisis difficulties.

Other signs can include intense loneliness and self doubt, excruciating psychic pain, overall feelings of incompetency, relationship difficulties, self harm such as cutting, drug use, over-spending or eating disorders. One of the most difficult aspects of having a personality disorder as a high-functioning individual is accepting that part of the illness also includes cognitive distortions. You can see where it might be hard to wrap one's head around the fact that you can have an IQ in the genius range, an advanced degree from an Ivy league university, and effectively problem-solve for a major corporation, and then come home and have your brain tell you that your partner is having an affair when they are, in fact, out buying you flowers. Or believe that someone is out to get you when they really aren't. I've created a simple Borderline Personality Disorder test to see if you can relate to some of the symptoms.

I "came out" -- put my picture and name all over the Internet as one with a mental illness -- in order to shed light on the fact that you can be a mother, wife, corporate sales executive, etc., and also have a part of your brain that doesn't work very well. And that (thank goodness), there are effective treatments for the baffling symptoms. Mental illness (I know you are cringing at those words) strikes all demographics, not just those who can't hold down a job. In fact, one in four Americans have a diagnosable mental illness in any given year. There are many others out there who have taken a hard look at the criteria of Borderline and found it to hold answers to some of the difficulties that couldn't be overcome despite enormous success in other areas of life.

If you can relate to anything I've talked about here, I want you to know that you are not alone. There are great treatment options. And you can use that very smart brain of yours to re-train the other part of the brain that hasn't served you too well.