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The question was submitted 03/05/2008

Subject: Sabotaging my own recovery

I am 21 years old and have been diagnosed with BPD and depression with a query about bipolar. This particular episode started when I was 18 and has been quite dramatic. What I mean is frequent (40+) trips to the (medical) hospital usually from prescription overdoses, 22 inpatient psychiatric admissions, 3 stays in ICU and another 2 in general wards after suicide attempts, stitches 17 times on self inflicted wounds as well as copious amounts of self harm not requiring medical intervention as well as intervention from the police on several occassions. It has basically been crisis after crisis.
I am now in a period of relative stability - I am doing a DBT skills training program at a psych hospital in the city as well as studying part time. However, in times of stability like this I find myself wishing that I was in crisis again, and in the past I have often missed it so much that I have forced myself to harm myself in some way so that I force myself back into crisis. I am then set back in my recovery and start all over again only to get to the same point and sabotage myself again.

I really do want to get better, I promise you that, and I am dedicated to my therapy, but there is this horrible part of my behaviour that I can't seem to stop. It is getting really scary. I have read in places that BPDs are sometimes seen as attention seeking - is this self sabotage just another aspect of my BPD? Is this a normal thing to be happening given the intensity/drama of my episode?

Answer from DepNet

Thank you for your question. You should be congratulated for identifying that you have a problem and for trying to work on it. It is to your credit that you have had some success.


When your life changes (in this case for the better) you can still have some longings for the past – even though you recognise that was destructive.


It is essential to talk about this in your DBT skills program. Sometimes it can give you a sense of control to induce a crisis rather than wait for one to happen. However if you have made real gains you may not get a crisis again ever, or not for a long time. Do stick with your work as you should find your life gets progressively better for you by staying on a steady path.


Sometimes bipolar disorder can show up with symptoms that are very like borderline personality disorder (BPD), and can worsen pre-existing BPD. If that is the case then mood stabilising treatment can help both the bipolar disorder and the BPD.


Mood stabilisers don’t help BPD much in the absence of bipolar disorder. BPD is primarily helped with psychological treatment.


If you can continue to work on your issues, stabilise your situation effectively but recognise your vulnerabilities you are well placed to make further gains.


Do continue to work on your issues and don’t give up.


You are welcome to discuss your question and this reply with your therapist.

The answer was published on DepNet 06/05/2008