Thread by @Drsafariboob

The Anatomy of a Borderline Personality Disorder #BPD Meltdown (and what you can try to help the person you love 💕)

A Shareable Thread 🪡🧵 1/15

The Trigger: you mostly won't understand why it's happened. 😕 Something happened though and the sick person has had a switch flicked. An electrical brain circuit has been catalysed and without the ability to emotionally regulate, the first domino topples. 2/15

The sick person quickly stops being able to process information. They may appear capable. They may seem to be hearing and responding but you can see or hear the crisis unfolding & escalating in front of you. No matter what you do it doesn't diminish and snowballs instead. 3/15

The Meltdown: the sick person is now in complete fight or flight. The fight is irrational & based in abandonment. Whatever happened, this person now convinced you AREN'T their friend/lover/family. Flight causes impulsivity in an already near-psychotic person, a suicide risk. 4/15

What's happening is called Splitting 💔, a psychological mechanism allowing a person to tolerate overwhelming emotions by seeing someone as either good or bad. This makes it easier to manage the emotions being felt, which on the surface seem to be contradictory. 5/15

The sick person will attack anyone they perceive 'not on their side'. Your option to be confrontational to provide rational thought has passed. As we are dealing in irrationality now, my suggestion is to respond in kind. 🙃 6/15

Drop your arguments, they're unimportant. Apologise. If strong enough, (irrationally) take responsibility. If the person is working on recovery later they will feel responsible. The shame associated with meltdowns can kill. You need to reassure that you are ON THEIR SIDE. 7/15

A hopefully obvious aside - your safety comes first. You're allowed to treat this like first aid & primarily keep yourself safe before providing assistance. Resources exist for your support, access them. It may be dangerous otherwise. You can contact emergency services. 🚑 8/15

The inside workings of a #BPD meltdown are like lightning in a bottle. Self awareness is near impossible as those established nueral pathways fire faster than we can keep up. The emotions associated are firing at 200%. We take our rejection & try to make others understand it.9/15

We do it by attacking. I'll use an example of my recent words, used on my fiancé. NB: My fiancé is my Favourite Person. Out of context but I used the words, with malice: "fuck you, how many times did you want to kill yourself today? I don't want to leave you, I want to die."10/15

The Consequences: first, it's like running a marathon. After I feel like I have brain damage. Second, the shame is all-consuming. You can see how there are few people that could withstand this for long & unfortunately it happens to those we are closest to & need the most. 11/15

People leave because of this. Nearly everyone. They justify it saying 'I won't put up with this abuse'. My question, why are you with this person? I would argue if you are close to someone with BPD you have directly benefited from some of their loose personal boundaries. 12/15

Why share this? I have the entire logic of #BPD wrapped up in a neat little bow 🎀 Logic doesn't work here. Embedded nueral pathways don't respond to it. Yet the only way we can practice these things is to keep trying to walk while we keep falling over 👶 And- 13/15

We need the support of loved ones. It doesn't work otherwise. We need community and acceptance. We didn't choose to have this disease, it was given to us by CSA, by abusive parents and by neglect and being misunderstood by the people we care about the most. 14/15

If you know somebody with this stigmatised disease, just tell them you care. Repeatedly. They will love you for even trying to understand what's happening. The pain felt is something you will never comprehend but you may ease it if you can just hold their hand through it. 15/15