DBSA Tennessee Past President, S.L. Brannon
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It’s the holidays. Let’s be attentive to one another!

11/26/2018

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The holidays can be extra difficult for folk living with mental illness. And, yes, mental illness is a real illness. Most everyone knows someone dealing with it in a very real way everyday. So, let’s attempt to raise our awareness to the subtleties of mental illness and attempt to “be there” for our friends, family, and neighbors. Here’s a great article to help us get started!


https://www.bphope.com/blog/when-friends-and-family-dont-understand-bipolar-disorder/
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Depression can leave this impression

1/24/2018

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Strong people give support inspite of personal problems

1/31/2017

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DBSA Jackson provides a weekly support group meeting for people living with mood disorders. The group facilitators are volunteers with problems of their own. For the past 15 years, these facilitators have proven themselves to be among the "strongest people".
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Need help? I'm here.

10/5/2015

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This is a new campaign launched by national DBSA. Remember, "I'm here. "

https://www.facebook.com/story.php?story_fbid=10153744595606122&id=95920556121

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BP Magazine takes on suicide

9/24/2015

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Thanks to BP magazine for shining a bright light on a dark topic. I am glad to be a part of a support group that helps prevent suicide. For over 13 years our group has served the Jackson, Tn. community faithfully. "Thank you" to , A Better Tomorrow inspirational support group.

TAKING SUICIDE PREVENTION UPSTREAM

Photo is courtesy of Woodley Wonder Works’ Flickr Photostream, under Creative Commons licensing.

Across the country, school districts are providing mental health awareness and suicide prevention training for teachers and school personnel. Some are mandated or encouraged to do so by state law, others are motivated by recent incidents, and some introduce this kind of education because suicide is now the second-leading cause of death among youth aged 15-24.

Teacher and parent training are key components in any plan to address teen suicide. Increasingly, however, communities are recognizing that kids need to learn about mental health, too. Social and emotional learning across the lifespan reduces risk factors and promotes protection factors for violence, substance abuse, negative health outcomes, and suicide. One way to provide universal student training is by including a mental health component in the standard wellness or health curriculum. School districts and individual schools can implement individual, more targeted programs as well.

Knowing how to cope and developing resilience are at the core of mental health awareness and suicide prevention efforts being implemented in Massachusetts with children as young as elementary school. The Commonwealth of Massachusetts places a high value on suicide prevention, with dedicated line-item funding in the state budget for the Department of Public Health Suicide Prevention Program. With support from state officials, the DPH has launched suicide prevention programs across the state and for people across the lifespan.

Some of the skill-building and suicide prevention programs in Massachusetts schools are

  • The PAX Good Behavior Game, which has been introduced by schools in collaboration with the DPH, teaches students self-regulation, self-control, and self-management in order to create an environment that is conducive to learning. (Ages 6-12)
  • The Open Circle program, which strengthens students’ social and emotional learning skills to increase pro-social behaviors and reduce problem behaviors, is utilized by many school districts. (Grades K-5)
  • Whyville utilizes problem-solving and other skills to help kids learn about their emotions in an online computer game. (Teens and pre-teens)
  • SOS Signs of Suicide® focuses on prevention through education by teaching students to identify symptoms of depression, suicidality, and self-injury in themselves and their peers. (Grades 8-12)
  • Break Free from Depression, developed by the Boston Children’s Hospital, focuses on increasing awareness about adolescent depression, how to recognize it, and how to get help. (High school)

There are dozens of programs that schools can use to promote skills development while fostering students’ mental health and their willingness to seek and accept help for mental health concerns. SAMHSA’s National Registry of Evidence-based Programs and Practices and the Suicide Prevention Resource Center Best Practices Registry include searchable descriptions for a wide variety of educational programs. For high school students, the SAMHSA Preventing Suicide: A Toolkit for High Schools has a comprehensive list of programs, but a search of the NREPP and BPR may yield programs added since the Toolkit was published.

What can you do? Find out how your school district handles mental health training and emotional skill building for students. If there is not currently a program and there is no interest from school officials, you might work with the parent-teacher organization, local mental health groups, and the local board of public health to raise awareness of the issue, then advocate for implementation of one or more programs. There may be grants available to cover the cost of training or there may be organizations in your community that would help subsidize the program.

The bottom line is that suicide prevention requires a comprehensive approach. It’s never too early to start and everyone – families, schools, communities, and peers that create supportive environments; individuals who learn and leverage positive coping skills; and mental and public health systems that treat and prevent risk factors – plays a part.

Your Turn

  • What do you think about the mental health awareness and/or suicide prevention programs that are provided to kids in your community?
  • What role should a school have in developing kids’ emotional and social skills?
  • What steps will you take to improve mental health awareness and suicide prevention in your local schools?

Editor’s Note: The Families for Depression Awareness Teen Depression Webinaris an accessible, free resource for training parents, teachers, and others who work with youth to recognize depression, talk about depression with parents and youth, and know what to do to help a young person struggling with depression. Register for the Teen Depression Webinar live with Dr. Michael Tsappis on September 30. 

Thanks to the MA Department of Public Health Suicide Prevention Program and the Suicide Prevention Resource Center for their support in developing this post.


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Healthy Grieving - - Denial

5/12/2015

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Healthy Grieving-Denial

Amber Wilsey

After the diagnosis, I have had to walk through a grieving process.  I grieve for the “death” of who I was, for the person who I am, and for my future self. Confusion and loss of self are huge players in this grief process.  Of course, sadness does too, much sadness.  I believe it is the same type of journey we go through when we lose our loved ones. Except this time, the person is me.  

Those five stages of grief are denial, anger, bargaining, depression and acceptance. I would imagine the denial stage is probably the most difficult to move out of after being diagnosed with a mental illness.  It has been for me.  The denial phase looked similar to this:  I cannot believe I am bipolar; all I went in for was for ADD; the doctor can’t be right; I don’t even know what bipolar is, how is that ME?  As Gru’s minions say “Wha???”  It even looks like: these meds are making me worse; I’m not sick or have mental problems; maybe I was misdiagnosed; maybe I’m really not bipolar since the medicines are not working. On and on and on…

Since I am still fairly new with the diagnosis, I can see the reoccurrence of denial throughout the past few years.  Thankfully, I am not stuck in the vortex of complete denial.  It helps to read, to learn, to use the internet, to search for others who are walking the same walk.  Thankfully, you are out there for me to glean from and from you I have hope.  

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Someone needs to hear your stories~

3/11/2015

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I'm writing my story in hopes that it will inspire others to share their story. I don't know if there is a "book" in everyone but I know for certain there is a story in there. I encourage you to share your story of overcoming some of life's challenges. Someone needs to hear what you have to say. They are waiting!

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Words are powerful

3/7/2015

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The big payoff of well-chosen words

By Stephen Propst

You may think that talk is cheap. But, when words are used thoughtlessly, carelessly, or hurtfully, they can take a heavy toll. Like an arrow, “wrong” words can be sharp, piercing a person’s spirit, ripping away at self-esteem, and making a person feel belittled or even betrayed. Ill-chosen words can strain friendships and create stress. And especially vulnerable are people who have bipolar disorder.

Now, let’s be honest. Dealing with bipolar disorder is not only tough for the people who have the illness, but it’s also a challenge for those who live with them. Taking time to consider the impact of what you say before you “fire away” makes it easier. Choosing your words carefully can strengthen relationships, fuel recovery, and make for a better quality of life for everyone.

“Never tell anyone that he looks tired or depressed,” says H. Jackson Brown Jr., in his book Life’s Little Instruction Book (Rutledge Hill Press, 1991). That’s good advice! Now, let’s look at 10 more comments to avoid making to someone who has bipolar disorder. These observations come from more than two decades of dealing with the illness and from years of leading support groups and consulting with families. The goal is to help family and friends to more peacefully coexist with those of us who have bipolar.


What not to say

You sound a little down today.
That’s what a friend said to me within the first 30 seconds when she phoned the other day. No kidding! Since I live with bipolar disorder, of course I don’t always feel 100 percent up to par. I just don’t need my symptoms constantly gauged or continually evaluated. It’s like having a never-ending physical. Most people with a mental illness know how they feel. Being told you are not sounding well is not constructive, nor is it a substitute for true compassion.


I thought you were taking your medication.

Dealing successfully with bipolar disorder cannot be reduced to whether or not someone has taken a pill. There are no quick fixes. Confronting a chronic, serious illness is an ongoing process, and there are bound to be ups and downs. The more you take the time to learn about bipolar disorder, the more you will understand how difficult managing such a condition can be. There are countless resources—books, videos, support groups, etc.—that address and reduce the mystery and misunderstanding surrounding bipolar disorder.


You’re too smart to have bipolar disorder.

When I first heard that remark, I felt so horrible, as if I could have prevented what had happened. Even worse, I felt that someone, such as a homeless person, was somehow more “deserving” of such an illness than I. The brain, like any organ in the body, is subject to having problems. It is cruel to say something that suggests that bipolar disorder doesn’t exist, isn’t legitimate, or isn’t as significant as any other medical condition.


You know he’s ‘bipolar,’ don’t you?

Reducing someone to the illness he faces is destructive. In fact, it is cruel to see a person only through the lens of a diagnosis. Unfortunately, it happens all too often. A person who has bipolar disorder should not be defined by that with which he might struggle. Guard your tongue. Focus on the person you know and love, and dwell on all that makes that individual special. Your friend or family member still has a life.


Stop acting like a fool!

Granted, some conduct associated with bipolar disorder can be very difficult to contend with. When you realize, however, that a particular behavior is actually symptomatic and born of the illness, it makes accepting and dealing with it much easier. I see families who think that their situation is unmanageable, until they meet other families facing the same circumstances. With education and patience, these families come to realize that there is an explanation for what they’ve been witnessing.

Guard your tongue. Focus on the person you know and love, and dwell on all that makes that individual special.


It doesn’t take much to set you off!

Those of us who have bipolar disorder are often more vulnerable and responsive to what happens around us. When you make careless statements, your tongue becomes a trigger that can rouse a reaction and escalate symptoms. You unnecessarily incite a mood change in the person you really want to help.


You’re lazy and don’t have a life anymore.

Are you pushing someone who has bipolar disorder to get on with life? Doing so might create stress, counteract recovery techniques, and worsen overall health. If you have a family, a job, social engagements, etc., consider yourself not only lucky, but also far apart from the typical individual who deals with bipolar disorder. Such a person has often dealt with a radical departure from any sense of a normal routine. Recovery takes time and work, and the role you play is critical. Help by using constructive dialogue that acknowledges progress. Don’t push too hard and don’t expect everything to happen overnight.


We used to have high hopes for you.

I sat at a support group and heard a mother say: “My son was going to be a doctor and have a wonderful family, but now he has bipolar disorder.” As I listened, I watched the young man’s face just drop. He was crushed by his mother’s words. Such a statement is not healthy, because it does not convey unconditional love. What you say does matter. Remember that we are all human beings, not human “doings;” the more you acknowledge our being, the more we can end up doing. There is no need to squash hope or diminish dreams.


Don’t take everything so personally.

With bipolar disorder, there are obvious physical symptoms, such as changes in appetite or sleep; the mind, as well as the brain, are impacted. The patient’s self-esteem also takes a tremendous hit. That’s why a promised phone call that never comes may be taken much harder than you might imagine. Likewise, saying things that ignore or make light of someone’s sense of self-esteem should be avoided.


You seem a little overly enthusiastic.

Remember that someone who has bipolar disorder is still entitled to a personality. Before I had bipolar disorder, I was outgoing, happy-go-lucky and quick-witted. Now even though I have this illness, those same personality traits still exist. At a support group recently, a young man was very energetic and expressive. Someone accused him of being manic. Fortunately, a psychiatrist was present. He said that the young man was displaying no manic symptoms whatsoever and that it was cruel to strip a person of his personality merely because he has a diagnosis. The doctor added that anyone is entitled to a full, normal range of emotions.


What you can say
Sticks and stones can break bones, but words hurt, too. Talking carelessly can shatter self-esteem and stifle a person’s motivation to have a life again. Instead, use statements that are more likely to strengthen relationships and support recovery.

Here are some simple phrases to get started:

“I love you, and I care.”
“You’re not alone in this.”
“I’m sorry you’re in so much pain.”
“I’m always willing to listen.”
“I’ll be your friend no matter what.”
“This will pass, and we can ride it out together.”
“You are important to me.”
“When all this is over, I’ll still be here.”


Speaking of differences
Last year, at the Fernbank Museum of Natural History in Atlanta, Georgia, an amazing, special exhibit revealed that every imaginable genetic differentiation—body size, health, anything—is attributable to less than one percent of all genes (Human Genome Project). We are more than 99 percent identical. So, if you know someone who has bipolar disorder, why not concentrate on speaking to the 99 percent of that person’s humanity that really matters?

Talk is not cheap. It pays to use words that encourage, enlighten, and empower. You can make a positive difference in your loved-one’s recovery and in your peace of mind.

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About the value of family

2/17/2015

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I was raised appreciating my family. However, in 1993, I met a personal health challenge that put me in great need of help and support. My family rose to the occasion with love and support I desperately needed. So, I learned anew the meaning of family in my midlife. Since that time I've worked to be there for my biological family and to be "family" to others with a similar need as mine.

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about recovery & depression

2/9/2015

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I'm grateful for all of the support that got me through my time of recovery. Today I appreciate the support I have in gaining more wellness each day.

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about Bipolar Disorder

1/31/2015

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What are some symptoms of BP? See what bipolar disorder can be like. Pass this along to someone in need. Dark Glasses & Kaleidoscopes - YouTube http://bit.ly/1ExeuNA

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Those special words

1/6/2015

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Allen Doederlein reflects on 2014

12/17/2014

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Allen Reflects on Thriving in 2014

As DBSA’s 2014: The Year of Thriving comes to a close, it seems appropriate to reflect on what we’ve accomplished this past year, and to think about what’s yet to come.

At the beginning of 2014, we outlined our vision of a future where every adult and child living with a mood disorder has the opportunity not just to survive, but to thrive. To some, this was a message of hope; to others, it seemed a goal almost impossible to imagine. I completely understand how some of my peers might find total wellness to be an unattainable goal. Indeed, I too have experienced times in my life when the only reality I could imagine was the intense pain of depression. In fact, I experienced times this very year when thriving seemed so very far away for me personally. But amidst messages about the danger and drain of people with mental health conditions, and my own concurrent thoughts of self-loathing and self-stigma, to know that there was a community that would hope for the return of my best self was a blessing. To hold hope when we cannot carry it ourselves: this has always seemed, to me, the fundamental purpose of peer support. DBSA was founded on a model of peer support, and DBSA will always be about creating opportunities for peer support, and through peer support—the thousands of people meeting in communities across the country—we are creating a world in which all of us may be reminded of our potential, our strength, and our best selves.

For me to return to a place of thriving took a lot of time and work and collaboration. It also took some luck. For I have been very lucky: to have found clinicians that do not put limitations on what my life can be; to have the support of loved ones and colleagues who remind me of who I am, not what condition I live with; to have insurance that gives me access to quality health care that covers both my physical and mental health; and to find inspiration in my work and the amazing people I have the privilege of working with, and for, in my role at DBSA.

Such good fortune—in clinical collaboration, in supportive community, in access to resources, in meaningful work—are what I, and the DBSA Board and staff, want for everyone, not just the very lucky.

So in 2014, we asked our peers, families, clinicians, researchers, politicians, and the public to expect more. We asked our community to promote and seek full wellness—because better is not well, and everyone deserves the opportunity to thrive. 

I am proud of the work DBSA accomplished in 2014, and I encourage you to review our 2014: Year of Thriving programs. I believe that we did open minds—and even a few doors—to the possibility of thriving. A few highlights include:

  • In January, DBSA welcomed the Balanced Mind Parent Network into our family of programs to enable us to provide critical support for parents and to create a thriving future for children living with mood disorders.
  • In April, Target Zero to Thrive asked clinicians and peers to set zero, not just reduced, symptoms as a new standard for successful treatment. 
  • In May, DBSA kicked off our six-month Positive Six: Thrive campaign, challenging us to make a small change each month to support our health.
  • In June, DBSA completed a third contract with the VA to train their Veteran peer specialist workforce.
  • In August, DBSA joined forces with DBSA New Jersey to host the From Surviving to Thriving weekend of public and chapter educational events featuring a special interview with Demi Lovato.
  • In September, DBSA hosted Better Is Not Well—a peer and professional panel that explored ways to elevate mental health treatment to complete wellness.
  • This fall, DBSA hosted a series of webinars on Treatment Choices, Health Care Reform, and Restoring Intimacy.
  • In November, DBSA issued the WHO-Five Challenge to mental health professionals to integrate wellness measurements, like the WHO-Five, into their practice.

But so much more must be done. So we ask,

“What needs to happen for us to have wellness change from being a possibility for some to a probability for most?”

It will require:

  • Better Treatments: DBSA will continue to work with our esteemed Scientific Advisory Board to integrate peers into the development of new and better treatments— medical and non-medical. And, to connect our peers and parents to studies that hold the promise of a brighter future for ourselves, our children, and our peers.
  • New Measurements: DSBSA will continue to promote widening the definition of treatment success to include not just elimination of symptoms, but presence of wellness.
  • Access to Quality Mental Health Care: DBSA will continue to advocate for the rights of all adults and children living with mood disorders to receive access to quality mental and physical health care.
  • Increased Expectations: DBSA will continue to spread the message that better is not good enough. That wellness IS possible. That everyone deserves the opportunity to not just survive, but thrive.
  • Peer Support: DBSA is committed to continuing, and increasing both the availability and quality of, life-saving in-person and online peer support for people who have diagnoses, parents, family, and friends.
  • Inspired, Imperfect Action: DBSA will continue to ask ourselves, our peers, our parents, our clinicians, our legislators, and our communities to take action. It may be small. It most certainly will not be perfect. But it will be progress—action inspires action, which in turn inspires more action.

We made some significant strides this past year, but we do not fool ourselves by believing that these first steps have produced monumental change. That will take persistence. That will take courage. That will take time. That will take hope. That will take ALL of us.

It is through thousands, indeed millions, of inspired, imperfect actions that we will slowly transform these small steps into big changes and create a future where wellness is no longer a possibility for only some lucky few, but a probability for all.

Thank you for joining us on this journey,

– Allen

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You do not know

11/21/2014

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I have many cherished friends living with major, "invisible" health challenges. Everyday they work very hard to prevent others from knowing of their struggles. They work to "pass" as being just another face in the crowd.

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Mental Illness Awareness

10/5/2014

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Help for depression, interview with Steve Brannon

9/2/2014

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Help available for dealing with depression

Beth Knoll 12:39 a.m. CDT August 27, 2014 The Jackson Sun

A life lived with depression can feel like a "deep, dark place," said Steve Brannon. But with a variety of pathways to recovery, hope is never out of reach — even during the toughest times.

Society often views depression in extremes, said Brannon, state director of Depression and Bipolar Support Alliance of Tennessee, as depression is often seen as an untreatable illness — or not as an illness at all. Depression should be taken very seriously, he said, but it shouldn't be approached in a "fatalistic" manner.

"Depression is treatable, and it responds quite well to treatment," Brannon said.

Describing depression as the "common cold of emotional mental disorders," Paul Deschenes — clinical psychologist and director of counseling services at Union University — said most people experience depression at some point in their life

Deschenes said depression can be caused by a variety of factors, including the weather or the loss of a loved one. Because depression can be genetically based, it has the potential to be passed from one generation to the next, Brannon said.

In many cases, feeling depressed is normal, as no one is happy all the time, Deschenes said. What is not normal is when the grief and sadness continues indefinitely and begins to interfere with major areas in a person's life — signaling a more significant form of depression.

"They might experience things like negative thinking, self-criticism," Deschenes said. "They might experience feelings of hopelessness. Some people have thoughts of self-blame, and generally the thinking gets very negative, pessimistic. They might see the glass as being half-empty rather than half-full."

Symptoms

Additional symptoms can vary and even seem contradictory, Brannon said. Some people develop an increased appetite when they are depressed, while others may lose their appetite. Some people may sleep more often, while others experience insomnia. Some people may voice their thoughts of hopelessness, while others may not say a word.

Brannon said that a person with depression may stop bathing or using proper hygiene, and he or she may stay in the same clothes for weeks at a time. Deschenes also noted that a person may feel a loss of energy in accomplishing everyday tasks, as well as experience a decreased sex drive.

People who are depressed are more likely to develop other health conditions such as diabetes and heart disease, Brannon said. Their lifespan also can be shortened up to 25 years.

"It might affect their relationships," Deschenes added, because people experiencing depression often decline invitations for social engagements or drop out of church. "Ultimately, left untreated, some depression might get so bad that it turns to suicide."

Deschenes said a depressed person often wants to sit at home and be alone with their thoughts, which can fuel negative feelings. As a result, he said people should get out of the house and begin taking small steps to return to a healthy level of functioning.

Steps forward

Picking up an enjoyable hobby or volunteering can help ease depression, Deschenes said. Because depression can cause distorted thinking, spending time with positive people can halt irrational and harmful thoughts as well.

Exercise also can help people overcome depression and could be as effective as medication in some cases, Deschenes added. In addition, he encouraged people to return to church if they have stopped attending, as a person's faith speaks to issues such as hope.

"Whatever help an individual goes for, we recommend that folks not only be very religious about medication but also go to counseling," Brannon said.

With new medical treatment options introduced regularly, Brannon said treatments can include transcranial magnetic stimulation, in which part of the brain is stimulated with magnetic waves. While the success rates can vary, he said the results have been encouraging and the technology is expected to continue improving.

Brannon added that people with depression should develop a support group. The individuals who form a person's support group need to check up on how the person feels emotionally, know whether the person is taking his or her medication and be available to talk whenever the person may need them.

The support group also needs to be able to recognize the symptoms of depression, as well as know when the depressed person is in need of medical attention, Brannon said.

Suicide

Noting that teenagers and the elderly are more susceptible to suicidal tendencies, Deschenes said people should not be afraid of causing a suicide by asking if someone is suicidal. If someone is hinting at suicide or displaying suicidal tendencies, he said family and friends should approach the situation seriously and take the person to a mental health professional.

People also should not think that a suicide is inevitable for someone experiencing suicidal thoughts, Deschenes said. Most of the time, a person averted from a suicide attempt and helped by professionals can regain and lead a normal life.

"When people get into a deep, dark place like Robin Williams did, trust seems to go away," Brannon noted, as a dangerous sign of suicide is when a person stops trusting others to help them manage their depression. "It is times like that the support network has to realize that they can't help this individual they love — they need someone to call."

The National Suicide Prevention Lifeline, which can be reached at 1(800) 273-8255, is a valuable resource for people contemplating suicide, Brannon said.

Support group

Brannon noted that Jackson also has a mood disorder support group, called "A Better Tomorrow." Meeting at 6:30 p.m. each Monday at St. Mary's Catholic Church, the group provides encouragement, education and information services for people with depression, as well as their family and friends.

The group often becomes like an extended family for members, Brannon said, as people with depression can understand what other group members face.

"It's something about being understood that's healing in itself," Brannon said. "That is so valuable for someone living with depression. You can't put a price on that."

To learn more about the Jackson depression support group, visit the Depression and Bipolar Support Alliance of Tennessee's website at www.dbsatennessee.org. The alliance also can be reached at (731) 215-7200.

Reach Beth Knoll at (731) 425-9641. Follow her on Twitter @merribethknoll.

What to know

• The National Suicide Prevention Lifeline, which can be reached at 1(800) 273-8255, is a valuable resource for people contemplating suicide.

• Jackson's mood disorder support group, called "A Better Tomorrow," meets at 6:30 p.m. each Monday at St. Mary's Catholic Church. The group provides encouragement, education and information services for people with depression, as well as their family and friends.

• To learn more about the Jackson depression support group, visit the Depression and Bipolar Support Alliance of Tennessee's website at www.dbsatennessee.org. The alliance also can be reached at (731) 215-7200.

Steve Brannon(Photo: Submitted)

Paul Deschenes(Photo: Submitted)

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WHAT IS DBSA?

8/19/2014

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The Depression and Bipolar Support Alliance (DBSA) is the leading patient-directed national organization focusing on depression and bipolar disorder. The organization fosters an environment of understanding about the impact and management of these life-threatening illnesses by providing up-to-date,

scientifically-based tools and information. DBSA supports research to promote more timely diagnosis, develop more effective and tolerable treatments and discover a cure. The organization works to ensure that people living with mood disorders are treated equitably. Assisted by a scientific advisory board comprised of the leading researchers and clinicians in the field of mood disorders, DBSA has more than 750 peer-run support groups across the country. Nearly two million people request and receive information and assistance each year. DBSA’s mission is to improve the lives of people living with mood disorders. For more information about DBSA or depression and bipolar disorder, please visit www.DBSAlliance.org or call (800) 826-3632.

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Allen Doederlein, President, DBSA

Nelly Piraja

Steve Brannon, State Director, DBSA Tennessee

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Recent BP zine article on stress and diet

8/8/2014

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Healthy Lifestyle May Buffer Against Stress-Related Cell Aging

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DEMI LAVATO shares at DBSA FORUM

7/20/2014

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DBSA President's Itinerary for July Visit

7/9/2014

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DBSA Tennessee

Dear Leaders,

  14 days and Allen will be here!  Do you believe it?

July 23, Wednesday – Chattanooga, TN  - Chattanooga Pendulums, Marilou Coates & Joe Herman
               Marilou - 423-322-5156,    Joe  - 423-504-7172

July 24, Thursday -Maryville (Knoxville). Larry Drain
             Larry  - 865-406-4809

July 25, Friday - Nashville- 6:30 pm presentation -Living and Thriving with Mental Health Issues- Reception Following
                              Hope park Church, 8001 Hwy 70 Sout, Bellevue, TN    Public invited and wanted
     26th, Saturday - DBSA Picnic  11 am to 4pm,  DBSA members and support people.
                                      6-10pm , Dinner and music downtown Nashville
               Danielle - 931-623-1400

July 27, Sunday - Jackson - Steve Brennon
              Steve - 731-693-6981


July-28, Monday – Memphis, TN - Chris Dowdy & Billy Higgins
                Chris - 901-409-6906,    Billy - 901-461-7055

July 29, Tuesday -Return to Chicago

  I am making the assumption that all are invited to events in each city. Would each chapter leader please send out an email detailing information of your evening? I have included Your phone numbers for any questions anyone might have regarding your event. I of course, am also available for any questions for clarification.

  It is obvious to me that Tennessee will show, Allen the best of Southern hospitality. Thank you all for making this a big success!


Daisy Jabas
Assistant State Director
DBSA Tennessee
615-799-8001

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DBSA PRESIDENT Allen Doederlein will visit across Tennessee

7/9/2014

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Daisy Jabas, Assistant Director, submitted this abbreviated itinerary:

I wanted to give each of you Allen Doerderlein's Tennessee visit intenery as it is known now.

July 23rd or 24th, arrive in Maryville, Tn
July 24th- 6 pm presentation for Larry Drain's Speaker Circuit
July 25th- 6 pm Nashville presentation/ reception
July 26th-Nashville Picnic for DBSA Members
July 27th - Arrive in Jackson, TN, DBSA Jackson Doerderlein event (leave Jackson that evening or on e 28th)
July 28th- DBSA Memphis Doerderlein event
Allen says "so long Tennessee, I shall return soon."  on Monday the 28th orTuesday the 29th
Return to Chicago.

More details of all events will be shared as they are organized. Everyone is invited to attend all events,and encouraged to do so, wherever the event is being held. I know that I am like all of you, eagerly awaiting and very excited about Allen's visit. Please keep me informed regarding all aspects of his visit as your Chapter creates them.

Our Doerderlein Event Committee is hard at work, planning and organizing details for a very productive and successful visit. Thank you everyone for your help with this and more so, thank you for your continued dedicated work for all those that live with mood disorders in Tennessee.

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Larry and Linda need help and get notice!

7/7/2014

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Exciting news is always welcome. One of our own steps out to bring national attention to those suffering due to lack of medical healthcare coverage.  Links to articles in The Tennessean and USA Today are below.

Larry Drain, DBSA Tennessee Legislative Liaison, is well known among many for his staunch work in advocacy for health care for all. Larry and Linda Drain share their story, open up their lives, in hopes that many will find the help they need. After 33 years of marriage, Larry and Linda had no other choice but to separate in order for Linda to keep the healthcare coverage she so desperately needs. Also, Larry is without healthcare coverage because his income is "too low" to meet the requirements for coverage.


The NBC Today show asked to interview Larry and Linda. The interview is expected to happen today. Airing of their interview is expected some time this week. Let's all send our best wishes and thoughts to this couple as they do all that they can to see that no one else needlessly suffers in like fashion.


Respectfully, 
Steve Brannon
State Director
DBSA Tennessee
sbrannon@DBSATennessee.org


Links to Larry and Linda's story:

http://usat.ly/VSQXne

http://tnne.ws/VSQCAY


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Larry Drain sends out a thank you for help with letters to Governor Haslam

6/19/2014

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Picture


Thanks for the support
by Larry Drain, hopeworkscommunity

The following organizations have offered support of "Dear Governor Haslam".  They have put links to this site or printed the letters on their websites.  I really appreciate it.  I invite you or your organization to do the same.


Tennessee Health Care Campaign.
Tennessee Citizen Action.
Tennessee Disability Coalition.
Tennessee Chapter Depression and Bipolar Support Alliance.

AGAIN THANKS.

WRITE GOVERNOR HASLAM TODAY

hopeworkscommunity | June 1, 2014 

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NIMH information on treatment Borderline Personality Disorder

5/9/2014

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What is borderline personality disorder?Borderline personality disorder is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed borderline personality disorder as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses.

Because some people with severe borderline personality disorder have brief psychotic episodes, experts originally thought of this illness as atypical, or borderline, versions of other mental disorders.1 While mental health experts now generally agree that the name "borderline personality disorder" is misleading, a more accurate term does not exist yet.

Most people who have borderline personality disorder suffer from:

  • Problems with regulating emotions and thoughts
  • Impulsive and reckless behavior
  • Unstable relationships with other people.
People with this disorder also have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides.

According to data from a subsample of participants in a national survey on mental disorders, about 1.6 percent of adults in the United States have borderline personality disorder in a given year.2

Borderline personality disorder is often viewed as difficult to treat. However, recent research shows that borderline personality disorder can be treated effectively, and that many people with this illness improve over time.1,3,4

What are the symptoms of borderline personality disorder?According to the DSM, Fourth Edition, Text Revision (DSM-IV-TR), to be diagnosed with borderline personality disorder, a person must show an enduring pattern of behavior that includes at least five of the following symptoms:

  • Extreme reactions—including panic, depression, rage, or frantic actions—to abandonment, whether real or perceived
  • A pattern of intense and stormy relationships with family, friends, and loved ones, often veering from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)
  • Distorted and unstable self-image or sense of self, which can result in sudden changes in feelings, opinions, values, or plans and goals for the future (such as school or career choices)
  • Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating
  • Recurring suicidal behaviors or threats or self-harming behavior, such as cutting
  • Intense and highly changeable moods, with each episode lasting from a few hours to a few days
  • Chronic feelings of emptiness and/or boredom
  • Inappropriate, intense anger or problems controlling anger
  • Having stress-related paranoid thoughts or severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality.
Seemingly mundane events may trigger symptoms. For example, people with borderline personality disorder may feel angry and distressed over minor separations—such as vacations, business trips, or sudden changes of plans—from people to whom they feel close. Studies show that people with this disorder may see anger in an emotionally neutral face5 and have a stronger reaction to words with negative meanings than people who do not have the disorder.6

Suicide and Self-harmSelf-injurious behavior includes suicide and suicide attempts, as well as self-harming behaviors, described below. As many as 80 percent of people with borderline personality disorder have suicidal behaviors,7 and about 4 to 9 percent commit suicide.4,7

Suicide is one of the most tragic outcomes of any mental illness. Some treatments can help reduce suicidal behaviors in people with borderline personality disorder. For example, one study showed that dialectical behavior therapy (DBT) reduced suicide attempts in women by half compared with other types of psychotherapy, or talk therapy. DBT also reduced use of emergency room and inpatient services and retained more participants in therapy, compared to other approaches to treatment.7 For more information about DBT, see the section, "How is borderline personality disorder treated?"

Unlike suicide attempts, self-harming behaviors do not stem from a desire to die. However, some self-harming behaviors may be life threatening. Self-harming behaviors linked with borderline personality disorder include cutting, burning, hitting, head banging, hair pulling, and other harmful acts. People with borderline personality disorder may self-harm to help regulate their emotions, to punish themselves, or to express their pain.8 They do not always see these behaviors as harmful.


When does borderline personality disorder start?Borderline personality disorder usually begins during adolescence or early adulthood.1,9 Some studies suggest that early symptoms of the illness may occur during childhood.10,11

Some people with borderline personality disorder experience severe symptoms and require intensive, often inpatient, care. Others may use some outpatient treatments but never need hospitalization or emergency care. Some people who develop this disorder may improve without any treatment.12

Studies suggest early symptoms may occur in childhood


What illnesses often co-exist with borderline personality disorder?Borderline personality disorder often occurs with other illnesses. These co-occurring disorders can make it harder to diagnose and treat borderline personality disorder, especially if symptoms of other illnesses overlap with the symptoms of borderline personality disorder.

Women with borderline personality disorder are more likely to have co-occurring disorders such as major depression, anxiety disorders, or eating disorders. In men, borderline personality disorder is more likely to co-occur with disorders such as substance abuse or antisocial personality disorder.13

According to the NIMH-funded National Comorbidity Survey Replication—the largest national study to date of mental disorders in U.S. adults—about 85 percent of people with borderline personality disorder also meet the diagnostic criteria for another mental illness.2

Other illnesses that often occur with BPD include diabetes, high blood pressure, chronic back pain, arthritis, and fibromyalgia.14,15 These conditions are associated with obesity, which is a common side effect of the medications prescribed to treat borderline personality disorder and other mental disorders. For more information, see the section, "How is borderline personality disorder treated?"

What are the risk factors for borderline personality disorder?Research on the possible causes and risk factors for borderline personality disorder is still at a very early stage. However, scientists generally agree that genetic and environmental factors are likely to be involved.

Studies on twins with borderline personality disorder suggest that the illness is strongly inherited.16,17 Another study shows that a person can inherit his or her temperament and specific personality traits, particularly impulsiveness and aggression.18 Scientists are studying genes that help regulate emotions and impulse control for possible links to the disorder.19

Social or cultural factors may increase the risk for borderline personality disorder. For example, being part of a community or culture in which unstable family relationships are common may increase a person's risk for the disorder.1 Impulsiveness, poor judgment in lifestyle choices, and other consequences of BPD may lead individuals to risky situations. Adults with borderline personality disorder are considerably more likely to be the victim of violence, including rape and other crimes.

How is borderline personality disorder diagnosed?Unfortunately, borderline personality disorder is often underdiagnosed or misdiagnosed.20,21

A mental health professional experienced in diagnosing and treating mental disorders—such as a psychiatrist, psychologist, clinical social worker, or psychiatric nurse—can detect borderline personality disorder based on a thorough interview and a discussion about symptoms. A careful and thorough medical exam can help rule out other possible causes of symptoms.

The mental health professional may ask about symptoms and personal and family medical histories, including any history of mental illnesses. This information can help the mental health professional decide on the best treatment. In some cases, co-occurring mental illnesses may have symptoms that overlap with borderline personality disorder, making it difficult to distinguish borderline personality disorder from other mental illnesses. For example, a person may describe feelings of depression but may not bring other symptoms to the mental health professional's attention.

No single test can diagnose borderline personality disorder. Scientists funded by NIMH are looking for ways to improve diagnosis of this disorder. One study found that adults with borderline personality disorder showed excessive emotional reactions when looking at words with unpleasant meanings, compared with healthy people. People with more severe borderline personality disorder showed a more intense emotional response than people who had less severe borderline personality disorder.6

What studies are being done to improve the diagnosis of borderline personality disorder?Recent neuroimaging studies show differences in brain structure and function between people with borderline personality disorder and people who do not have this illness.22,23 Some research suggests that brain areas involved in emotional responses become overactive in people with borderline personality disorder when they perform tasks that they perceive as negative.24 People with the disorder also show less activity in areas of the brain that help control emotions and aggressive impulses and allow people to understand the context of a situation. These findings may help explain the unstable and sometimes explosive moods characteristic of borderline personality disorder.19,25

Another study showed that, when looking at emotionally negative pictures, people with borderline personality disorder used different areas of the brain than people without the disorder. Those with the illness tended to use brain areas related to reflexive actions and alertness, which may explain the tendency to act impulsively on emotional cues.26

These findings could inform efforts to develop more specific tests to diagnose borderline personality disorder.6


How is borderline personality disorder treated?Borderline personality disorder can be treated with psychotherapy, or "talk" therapy. In some cases, a mental health professional may also recommend medications to treat specific symptoms. When a person is under more than one professional's care, it is essential for the professionals to coordinate with one another on the treatment plan.

The treatments described below are just some of the options that may be available to a person with borderline personality disorder. However, the research on treatments is still in very early stages. More studies are needed to determine the effectiveness of these treatments, who may benefit the most, and how best to deliver treatments.

PsychotherapyPsychotherapy is usually the first treatment for people with borderline personality disorder. Current research suggests psychotherapy can relieve some symptoms, but further studies are needed to better understand how well psychotherapy works.27

It is important that people in therapy get along with and trust their therapist. The very nature of borderline personality disorder can make it difficult for people with this disorder to maintain this type of bond with their therapist.

Types of psychotherapy used to treat borderline personality disorder include the following:28

  1. Cognitive behavioral therapy (CBT). CBT can help people with borderline personality disorder identify and change core beliefs and/or behaviors that underlie inaccurate perceptions of themselves and others and problems interacting with others. CBT may help reduce a range of mood and anxiety symptoms and reduce the number of suicidal or self-harming behaviors.29
  2. Dialectical behavior therapy (DBT). This type of therapy focuses on the concept of mindfulness, or being aware of and attentive to the current situation.1 DBT teaches skills to control intense emotions, reduces self-destructive behaviors, and improves relationships. This therapy differs from CBT in that it seeks a balance between changing and accepting beliefs and behaviors.30
  3. Schema-focused therapy. This type of therapy combines elements of CBT with other forms of psychotherapy that focus on reframing schemas, or the ways people view themselves. This approach is based on the idea that borderline personality disorder stems from a dysfunctional self-image—possibly brought on by negative childhood experiences—that affects how people react to their environment, interact with others, and cope with problems or stress.31
Therapy can be provided one-on-one between the therapist and the patient or in a group setting. Therapist-led group sessions may help teach people with borderline personality disorder how to interact with others and how to express themselves effectively.

One type of group therapy, Systems Training for Emotional Predictability and Problem Solving (STEPPS), is designed as a relatively brief treatment consisting of 20 two-hour sessions led by an experienced social worker. Scientists funded by NIMH reported that STEPPS, when used with other types of treatment (medications or individual psychotherapy), can help reduce symptoms and problem behaviors of borderline personality disorder, relieve symptoms of depression, and improve quality of life.32 The effectiveness of this type of therapy has not been extensively studied.

Families of people with borderline personality disorder may also benefit from therapy. The challenges of dealing with an ill relative on a daily basis can be very stressful, and family members may unknowingly act in ways that worsen their relative's symptoms.

Some therapies, such as DBT-family skills training (DBT-FST), include family members in treatment sessions. These types of programs help families develop skills to better understand and support a relative with borderline personality disorder. Other therapies, such as Family Connections, focus on the needs of family members. More research is needed to determine the effectiveness of family therapy in borderline personality disorder. Studies with other mental disorders suggest that including family members can help in a person's treatment.33

Other types of therapy not listed in this booklet may be helpful for some people with borderline personality disorder. Therapists often adapt psychotherapy to better meet a person's needs. Therapists may switch from one type of therapy to another, mix techniques from different therapies, or use a combination therapy. For more information see the NIMH website section on psychotherapy.

Some symptoms of borderline personality disorder may come and go, but the core symptoms of highly changeable moods, intense anger, and impulsiveness tend to be more persistent.34 People whose symptoms improve may continue to face issues related to co-occurring disorders, such as depression or post-traumatic stress disorder.4 However, encouraging research suggests that relapse, or the recurrence of full-blown symptoms after remission, is rare. In one study, 6 percent of people with borderline personality disorder had a relapse after remission.4

MedicationsNo medications have been approved by the U.S. Food and Drug Administration to treat borderline personality disorder. Only a few studies show that medications are necessary or effective for people with this illness.35 However, many people with borderline personality disorder are treated with medications in addition to psychotherapy. While medications do not cure BPD, some medications may be helpful in managing specific symptoms. For some people, medications can help reduce symptoms such as anxiety, depression, or aggression. Often, people are treated with several medications at the same time,12 but there is little evidence that this practice is necessary or effective.

Medications can cause different side effects in different people. People who have borderline personality disorder should talk with their prescribing doctor about what to expect from a particular medication.

Other TreatmentsOmega-3 fatty acids. One study done on 30 women with borderline personality disorder showed that omega-3 fatty acids may help reduce symptoms of aggression and depression.36 The treatment seemed to be as well tolerated as commonly prescribed mood stabilizers and had few side effects. Fewer women who took omega-3 fatty acids dropped out of the study, compared to women who took a placebo (sugar pill).

With proper treatment, many people experience fewer or less severe symptoms. However, many factors affect the amount of time it takes for symptoms to improve, so it is important for people with borderline personality disorder to be patient and to receive appropriate support during treatment.

How can I help a friend or relative who has borderline personality disorder?If you know someone who has borderline personality disorder, it affects you too. The first and most important thing you can do is help your friend or relative get the right diagnosis and treatment. You may need to make an appointment and go with your friend or relative to see the doctor. Encourage him or her to stay in treatment or to seek different treatment if symptoms do not appear to improve with the current treatment.

To help a friend or relative you can:

  • Offer emotional support, understanding, patience, and encouragement—change can be difficult and frightening to people with borderline personality disorder, but it is possible for them to get better over time
  • Learn about mental disorders, including borderline personality disorder, so you can understand what your friend or relative is experiencing
  • With permission from your friend or relative, talk with his or her therapist to learn about therapies that may involve family members, such as DBT-FST.
Never ignore comments about someone's intent or plan to harm himself or herself or someone else. Report such comments to the person's therapist or doctor. In urgent or potentially life-threatening situations, you may need to call the police.

How can I help myself if I have borderline personality disorder?Taking that first step to help yourself may be hard. It is important to realize that, although it may take some time, you can get better with treatment.

To help yourself:

  • Talk to your doctor about treatment options and stick with treatment
  • Try to maintain a stable schedule of meals and sleep times
  • Engage in mild activity or exercise to help reduce stress
  • Set realistic goals for yourself
  • Break up large tasks into small ones, set some priorities, and do what you can, as you can
  • Try to spend time with other people and confide in a trusted friend or family member
  • Tell others about events or situations that may trigger symptoms
  • Expect your symptoms to improve gradually, not immediately
  • Identify and seek out comforting situations, places, and people
  • Continue to educate yourself about this disorder.
Where can I go for help?If you are unsure where to go for help, ask your family doctor. Other people who can help are:

  • Mental health professionals, such as psychiatrists, psychologists, social workers, or mental health counselors
  • Health maintenance organizations
  • Community mental health centers
  • Hospital psychiatry departments and outpatient clinics
  • Mental health programs at universities or medical schools
  • State hospital outpatient clinics
  • Family services, social agencies, or clergy
  • Peer support groups
  • Private clinics and facilities
  • Employee assistance programs
  • Local medical and psychiatric societies.
You can also check the phone book under "mental health," "health," "social services," "hotlines," or "physicians" for phone numbers and addresses. An emergency room doctor can provide temporary help and can tell you where and how to get further help.

What if I or someone I know is in crisis?If you are thinking about harming yourself, or know someone who is:

  • Call your doctor.
  • Call 911 or go to a hospital emergency room to get immediate help or ask a friend or family member to help you do these things.
  • Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or TTY: 1-800-799-4TTY (4889) to talk to a trained counselor.
  • If you are in a crisis, make sure you are not left alone.
  • If someone else is in a crisis, make sure he or she is not left alone.
Citations
  1. Gunderson JG. A BPD Brief: An Introduction to Borderline Personality Disorder: Diagnosis, Origins, Course, and Treatment. (ed)^(eds).http://www.borderlinepersonalitydisorder.com/documents/A%20BPD%20BRIEF%20revised%202006%20WORD%20version%20--%20Jun%2006.pdf . Accessed on July 30, 2007.
  2. Lenzenweger MF, Lane MC, Loranger AW, Kessler RC. DSM-IV personality disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007 Sep 15;62(6):553–64.
  3. Paris J, Zweig-Frank H. A 27-year follow-up of patients with borderline personality disorder. Compr Psychiatry. 2001 Nov–Dec;42(6):482–7.
  4. Zanarini MC, Frankenburg FR, Hennen J, Reich DB, Silk KR. The McLean Study of Adult Development (MSAD): overview and implications of the first six years of prospective follow-up. J Personal Disord. 2005 Oct;19(5):505–23.
  5. Meyer B, Pilkonis PA, Beevers CG. What's in a (neutral) face? Personality disorders, attachment styles, and the appraisal of ambiguous social cues. J Pers Disord. 2004 Aug;18(4):320–36.
  6. Hazlett EA, Speiser LJ, Goodman M, Roy M, Carrizal M, Wynn JK, Williams WC, Romero M, Minzenberg MJ, Siever LJ, New AS. Exaggerated affect-modulated startle during unpleasant stimuli in borderline personality disorder. Biol Psychiatry. 2007 Aug 1;62(3):250–5.
  7. Linehan MM, Comtois KA, Murray AM, Brown MZ, Gallop RJ, Heard HL, Korslund KE, Tutek DA, Reynolds SK, Lindenboim N. Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Arch Gen Psychiatry. 2006 Jul;63(7):757–66.
  8. Kleindienst N, Bohus M, Ludascher P, Limberger MF, Kuenkele K, Ebner-Priemer UW, Chapman AL, Reicherzer M, Stieglitz RD, Schmahl C. Motives for nonsuicidal self-injury among women with borderline personality disorder. J Nerv Ment Dis. 2008 Mar;196(3):230–6.
  9. Chanen AM, Jackson HJ, McCutcheon LK, Jovev M, Dudgeon P, Yuen HP, Germano D, Nistico H, McDougall E, Weinstein C, Clarkson V, McGorry PD. Early intervention for adolescents with borderline personality disorder using cognitive analytic therapy: randomised controlled trial. Br J Psychiatry. 2008 Dec;193(6):477–84.
  10. Zelkowitz P, Paris J, Guzder J, Feldman R. Diatheses and stressors in borderline pathology of childhood: the role of neuropsychological risk and trauma. J Am Acad Child Adolesc Psychiatry. 2001 Jan;40(1):100–5.
  11. Zanarini MC, Frankenburg FR, Khera GS, Bleichmar J. Treatment histories of borderline inpatients. Compr Psychiatry. 2001 Mar–Apr;42(2):144–50.
  12. Zanarini MC. Ten-Year Course of Borderline Personality Disorder. (ed)^(eds). Borderline Personality Disorder: Course, Outcomes, Interventions.http://web4.streamhoster.com/video4nea/michigan/02%20Ten%20Year%20Course%20of%20Borderline%20Personality%20Disorder_files/intro.htm . Accessed on March 28, 2008.
  13. Tadic A, Wagner S, Hoch J, Baskaya O, von Cube R, Skaletz C, Lieb K, Dahmen N. Gender differences in axis I and axis II comorbidity in patients with borderline personality disorder.Psychopathology. 2009;42(4):257–63.
  14. Frankenburg FR, Zanarini MC. Obesity and obesity-related illnesses in borderline patients. J Personal Disord. 2006 Feb;20(1):71–80.
  15. Sansone RA, Hawkins R. Fibromyalgia, borderline personality, and opioid prescription. Gen Hosp Psychiatry. 2004 Sep–Oct;26(5):415–6.
  16. Torgersen S, Lygren S, Oien PA, Skre I, Onstad S, Edvardsen J, Tambs K, Kringlen E. A twin study of personality disorders. Compr Psychiatry. 2000 Nov–Dec;41(6):416–25.
  17. Coolidge FL, Thede LL, Jang KL. Heritability of personality disorders in childhood: a preliminary investigation. J Pers Disord. 2001 Feb;15(1):33–40.
  18. Lynam DR, Widiger TA. Using the five-factor model to represent the DSM-IV personality disorders: an expert consensus approach. J Abnorm Psychol. 2001 Aug;110(3):401–12.
  19. Lis E, Greenfield B, Henry M, Guile JM, Dougherty G. Neuroimaging and genetics of borderline personality disorder: a review. J Psychiatry Neurosci. 2007 May;32(3):162–73.
  20. Ruggero CJ, Zimmerman M, Chelminski I, Young D. Borderline personality disorder and the misdiagnosis of bipolar disorder. J Psychiatr Res. 2010 Apr;44(6):405–8.
  21. Paris J. The diagnosis of borderline personality disorder: problematic but better than the alternatives. Ann Clin Psychiatry. 2005 Jan–Mar;17(1):41–6.
  22. Emotion-Regulating Circuit Weakened in Borderline Personality Disorder. (ed)^(eds). http://www.nimh.nih.gov/science-news/2008/emotion-regulating-circuit-weakened-in-borderline-personality-disorder.shtml. Accessed on Oct 10, 2008.
  23. King-Casas B, Sharp C, Lomax-Bream L, Lohrenz T, Fonagy P, Montague PR. The rupture and repair of cooperation in borderline personality disorder. Science. 2008 Aug 8;321(5890):806–10.
  24. Kernberg OF, Michels R. Borderline personality disorder. Am J Psychiatry. 2009 May;166(5):505–8.
  25. Silbersweig D, Clarkin JF, Goldstein M, Kernberg OF, Tuescher O, Levy KN, Brendel G, Pan H, Beutel M, Pavony MT, Epstein J, Lenzenweger MF, Thomas KM, Posner MI, Stern E. Failure of frontolimbic inhibitory function in the context of negative emotion in borderline personality disorder. Am J Psychiatry. 2007 Dec;164(12):1832–41.
  26. Koenigsberg HW, Siever LJ, Lee H, Pizzarello S, New AS, Goodman M, Cheng H, Flory J, Prohovnik I. Neural correlates of emotion processing in borderline personality disorder. Psychiatry Res. 2009 Jun 30;172(3):192–9.
  27. Binks CA, Fenton M, McCarthy L, Lee T, Adams CE, Duggan C. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev. 2006;(1):CD005652.
  28. Stone MH. Management of borderline personality disorder: a review of psychotherapeutic approaches. World Psychiatry. 2006 Feb;5(1):15–20.
  29. Davidson K, Norrie J, Tyrer P, Gumley A, Tata P, Murray H, Palmer S. The effectiveness of cognitive behavior therapy for borderline personality disorder: results from the borderline personality disorder study of cognitive therapy (BOSCOT) trial. J Personal Disord. 2006 Oct;20(5):450–65.
  30. McMain S, Pos AE. Advances in psychotherapy of personality disorders: a research update. Curr Psychiatry Rep. 2007 Feb;9(1):46–52.
  31. Kellogg SH, Young JE. Schema therapy for borderline personality disorder. J Clin Psychol. 2006 Apr;62(4):445–58.
  32. Blum N, St John D, Pfohl B, Stuart S, McCormick B, Allen J, Arndt S, Black DW. Systems Training for Emotional Predictability and Problem Solving (STEPPS) for outpatients with borderline personality disorder: a randomized controlled trial and 1-year follow-up. Am J Psychiatry. 2008 Apr;165(4):468–78.
  33. Hoffman PD, Fruzzetti AE. Advances in interventions for families with a relative with a personality disorder diagnosis. Curr Psychiatry Rep. 2007 Feb;9(1):68–73.
  34. McGlashan TH, Grilo CM, Sanislow CA, Ralevski E, Morey LC, Gunderson JG, Skodol AE, Shea MT, Zanarini MC, Bender D, Stout RL, Yen S, Pagano M. Two-year prevalence and stability of individual DSM-IV criteria for schizotypal, borderline, avoidant, and obsessive-compulsive personality disorders: toward a hybrid model of axis II disorders. Am J Psychiatry. 2005 May;162(5):883–9.
  35. Binks CA, Fenton M, McCarthy L, Lee T, Adams CE, Duggan C. Pharmacological interventions for people with borderline personality disorder. Cochrane Database Syst Rev. 2006;(1):CD005653.
  36. Zanarini MC, Frankenburg FR. omega-3 Fatty acid treatment of women with borderline personality disorder: a double-blind, placebo-controlled pilot study. Am J Psychiatry. 2003 Jan;160(1):167–9.

For more information on borderline personality disorderVisit the National Library of Medicine's:

MedlinePlus 

En Español 

For information on clinical trials

National Library of Medicine clinical trials database 

Information from NIMH is available in multiple formats. You can browse online, download documents in PDF, and order materials through the mail. Check the NIHM website for the latest information on this topic and to order publications. If you do not have Internet access, please contact the NIMH Information Resource Center at the numbers listed below.

National Institute of Mental Health
Science Writing, Press & Dissemination Branch
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513 or 1-866-615-NIMH (6464) toll-free
TTY: 301-443-8431 or 1-866-415-8051 toll-free
FAX: 301-443-4279
E-mail: nimhinfo@nih.gov
Website: http://www.nimh.nih.gov

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