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[Guest guest]

michael, i am on your side. i am on your side. and i am on

everytone's side. THIS is one of the hardest things a parent will go

thru short of the death of a child....and some feel it is a slow

painful death for all.

the brain can and does alter its physiologic function based on

environment and there are permanent changes to the brain structure

brought about by childhood and later environmental influences, though

the earlier the larger the change.

i keep my perspective by reminding myself that about 10% of the pop.

either has BP trtaits or BPD-numbers vary, but it is prevelant. MOST i

(professionally) and we all personally never know we are seeing. only

the most afflicted-or those w/co-morbid ds. get to treatment. most

muddle thru, often unhappily, some, some i know, and w/o tx find a

niche-a calling, a job, a marriage, a large family, religion, etc tec

and except for the infrequent flare-up when under extroidinary stress

do ok. some even do well. i know a few docs, even one surgeon who do

great professionally(one operated on me-neurosurgeon yet!), BUT

rarely can overreact in his private life-interpersonal relationships,

but keeps problems from professional life.

even the BP's i have seen ALL have more than hope-they ALL can

improve their lives, they all can seek stability, with or w/o(though

for severe pts tx is often nec.) help. as they age they do find

niches...like all of us the most exciting, but anxious years are the

one with thew most freedom. to a BP i believe these are terrifying

years where the sense that they dont know where they belong, or co

nclusion that they do not belong creats much suffering, and maybe

spurs the most self-destructive years in their, and the diseases

years: age 15-34. after that things may calm down-dependimng on many

things-family support(if they have not alienated everyone), whether

they have been able to maintain a primary relationships, whether they

have had any close relationships that were " healing " -the listr of

factors are endless, as you know.

BP's off meds-of course. only the very worst 10-20% generaLLY are

prescribed medication. most common pattern of this 10% is to be on

and off-therapy as well as medication.

there are many, many, many ways to get control of sx; many, many,

mnay stories of recovery(by this i mean attain high fx w/little

disruption from still underlying presence of primitive def.

mechanisms-i do not at this time believe that the brain ds-the

integrity of the brain heals-that wouyld go against what we know of

the brains fx; the physiologic changes in the brain caused by BPD-

maybe some diminution with tx or a lower stress circumstances and

over time) cure? what is cure? some are able to consistently not

exhibit enough sx to no longer " qualify " for the dx-but that brings

up the " labeling " dilemna and shortcomings of the whole DSM system.

i believe a best case scenario is a relatively happy, productive

stable individual, who takes care in not letting themselves be placed

in a situation that has very high stress or speaks directly w/ stress

to their individual issues.

i work each day with and for my dtr to achieve this end.

i hope and wish for all your children relief from this dreadful

illness, and for us, to have a child who grows up, leaves the nest

and who we can enjoy with the average amount of concern for.

love, rivka