Gun ownership is a hot-button issue in the United States right now: after multiple mass shootings that clearly involved perpetrators with mental health problems, many wonder whether or not EVERYONE should have the right to bear arms.

For the purposes of this blog, I will make a few quick points to get the politics out of the way. I’m NOT here to discuss politics. This blog is about helping individuals and families afflicted by Borderline Personality Disorder, a serious mental health condition.

1. Rights are not unlimited. All rights come with responsibilities. Decades old legislation and supreme court decisions have already excluded certain populations of people from owning firearms. Contrary to popular belief, this hallowed right is technically “infringed” upon quite regularly. Even the first amendment is constrained: you can not spew hate speech or incite violence without being held accountable. Like it or not, ALL of our rights as Americans have limitations.

2. If you have ever been involuntarily committed to a mental health facility, you might still be able to legally buy a firearm depending on your state’s laws and the specifics of your committal. Privacy laws with respect to mental health are complicated. In most cases, you’re only flagged for “mental health” in the Federal background check system if a court of law determined you to be incompetent. Otherwise, if you were horribly depressed and cutting yourself, and were subsequently sent to a hospital per order of your psychiatrist, your name will probably never make the Federal database. Emergency commitments are different than legal commitments (please consult an attorney for further guidance).

3. “Locking up the crazies” is not the answer. The people spouting this nonsense typically have a few screws loose themselves. Statistically speaking, the vast majority of people with mental illness NEVER harm anyone. Some might not even self harm. Mental illness is not always permanent, and when treated correctly, people can lead full, normal lives. People with mental health challenges are more likely to hurt themselves before anyone else. Although there have been a few noteworthy cases of people with BPD who have committed murder, they represent a miniscule percentage of the entire BPD population.

Don’t confuse anger and emotional instability with a lack of empathy. People with BPD aren’t necessarily psychotic or sociopaths. Quite the opposite: most people with BPD have a keen sense of empathy (understanding the feelings of others) but are operating from an extreme emotional handicap that prevents them from interacting with people normally.

All of that being said, if you have a BPD diagnosis or know someone who does, a firearm/gun should be given to a trustworthy individual for safekeeping until further notice.

Suicide is often highly impulsive. Having a gun within arm’s reach makes suicide quick and easy. When someone is prevented from committing suicide, they often wonder what they were thinking after a couple weeks of emergency therapy. When abated, suicidal impulses will pass. This is well documented medical fact. People can eventually live happy, productive lives.

Of course, people will say suicide prevention is useless, since there are a myriad of ways to kill oneself. This is an intellectually dishonest position that fails to take into account the complications of jumping off a bridge, slitting one’s wrists, overdosing, or stepping in front of an oncoming train. When attempting suicide “in public” there’s a good chance others will stop you from being successful, hence the conclusion that suicide attempts are actually “cries for help” more than actual death wishes. Overdosing requires easy access to lethal medication and the ability to go absent long enough to die. Slitting one’s wrists is extremely painful and one can lose consciousness, and then wake up hours later in an emergency room after being found by a loved one. Suicide by firearm is extremely efficient and much different than other methods.

People with BPD are also prone to rages during which they will act violently, perhaps temporarily falling into a state of psychosis when under extreme emotional duress. Quick access to a firearm can have deadly consequences for a lover, friend, or family member unlucky enough to be in the path of a full blown BPD explosion. Yet, hours later, the individual with BPD will realize that their homicidal impulse was wrong and completely irrational. With therapy and medication, rages can be less violent and prevented. Like suicide, access to firearms makes homicide profoundly easy.

I have officially had BPD for 13 years. I do NOT own a firearm. I have self-harmed and acted violently, but never hurt anyone physically except for myself. There are a few scars and burn marks on my body to prove it. The damage I have done to others is mostly psychological and emotional. That doesn’t make it better than physical harm or “right”, but it does mean I still have a chance to salvage the relationships I have ruined.

If you have BPD and own firearms, large knives, lethal medication, or any other dangerous object, please give them to someone you trust during a moment of clarity for safekeeping.

If someone you love has BPD and they have access to dangerous objects, remove these items from their possession.

You will thank me later, especially if you or someone you love is suffering horribly at the hands of Borderline Personality. Firearms only complicate matters.

The trouble is, I can’t always get to sleep. I end up rolling around in my bed feeling anxious or experiencing unsettling thoughts. Luckily I was able to sleep 2 days last week, and was helpful. Unfortunately, I didn’t keep up with my exercise routine and fell off my work schedule.

When I don’t have a productive day, I get anxious I will not regain the focus to bounce back. Obviously we all need time to rest, but I fear “rest days” will turn into a permanent crutch opposed to a brief time to recharge.

What might be causing my depression and low mood?

1. Meds changes. I am coming off Welbutrin. I had been on 300mg XR for 10 years. My doctor and I decided to reduce it to 150mg XR for a month. Celexa 20mg was added for anxiety and to balance any withdrawal effects. Now 20 days into the meds change, my body should be adjusted to the decreased Welbutrin. It has a half-life of 20 hours, so I thought the most adverse withdrawal effects (if any) would have already passed. Perhaps the addition of Celexa and Welbutrin XR decrease are messing up my head?

2. Physical exhaustion. I started exercising to lose weight 13 months ago, and it worked. I actually completed my first distance race (a 5K) in 11 years a couple weeks ago. I’m never really content with being “somewhat” in shape and have been pushing myself to get stronger. I recently added long runs to my regimen. The early summer heat in Florida has taken me off guard. Last week before I fell into a depression, I finished a 6 mile run on a hot evening, and experienced some symptoms of heat exhaustion (nausea, profuse sweating, goosebumps, and chills). 3 hours later I recall feeling completely drained. I was depressed for the next two days. Maybe I’m exercising beyond my capabilities.

3. Anxiety. This has been alive and well inside me for years. No need to rehash it in another blog. After a while, the mind AND body tires of the “fight or flight” sensations anxiety produces, and depression can result.

4. Stressors. I have a few things going on in life that are stressful and have unknown, potentially highly consequential outcomes. I’m anxious about them. On some days I can focus on the rest of my life, but on others these issues consume me. You can only tolerate so much stress before your body shuts down.

5. BPD thinking. Like anxiety, BPD thought patterns are still prevalent, although I do have increased control over them. Battling these thoughts is tiresome. I wish I could have a few days off to truly mentally relax, but that isn’t always possible. Coping with items #1-4 would be much easier without the BPD wildcard, but it is still something I must tolerate.

During my therapy appointment today, it was suggested I should eliminate factors causing my depression by process of elimination, and then retool myself to balance better moving forward.

This is a rational and deliberate approach to addressing my concerns, but my fear is that taking too much time off will ruin my productivity and get me into bad habits.

To be fair, doing the same thing and expecting the depression to disappear on its own is insanity.

The frustrating thing with depression is that it happens in the first place. Why can’t I just be tired and need an extra hour of rest? Instead, my whole sense of self and entire day come crashing down.

It is a warning sign that something needs to be fixed, or that energy must be reallocated to more important areas of my life. Hopefully with some additional rest from exercise and relief from anxiety symptoms, I will feel better soon.

Anxiety has plagued me since my youth. Depression started mid-way through college and has persisted in various forms until the present. Prior to starting medication and formal out patient therapy following a borderline personality rage, I was subsisting on very negative thought processes, motivation techniques, and mental imagery.

Negative self-motivation might sound crazy to some people, but it literally became a way of life for me when I was tired and needed and extra “push” to get things done. Some people involved in sports might think of “negative motivation” as a coach using aggressive, overly critical language (to be mild) as a way to focus his/her players. This works with some people who are already innately motivated by positive thoughts. For those that rely on negative motivation, however, it only reinforces bad habits.

For example, I suffer from intense anxiety before races, sometimes even before intense workouts. This inevitably produces symptoms of extreme panic, including diarrhea and vomiting. Some athletes experience a “healthy” degree of nervousness before a performance event that helps them focus and use adrenaline to boost their competitiveness. In my case, all the adrenaline and “fight or flight” anxious thinking paints me into a terrifying corner that makes competition a horrifying experience. If I don’t vomit before an event, I might vomit during it, or most likely, at the end.

Races are supposed to be a chance to let loose, surprise yourself, and kick some ass. They are the venue where all your training and hard work pays off. The same is true for people who are musicians or singers: the stage is where the money is made. Students in high school or college might be extremely capable scholars but find they become very anxious before taking standardized tests because of their importance relative to moving up the educational chain. Anxiety and panic cancel all the gains made from practice and study before a performance event.

CBT Stop Thought Technique: Helpful for Stopping Invasive Thoughts, Anxiety, and Depression

It’s a fairly simple:

1. Identify the negative thought.
2. Think, say, or make some gesture that means STOP. (Disarm the thought)
3. Focus on something else: peaceful thoughts, positive thinking, serenity, assertive thoughts (the glass is half full, etc.)
4. Repeat process if the thought(s) return.

Anyone can use this technique, and you don’t necessarily need a therapist’s assistance unless your thoughts are particularly troubling, pervasive, or so “routine” that you can’t think of any creative ways to interdict them.

The “Stop Thought Technique” is literally a mental exercise, not unlike working out to lose weight, training for a 5K run, or getting ready for football season. You are conditioning your mind to stop unproductive thoughts and replace them with positive thinking. Conditioning of any sort takes time, so you must be patient and persistent. There will inevitably be days when stopping thoughts doesn’t come easy, just as the aspiring basketball player will occasionally struggle with his or her shooting technique.

It took a long time for negative thinking to become a way of life, and it will take some time to replace it.

There are a few variations on the “STOP” declaration. Some people use a rubber band to lightly snap their wrist; others might literally scream out loud to scare the thought off; while others find they need a specific environment (ie. sitting quietly in a room, relaxing after work, etc.) to be more receptive to disarming negative thoughts. After stopping thoughts in a peaceful environment, they springboard to more stressful environments.

For me, being persistent will be the key. I’m at the point where I can identify negative thoughts, but still allow them to produce anxiety or rely on them as a motivational tool. The process is also graduated. That means you can’t expect to hit home runs on day one. Instead, like a beginning baseball player, focus on making contact with the ball; then move forward slowly.

Finally, coming up with positive thoughts to supplant the disarmed negativity can be challenging. Start off with a couple basic thoughts that give you peace, no matter how insignificant and build on them. Don’t worry how effective they are at holding off the bad cognition, just realize you are working on a process to improve yourself and that it will take time.

You’re not morally or psychologically “weak” if you have PTSD

We expect too much from our soldiers. We can not expect them to shrug off the horrors of war without needing some form of therapy or group counseling with other veterans. In fact, the presence of PTSD in a soldier is evident of a healthy mind that suffered extreme stress, opposed to someone who returns with little perspective other than the number of enemies they killed. The latter case would be an instance of sociopathic tendencies that should immediately raise red flags. There is a difference between doing one’s duty and having callous disregard for human life; enemy or not.

Troops from World War 2, Korea, and Vietnam didn’t have PTSD – is this pop psychology or the result of coddling our youth?

No. Not in the least. The fact to the matter is, PTSD in troops has occurred in every war, we just didn’t recognize it as a sign of psychological stress until recently.

Sadly, our relatives who returned from major wars in the past few decades had little to no psychological support. What inevitably resulted? Alcoholism. Extreme depression. Suicide. Family dysfunction. Paranoia. Flashbacks. Extreme anxiety.

The fact that Uncle John “drank World War 2 away with Jim Bean and Jack Daniels” is neither healthy nor ultimately productive for his family. What might have been a typical case of PTSD went unchecked, and it resulted in an immense toll on John’s family, his relatives, friends, and children. Ask any child of a troubled former soldier what their father or mother should have done after the war, and most will say “get counseling”. Drinking, drugging, and denial ARE NOT viable solutions.

Mental Illness Still Has a Stigma Attached to it in the USA, particularly for our troops

In the USA, we like to think we are super strong, super confident, super tough, go-getters who feel nothing other than our own success and pride. The fact is, buried beneath this jingoistic hubris, we are still all human beings with feelings, emotions, and souls.

That you feel disturbed after watching your platoon mates dismembered during an IED detonation is completely NORMAL.

That you feel intense fear after losing a limb or taking a bullet in the line of duty is completely NORMAL.

That you can’t wrap your head around “normal American life” after spending several intense months witnessing the awful effects of war is completely NORMAL.

Those who deny these feelings are kidding themselves. They are compartmentalizing their lives and will eventually deteriorate, or spend the rest of their lives in a diminished state of living, forever haunted by what they experienced.

PTSD and other post-war psychological stress is best treated immediately, regularly, and among other veterans who know what you experienced. You don’t have lie on the couch of a psychiatrist and spill your guts. Instead, look for support groups, stay in touch with your military friends, and promise yourself you will do everything humanly possible to work through the stress.

One particularly successful method of treating PTSD doesn’t involve traditional notions of therapy at all. In fact, veterans are instead teamed with a trained dog who acts as a companion and helper. It might sound a little flaky to some people, but it has been extremely successful for some of the worst cases of post-war PTSD. Best of all, having an animal companion with you to help navigate day-to-day activities is nothing unusual or suspicious to other civilians: they see a man or woman with an attentive pet, not someone who is “weak” or otherwise deficient in character.

Before setting foot on the battlefield, our soldiers were unique individuals with various personality traits, personal histories, and stressors in their lives. Adding a traumatic experience to anyone’s “psychological history” will undoubtedly cause some disturbance in what is perceived as reality. Some of the toughest people on the outside are actually terrified inside. Their rough exteriors seems impressive and encouraging to others, but there is a cost to faking your way through life as if nothing bothers you.

If you or a family member has recently returned from war and are having trouble re-adjusting to life, you are NOT alone and NOT weak. Talk to other veterans and find the nearest meeting, support group, or PTSD screening clinic for a review. You wouldn’t return home with a physical wound left untreated and festering. Don’t ignore your mental struggles either.

Welbutrin XR (Extended Release) is meant to treat depression, slowly releasing its dosage throughout the day. It is an selective serotonin reuptake inhibitor (SSRI). Before everyone leaves the room (those damn SSRIs!) Welbutrin has been helpful to me: it has had a stimulant effect on me that gets my day moving and gives me a little extra nudge to be productive. Lately, however, due to increased anxiety in other parts of my life, the Welbutrin has pushed me a little too far. I’ve felt very cranked up (or “wired”), mentally zooming around my life. This sensation teamed with anxiety produces a nervous stomach. I’ve actually had diarrhea and vomited multiple times in recent months. Enough of that.

Now I’m tapering off with 150 mg Welbutrin XR generic (buproprion). My doctor also started me on an introductory dosage of Celexa.

Celexa is also a SSRI ( YIKES! ) that has indications for depression, but can be used off-label for anxiety. The thought is to slowly ween myself off the long dependence on Welbutrin and use a minimal dosage of Celexa to balance the anxiety. Celexa should help slow my mind down during the day, without making me too listless or sleepy.

I’m only a couple days in so I can’t judge how the change has affected me yet. The first day I took Celexa, I did notice my feelings and physical sensations of anxiety (nervous stomach) were muffled. They were still alive and well within me, but not screaming me into a panic. That was actually quite pleasant.

The second day on the Welbutrin draw-down and Celexa introduction, I began to feel a little less focused during the day. The “go-go-go” sensation I had previously that amped up my anxiety levels was decreased. This sensation was new and not troublesome (yet). If my drowsiness increases during the day I will have to either take the Celexa at night or drop it altogether. I don’t have time to waste experimenting with new meds. I need to be productive throughout the day, without going over-the-top and becoming unhinged.

Will I be on SSRIs / anti-depressants forever?

That’s a complicated question. My parents would like me off all medication. They seem to either not trust them, or feel embarrassed that their son is on them in the first place. In reality, that embarrassment is their own: they were part of the reason I ended up needing therapy and meds for 10+ years.

That said, naturally there may come a time when medication is NOT necessary even though it feels safer to take it “just to be sure”.

I asked my new doctor about the “permanence” of taking anti-depressants, and she said it depends on the individual. Some people can eventually come off all medication and lead productive lives provided their symptoms are under control. Others need to take them indefinitely. Meds are taken to balance chemical deficiencies or excesses in the brain, so it would follow that the only time to stop them is if one’s physiological condition has changed. This is actually possible in some cases, particularly if therapy is also utilized to ward off unproductive behavior and thought patterns.

Of course, this is where all the anti-SSRI crowds and conspiracy theorists jump in. There have been many instances of people who have been over-medicated simply because the science of psychiatry is imprecise short of running expensive, time consuming brain scans each time a new med is prescribed. As a result, when new science or therapy emerges that relieves someone from taking medication, they tend to harp on about how their mind was being controlled and day-to-day life ruined.

They fail to realize that the best treatment available to them – given the science at the time and their financial constraints – was being “over medicated”. It is easy to criticize in hindsight but the fact remains that those who DO criticize don’t realize a very simple truth: they are still alive and well to speak their mind, and the meds DID prevent them from committing suicide, losing a job, loosing their temper, or otherwise acting out.

A couple hundred years ago, leeches were used to suck blood out of the bodies of sick patients. The thinking was primitive but logical: the leech would absorb the diseased blood, and then the body would replenish itself with “clean”, healthy blood. That was the best one hope for.

Nowadays a doctor prescribing a leech for the stomach flu would be laughed out of his medical practice. Science improved and we now have anti-bacterial medication and treatments to fight viruses.

Psychiatry is evolving and will continue to evolve. Perhaps it’s still in the “hang a leech from your ear” phase, but in time it will improve if we give it a chance. I’ve been on SSRIs for a decade plus and the government does not control my mind. I also have not killed myself either.

I have ignored the Jodi Arias trial in the USA up until last week when she was found guilty. Arias – of Mesa, Arizona – stood accused of shooting, stabbing, and slashing the throat of her now dead boyfriend, and the evidence against her was overwhelming. I wasn’t surprised that she was found guilty, but I was surprised that so-called “medical professionals” on TV were making completely outrageous statements about her psychological condition.

During the trial, Jodi Arias’ psychiatrist testified that Jodi had an Axis 2 diagnosis of Borderline Personality Disorder. I didn’t know that until last week when the hacks on HLN’s Dr. Drew On Call were trying to quarterback her psychological state. Arias now faces the penalty phase of her trial during which she might get sentenced to death. Naturally, she was put on suicide watch and was temporarily transferred to a psychiatric prison where doctors denied all visitation requests and had her medicated.

To be Clear: I do not excuse Arias from murdering her boyfriend because she has mental illness. I do not condone what she did because she has Borderline Personality. Dr. Drew and others held her solely responsible for her actions and that is not unreasonable.

That said, the picture they painted of how BPD *might* have developed and *why* it had such horrific consequences for Arias was completely unprofessional and misleading.

First of all, Dr. Drew was trying to explain BPD in a 4 minute segment with 3 other “doctors” (used loosely), a co-host, and 2 lawyers. Like most shows on HLN, one person says something and then the rest yell at each other like bratty kids having a roid rage. There was no thoughtful debate about Borderline Personality: it was more like “it’s not our problem – hang her high”.

I respectfully disagree with their assessment. They understandably suggested Arias was a manipulative, melodramatic, moody, unpredictable b*tch who was not worth the bother of saving. They never considered for one moment that there may have been environmental factors early in her life that made her BPD so profound and violent.

As someone with BPD, it is my responsibility to get treatment and to behave appropriately.

The upsetting part of the entire dialog was that neither Dr. Drew nor his “experts” failed to explain how Borderline Personality actually develops. Dr. Drew said “genetic and environmental factors” and that was it. I don’t think it is that simple.

We can not choose which circumstances we are born into, which parents we get, which family, and their ability to nurture us as children. Some families get lucky and have even tempered kids. A happy childhood leads to productive adult life. Some families get troubled kids but have the foresight to get psychological help long before problems metastasize. Then, there are troubled families with troubled kids who never get help (because they are in denial, abusive, or irresponsible) and psychological problems explode as adolescence begins, at which point they simply say “You’re becoming an adult, it’s your problem to deal with.”

Guess what? It sure as hell is my problem, but I’m not necessarily at fault for it. What Jodi Arias did was unforgivable and horrific. I don’t believe for one second that murdering your boyfriend in such a gruesome manner is at all inline with proper recovery from borderline personality disorder.

While we CAN cast blame on Arias for her present actions, we can NOT also blame her for developing a mental health problem.

My own parents ignored all the psychological problems their children had, and disclaim any responsibility for not getting help early on. They are also under the impression everything they did as parents was “always right” and that our childhood was “wonderful”.

Really? Both my brother and I have self harmed on several occasions, have been on meds for more than a decade, and need constant therapy. Another brother has sought treatment for attention deficit disorder and concentration, but in reality he was in need of therapy and medication as needed to get through college. The only brother who escaped the mental problems was – not surprisingly – the one they spent the most time on and found the most amenable to their own personalities.

Beyond that, my parents lived vicariously through their children, ignoring obvious warning signs of mental health problems. Instead, they chose to be “so proud” (in my mother’s words) when we achieved something and “so embarrassed” when we screwed up. My Mom would feel ashamed if one of us sneezed in church. Otherwise, when the honor roll came out she was all for taking compliments from other parents and being told “what a great mother she is”.

I beg to differ. My problems with depression, anxiety, and BPD could have been addressed much earlier in life when they initially surfaced in grammar school. But my parents refused to realize they were doing anything wrong, and that their children might need counseling to be happy, well situated adults.

What has resulted?

Years of torment, self abuse, uncontrollable rage, bad relationships, emptiness, acting out, suicidal gestures, gambling and substance abuse problems, depression…the list goes on.

Guess what, it IS my problem to deal with, but I’m NOT the one purely at fault.

In fact, one of the more reasonable doctors on Dr. Drew’s show – amid the screaming match – suggested that Arias had displayed suicidality earlier in her life that was obviously ignored by those around her. Why wasn’t Arias committed for treatment? Why didn’t someone suggest a support group? Why didn’t her family coax her into the office of a good therapist?

Who abused her? Why aren’t they locked up? Many females with BPD have histories of being sexually abused, many times by people within their own families. Why did that problem go unchecked? Why does everyone get to wash their hands in the name of “that’s history” and expect Arias to be a model citizen?

Dr. Drew and his colleagues know better (at least I hope). During Britney Spears’ troubles a few years back, he famously said “Her only way out is suicide”, in the context of what might happen if she didn’t get help. That is perhaps the most disgusting thing a doctor can say on TV about anyone. Now he’s ready to pull the switch on Arias without having the least bit of scientific (or human, for that matter) curiosity about why she ended up such a train wreck.

Here’s my advice for TV doctors, who obviously work on TV because they are ineffective clinicians: before you speak, think first as a human, then as a doctor, and after that as an outraged citizen. More importantly, don’t bullsh*t for an hour on TV yelling back and forth with wholly unqualified guests who are only interested in promoting their latest book. You might actually give people hope if you’re positive.