So Bob, as a part of spring cleaning, I thought we would actually really try this time for serious and answer all the emails that we've had for a long time.

I've been cataloging these emails about borderline personality disorder. Oh, yeah.

So let's get to it. What do you say? Sure. So this first email is from patron Susie from Dayton, Ohio. She says,

Hi, Dr. Honda. I thought this Reddit thread asking for an explain like I'm so just chiming in here. Do you know Reddit at all? Do you look at Reddit?

Not I think I've looked at it twice. So there's one subreddit, which is like its own forum, if you will. That is called explain like I'm five or EL,

ELI five. And it's a great subreddit because people ask questions like explain general relativity. So someone who knows their stuff will explain it as if they're explaining it to a five year old.

That's awesome. So there was someone that did an ELI five explain like I'm five about borderline. So I thought we would read some people summaries. What is that?

Oh, this will be interesting. So this person unit zero on says, you know how sometimes you feel happy or sad. And other times you feel really happy or very sad.

You know, really happy or very sad. That's what it's like all the time. So just chiming in here. What do you think about that?

They're saying that folks with borderline personality disorder have a big range of affect.

Right. Does that feel accurate to you so far? I mean, yeah, I don't think I would ever describe BPD that way.

It's sort of like, oh, I'm happy as opposed to well, there's a reason, a trigger that makes that off. Usually not happy.

Right. I feel like this is one of the things that is focused on. It's focused on in the DSM, by the way.

Yeah. But we all understand that DSM is not your pathway to understanding many personality disorder.

It is a list of behavioral indications that a clinician can reliably use as a way of zeroing in on a diagnosis.

It's not a way to understand what's happening. And this highlighted notion of being really happy and really sad is what causes people to confuse borderline with bipolar.

Right. And also, even for bipolar, it's not just being really happy and really sad unless you also really emphasize the fact that when people are manic, it's a particular kind of thing.

It's funny. People miss that. I'll just spend five minutes with somebody who's actually in a manic state to understand that's what that is.

Yeah. And if you've never seen Mania or heard about it at length, you probably don't really understand it because it's really quite particular going on.

Their brain makes it, so they only have big feelings. That means that they don't often get to have the in between feelings that you and I have.

And sometimes can go from feeling okay to having really big feelings. This is getting worse as it's going. It feels fast to us, but it's normal for them.

It can be really hard work to have big feelings all the time like they do. And that's part of why they're so tired all the time.

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