Q. I'm 37, female (of course) and the mother of three. I have variously been diagnosed as bi-polar, dysthymic and BPD (which I consider a value judgment more than a diagnosis). I am currently not in treatment and have only been treated sporadically for the past decade or so. I'm in a stable, committed relationship with an understanding man. I am not verbally or physically abusive to anyone. I stopped self-mutilating several years ago because it bothered the children (burns)

I hold an okay job, and I'm a good parent. it took a lot of work to become that way, I might add. I manage my life around the sleep disorders and mood swings and it works, as long as I remember that the kids are the most important thing.

Unfortunately, I've held onto a couple of less desirable behaviors; picking is one of them. I have no toenails on most of my toes.

I have three questions, I'm sorry to say, all of them specific:

Considering that I was physically (but not sexually) abused and emotionally abused by my mother, that my parents divorced when I was young and that my father committed suicide when I was 9, what do you think the balance in the cause of my condition is? is it more genetic, or is it more environmental? both of my younger children have taken up the picking. my son is an anxious fellow (he's 15 now) he gets tension stomachaches, he has nightmares and episodes of sleep paralysis, as I do. he's adhd and rather severely dyslexic (or, to be more accurate, dysgraphic, as it's his writing ability that affected) despite all this he has relatively normal friends (though I keep a pretty tight leash on him) and he makes okay grades. he has realistic plans for his future.

He was never abused in any way, but he has gone through two divorces and some of my bad times - though I've been fairly stable for the past ten years. so what are the chances of him developing bpd? And, related: I was quite ill when my first child was born and unable to nurse her. but I did nurse my son and younger daughter, both of them past the age of two. (actually, I was quite surprised at how easily it came to me, and that I was good at it) I sometimes wonder if that didn't make a difference in my psychology and if anyone has ever considered it as an aspect of bpd? I truly think that my parenting abilities changed because of it, and I'm closer to the two younger children as well, though I love my oldest dearly. of course, I sort of forget her now that she's at college, unless I keep in daily contact. fortunately, that isn't too hard in these days of the internet.

My third question concerns one of my own personal coping mechanisms; music. which I hit a dead patch, when there's no way I can feel anything, or feel anything *about* anything, I often turn to music. rock, classical, Goth; anything with a strong emotional message. and it helps. I find that, through the music, I can feel things again. muted and perhaps not always positive, but I can feel when I need to. I've never seen or heard anyone else mention this; have you?

  A. Borderline disorder is biological in my estimation, and in the estimation of where the research is pointing. It is not purely biological. Just as your arm atrophies when you break a bone--one physical reaction (broken bone) causing another (muscle atrophy), BPD works the same way. You have a biological problem in the brain which in turn causes social atrophy. Just as you must do therapy to fix the atrophied muscle, you have to do therapy to fix the atrophied social adaptations. However, you must fix the biological problem before you do therapy in both cases.

Your mood problem, regardless of its name is biological. It is probably genetic, but the data at this time is not as strong as we like it to be to say this unequivocally. I do not know if your children will or will not have BPD. If they develop symptoms, they need treatment. I cannot give you any specific odds as to their chances of getting BPD. Not even an educated guess.

I do not know what to say about the music. Many folks listen to music to relax. Maybe it is a way for you to relax.