<P> Borderline personality disorder (BPD) has long been believed to be the one psychiatric disorder that produced the most intense emotional pain, agony, and distress in those who suffer with this condition . Studies have shown that borderline patients experience chronic and significant emotional suffering and mental agony . Borderline patients may feel overwhelmed by negative emotions, experiencing intense grief instead of sadness, shame and humiliation instead of mild embarrassment, rage instead of annoyance and panic instead of nervousness . People with BPD are especially sensitive to feelings of rejection, isolation and perceived failure . Both clinicians and laymen alike have witnessed the desperate attempts to escape these subjective inner experiences of these patients . Borderline patients are severely impulsive and their attempts to alleviate the agony are often very destructive or self - destructive . Suicidal ideation, suicide attempts, eating disorders (anorexia nervosa and bulimia nervosa), self - harm (cutting, overdosing, etc .), compulsive spending, gambling, sex addiction, violent and aggressive behaviour, sexual promiscuity and deviant sexual behaviours, or desperate attempts to escape through hard drugs . The intrapsychic pain experienced by those diagnosed with BPD has been studied and compared to normal healthy controls and to others suffering from major depression, bipolar disorder, substance use disorder, schizophrenia, other personality disorders, and a range of other conditions . The excruciatingly painful inner experience of the borderline patient is both unique and perplexing . In clinical populations, the rate of suicide of patients with borderline personality disorder is estimated to be 10%, a rate far greater than that in the general population and still considerably greater than for patients with schizophrenia and bipolar disorder . However, since 60--70% of patients with borderline personality disorder make suicide attempts, unsuccessful suicide attempts are far more frequent than completed suicides in patients with borderline personality disorder . </P> <P> The intense dysphoric states which patients diagnosed with borderline personality disorder (BPD) endure on a regular basis distinguishes them from those suffering from other personality disorders, major depressive disorder, bipolar disorder, and virtually all known Axis I and Axis II conditions . In a study, twenty - five dysphoric states (mostly affects) were found to be significantly more common among borderline patients than controls . Twenty - five other dysphoric states (mostly cognitions) were found to be both significantly more common among borderline patients than controls and highly specific to borderline personality disorder . These states tended to fall into one of four clusters: (1) extreme feelings, (2) destructiveness or self - destructiveness, (3) fragmentation or "identitylessness", and (4) victimization . In addition, three of the 25 more - specific states (feeling betrayed, like hurting myself, and completely out of control), when occurring together, were particularly strongly associated with the borderline diagnosis . Equally important, overall mean Dysphoric Affect Scale scores correctly distinguished borderline personality disorder from other personality disorders and mood disorders such as bipolar disorder, major depression, and anxiety disorders in 84% of the subjects . Taken together, the results of this study suggest that the subjective pain of borderline patients may be both more pervasive and more multifaceted than previously recognized, and that the overall "amplitude" (or intensity) of this pain may be a particularly good marker for the borderline diagnosis . </P> <P> Research suggests that physical pain and psychological pain may share some underlying neurological mechanisms . Brain regions that were consistently found to be implicated in both types of pain are the anterior cingulate cortex and prefrontal cortex (some subregions more than others), and may extend to other regions as well . Brain regions that were also found to be involved in psychological pain include the insular cortex, posterior cingulate cortex, thalamus, parahippocampal gyrus, basal ganglia, and cerebellum . Some advocate that, because similar brain regions are involved in both physical pain and psychological pain, we should see pain as a continuum that ranges from purely physical to purely psychological . Moreover, many sources mention the fact that we use metaphors of physical pain to refer to psychological pain experiences . </P> <P> Research has shown that use of analgesic paracetamol for several weeks reduces neural response to meaning threats, such as thinking about death, and reduces the agitation of people with dementia . However use of paracetamol for more general psychological pain remains disputed . </P>

What does it mean to be emotionally hurt