By JEFFREY COLLINS, Associated Press Writer Jeffrey Collins, Associated Press Writer – Thu Nov 19, 6:51 pm ET

COLUMBIA, S.C. – When an ambulance brought Daniel Webb home from the hospital after he hurt his knee in March, paramedics warned the then 550-pound man he probably wouldn't be able to get up from his recliner if they put him there, his wife said.

Webb told them to leave him there anyway. He would sit in that recliner, slowly dying, for the next eight months. Finally, paramedics were called back to his Greenwood home on Wednesday because he was in a lot of pain.

Webb's body was physically stuck to the power recliner and firefighters had to cut him from the chair to take him to the hospital. He died a few hours later, his body covered with sores and a "very bad odor," according to a police report.

Webb, 33, didn't ask for help for all those months, because he was ashamed and didn't have health insurance, said his wife, Ada. He slept and used the bathroom in his chair and she cleaned it every day. The former preacher would post sermons online from the chair, and it wasn't long before he decided he was ready to go home to the Lord, she said.

"After he sat there in that one spot for a week, he was embarrassed. It was like he already knew what was going to happen," Ada Webb said.

Webb's mother was the one who placed the final call to paramedics. Not only did crews have to cut apart the chair, but they had to cut a hole in the wall of the couple's mobile home about 70 miles west of Columbia to get him out. A police report said he weighed about 800 pounds, but his wife said he was closer to 500 pounds.

The hospital told Daniel Webb's wife he died from a heart attack, she said. The coroner's office isn't investigating the death and referred all questions to Greenwood County deputies, who sent their report, but didn't respond to a phone message.

Webb died on the couple's second anniversary. They met four years ago on MySpace, and Ada Webb said she didn't see a man who weighed more than 500 pounds, but instead saw a guy who loved the Lord and had a big heart.

"I had the worst anniversary yesterday I ever had, but I know he had the best one he ever had because he's with Jesus now," she said.

Daniel Webb drove school buses for nearly 15 years, until his weight made it impossible. His health kept getting worse, and Ada Webb said she begged hospital officials to keep him after doctors treated his knee injury in March. But the couple had no way to pay and were sent home.

For his first few weeks home, Daniel Webb was open to the idea of seeing someone. Getting to them was the problem.

"Everybody kept telling us, if you get here, we'll help you. We didn't have no way of getting him up, and nobody was willing to come help us," Ada Webb said. "He just kind of said, 'it's in God's hands' at that point."

Daniel Webb spent the rest of his days playing with his four dogs and talking about religion to other people on the Internet.

"I did all I could for him. He loved me with a passion," his wife said. "The only reason he held on to life here was for his family because he wanted to go home and be with the Lord."


This is sick...

Borderline personality disorder
From Wikipedia, the free encyclopedia


Borderline personality disorder (BPD) is a personality disorder described as a prolonged disturbance of personality function characterized by depth and variability of moods.^[1] The disorder typically involves unusual levels of instability in mood; "black and white" thinking, or splitting; chaotic and unstable interpersonal relationships, self-image, identity, and behavior; as well as a disturbance in the individual's sense of self. In extreme cases, this disturbance in the sense of self can lead to periods of dissociation.^[2] These disturbances can have a pervasive negative impact on many or all of the psychosocial facets of life. This includes difficulties maintaining relationships in work, home and social settings. Attempted suicide and completed suicide are possible outcomes, especially without proper care and effective therapy.^[3]
Because the term no longer reflects current thinking, there is an ongoing debate concerning whether this disorder should be renamed.^[4] There is related concern that the diagnosis stigmatizes people, usually women, and supports pejorative and discriminatory practices.^[5]

History

Since the earliest record of medical history, the coexistence of intense, divergent moods within an individual has been recognized by such writers as Homer, Hippocrates and Aretaeus, the last describing the vacillating presence of impulsive anger, melancholia and mania within a single person. After medieval suppression of the concept, it was revived by Bonet in 1684, who, using the term folie maniaco-mélancolique, noted the erratic and unstable moods with periodic highs and lows that rarely followed a regular course. His observations were followed by those of other writers who noted the same pattern, including writers such as the American psychiatrist C. Hughes in 1884 and J.C. Rosse in 1890, who described "borderline insanity." Kraepelin, in 1921, identified an "excitable personality" that closely parallels the borderline features outlined in the current concept of borderline.^[1]
Adolf Stern wrote the first significant psychoanalytic work to use the term "borderline" in 1938, referring to a group of patients with what was thought to be a mild form of schizophrenia, on the borderline between neurosis and psychosis. For the next decade the term was in popular and colloquial use, a loosely conceived designation mostly used by theorists of the psychoanalytic and biological schools of thought^{[citation needed]}. Increasingly, theorists who focused on the operation of social forces were recognized as well. During the 1940s and 1950s a variety of other terms were also used for this group of patients, such as "ambulatory schizophrenia" (Zilboorg), "preschizophrenia" (Rapaport), "latent schizophrenia" (Federn), "pseudoneurotic schizophrenia" (Hoch and Polatin), "schizotypal disorder" (Rado), and "borderline state" (Knight).
The 1960s and 1970s saw a shift from thinking of the borderline syndrome as borderline schizophrenia to thinking of it as a borderline affective disorder (mood disorder), on the fringes of manic depression, cyclothymia and dysthymia. In DSM-II, stressing the affective components, it was called Cyclothymic personality (Affective personality).^[2] In parallel to this evolution of the term "borderline" to refer to a distinct category of disorder, psychoanalysts such as Otto Kernberg were using it to refer to a broad spectrum of issues, describing an intermediate level of personality organization^[1] between neurotic and psychotic processes.^[6]
Standardized criteria were developed^[7] to distinguish BPD from affective disorders and other Axis I disorders, and BPD became a personality disorder diagnosis in 1980 with the publication of DSM-III.^[8] The diagnosis was formulated predominantly in terms of mood and behavior, distinguished from sub-syndromal schizophrenia which was termed "Schizotypal personality disorder."^[6] The final terminology in use by the DSM today was decided by the DSM-IV Axis II Work Group of the American Psychiatric Association.^[9]

Associated features

It has been noted that there is probably no other mental disorder about which so many articles and books have been written, yet about which so little is known based on empirical research.^[10]
Studies suggest that individuals with BPD tend to experience frequent, strong and long-lasting states of aversive tension, often triggered by perceived rejection, being alone or perceived failure.^[11] Individuals with BPD may show lability (changeability) between anger and anxiety or between depression and anxiety^[12] and temperamental sensitivity to emotive stimuli.^[13]
The negative emotional states particularly associated with BPD have been grouped into four categories: extreme feelings in general; feelings of destructiveness or self-destructiveness; feelings of fragmentation or lack of identity; and feelings of victimization.^[14]
Individuals with BPD can be very sensitive to the way others treat them, reacting strongly to perceived criticism or hurtfulness. Their feelings about others often shift from positive to negative, generally after a disappointment or perceived threat of losing someone. Self-image can also change rapidly from extremely positive to extremely negative. Impulsive behaviors are common, including alcohol or drug abuse, unsafe sex, gambling and recklessness in general.^[15] Attachment studies suggest individuals with BPD, while being high in intimacy- or novelty-seeking, can be hyper-alert^[10] to signs of rejection or not being valued and tend toward insecure, avoidant or ambivalent, or fearfully preoccupied patterns in relationships.^[16] They tend to view the world generally as dangerous and malevolent, and themselves as powerless, vulnerable, unacceptable and unsure in self-identity.^[10]
Individuals with BPD are often described, including by some mental health professionals (and in the DSM-IV),^[17] as deliberately manipulative or difficult, but analyses and findings generally trace behaviors to inner pain and turmoil, powerlessness and defensive reactions, or limited coping and communication skills.^[18][19][20] There has been limited research on family members' understanding of borderline personality disorder and the extent of burden or negative emotion experienced or expressed by family members.^[21] Parents of individuals with BPD have been reported to show co-existing extremes of over-involvement and under-involvement.^[22] BPD has been linked to increased levels of chronic stress and conflict in romantic relationships, decreased satisfaction of romantic partners, abuse and unwanted pregnancy; these links may largely be general to personality disorder and subsyndromal problems,^[23] but such issues are commonly raised in support groups and published literature for partners of individuals with BPD.^{[citation needed]}
Suicidal or self-harming behavior is one of the core diagnostic criteria in DSM IV-TR, and management of and recovery from this can be complex and challenging.^[24] The suicide rate is approximately 8 to 10 percent.^[25] Self-injury attempts are highly common among patients and may or may not be carried out with suicidal intent.^[26][27] BPD is often characterized by multiple low-lethality suicide attempts triggered by seemingly minor incidents, and less commonly by high-lethality attempts that are attributed to impulsiveness or comorbid major depression, with interpersonal stressors appearing to be particularly common triggers.^[28] Ongoing family interactions and associated vulnerabilities can lead to self-destructive behavior.^[22] Stressful life events related to sexual abuse have been found to be a particular trigger for suicide attempts by adolescents with a BPD diagnosis.^[29]

Diagnosis

Diagnosis is based on a clinical assessment by a qualified mental health professional. The assessment incorporates the patient's self-reported experiences as well as the clinician's observations. The resulting profile may be supported or corroborated by long-term patterns of behavior as reported by family members, friends or co-workers. The list of criteria that must be met for diagnosis is outlined in the DSM-IV-TR.^[2]

Borderline personality disorder was once classified as a subset of schizophrenia (describing patients with borderline schizophrenic tendencies). Today BPD is considered a relatively stable personality disorder and is used more generally to describe non-psychotic individuals who display emotional dysregulation, splitting and an unstable self-image. Individuals with BPD are at high risk of developing other psychological disorders such as anxiety and depression. Other symptoms of BPD, such as dissociation, are frequently linked to severely traumatic childhood experiences, which some put forth as one of the many root causes of the borderline personality. BPD has many similar characteristics to emotionally unstable personality disorder, subtype borderline; and complex post-traumatic stress disorder.

Diagnostic criteria (DSM-IV-TR = 301.83)

The Diagnostic and Statistical Manual of Mental Disorders fourth edition, DSM IV-TR, a widely used manual for diagnosing mental disorders, defines borderline personality disorder (in Axis II Cluster B) as:^[2][17]

A pervasive pattern of instability of interpersonal relationships, self-image and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-injuring behavior covered in Criterion 5
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sex, eating disorders, binge eating, substance abuse, reckless driving). Note: Do not include suicidal or self-injuring behavior covered in Criterion 5
5. Recurrent suicidal behavior, gestures, threats or self-injuring behavior such as cutting, interfering with the healing of scars (excoriation) or picking at oneself.
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days).
7. Chronic feelings of emptiness
8. Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation, delusions or severe dissociative symptoms

It is a requirement of DSM-IV that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.

Diagnostic criteria (ICD-10) - emotionally unstable personality disorder

The World Health Organization's ICD-10 defines a conceptually similar disorder to borderline personality disorder called (F60.3) Emotionally unstable personality disorder. It has two subtypes described below.^[32]

[edit] F60.30 Impulsive type

At least three of the following must be present, one of which must be (2):

1. marked tendency to act unexpectedly and without consideration of the consequences;
2. marked tendency to quarrelsome behaviour and to conflicts with others, especially when impulsive acts are thwarted or criticized;
3. liability to outbursts of anger or violence, with inability to control the resulting behavioural explosions;
4. difficulty in maintaining any course of action that offers no immediate reward;
5. unstable and capricious mood.

It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.

[edit] F60.31 Borderline type

At least three of the symptoms mentioned in F60.30 Impulsive type must be present [see above], with at least two of the following in addition:

1. disturbances in and uncertainty about self-image, aims, and internal preferences (including sexual);
2. liability to become involved in intense and unstable relationships, often leading to emotional crisis;
3. excessive efforts to avoid abandonment;
4. recurrent threats or acts of self-harm;
5. chronic feelings of emptiness.

It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.

Diagnostic criteria (CCMD)

The Chinese Society of Psychiatry's CCMD has a comparable diagnosis of Impulsive Personality Disorder (IPD). A patient diagnosed as having IPD must display "affective outbursts" and "marked impulsive behavior," plus at least three out of eight other symptoms. The construct has been described as a hybrid of the impulsive and borderline subtypes of the ICD-10's Emotionally Unstable Personality Disorder, and also incorporates six of the nine DSM BPD criteria.

Causes (etiology)

As with other mental disorders, the causes of BPD are complex and unknown.^[4] One finding is a history of childhood trauma, abuse or neglect,^[52] although researchers have suggested diverse possible causes, such as a genetic predisposition, neurobiological factors, environmental factors, or brain abnormalities.^[4]
At least one researcher believes BPD results from a combination that can involve a traumatic childhood, a vulnerable temperament and stressful maturational events during adolescence or adulthood.^[53]

Childhood abuse, neglect or separation

Numerous studies have shown a strong correlation between child abuse, especially child sexual abuse, and development of BPD. Many individuals with BPD report have had a history of abuse and neglect as young children.^[58] Patients with BPD have been found to be significantly more likely to report having been verbally, emotionally, physically or sexually abused by caregivers of either gender. There has also been a high incidence of incest and loss of caregivers in early childhood for people with Borderline Personality Disorder. They were also much more likely to report having caregivers (of both genders) deny the validity of their thoughts and feelings. They were also reported to have failed to provide needed protection, and neglected their child's physical care. Parents (of both sexes) were typically reported to have withdrawn from the child emotionally, and to have treated the child inconsistently. Additionally, women with BPD who reported a previous history of neglect by a female caregiver and abuse by a male caregiver were consequently at significantly higher risk for being sexually abused by a noncaregiver (not a parent). It has been suggested that children who experience chronic early maltreatment and attachment difficulties may go on to develop borderline personality disorder.

- Pisces -


Overview

Romantic Pisces, you are the twelfth and last sign of the zodiac. You are regarded as the sign of sensitivity and receptivity, and are a true chameleon by being mutable and infinitely complex. Your keywords are communion and vision, and you have the capacity to go beyond this world to the one of dreams and the spirit.


Ruling Planet

Your ruler Neptune, the planet of confusion and chaos, gets people out of habits that imprison them so that they question themselves and can discover another path toward growth and spirituality. Neptune is also the planet of imagination and illusion, and governs the dream world with all its many facets.


Element

Pisces is the third of the three water signs, which means that you are concerned with the realm of emotion and feeling. You deal with sensitivity, intuition, and deeper psychic aspects of life. You are able to conduct unconscious telepathic communication with others.


House

Your sign rules the twelfth house of the chart, the sector associated with the unconscious, need for seclusion, and places of restriction. This house describes the wellspring of your being, including psychological problems that you repress. This house is very healing and can promote personal and spiritual growth, once you make the effort to go deeper and face YOUR reality.


Mode

Pisces is a mutable sign. You adapt to the exigencies of life and ingeniously melt into circumstances like a chameleon. In your interaction with others, you are personable and compassionate, and successfully connect on a deep emotional level.


Strengths

Your strengths, dear Pisces, lie in your altruistic and empathetic nature, because you feel the urge to help people less fortunate than you. Your sensitivity and intuition make you a true healer. Your strong imagination and highly evolved creativity predispose you to artistic expression.


Weaknesses

Your main weaknesses are that you can be weak-willed, passive, and indecisive. Many times, you prefer to escape reality and indulge in your dreamworld. Chaos and confusion can be present in you, which may frustrate your circle of friends. At the same time, you can be oversensitive and fragile, feeling victimized by others.