Borderline personality disorder 

Introduction 

Mental and emotional health: talking therapies

Learn about different talking therapies that can help people overcome a range of problems, from depression to stress. Tip: check with your GP whether there are any IAPT services (Improving Access to Psychological Treatment) in your area.

Media last reviewed: 11/07/2013

Next review due: 11/07/2015

Associated mental health problems

Many people with borderline personality disorder also have another mental health or behavioural condition such as:

Personality disorders are conditions that can cause a range of distressing symptoms and patterns of abnormal behaviour.

This could include:

  • overwhelming feelings of distress, anxiety, worthlessness or anger
  • difficulty managing such feelings without self-harming, for example by abusing drugs and alcohol or taking overdoses
  • difficulty maintaining stable and close relationships
  • sometimes, periods of loss of contact with reality
  • in some cases, threats of harm to others

Read more about the symptoms of borderline personality disorder.

Personality disorders typically emerge in adolescence and persist into adulthood. They may be associated with genetic and family factors, and experiences of distress or fear during childhood, such as neglect or abuse, are common. Personality disorders range from mild to severe.

What is borderline personality disorder (BPD)?

It used to be thought people with borderline personality disorder (BPD) were at the ‘border’ between:

  • neurosis, where a person is mentally distressed but can still tell the difference between their perception and reality
  • psychosis, where a person is unable to tell the difference between their perception and reality, and may experience delusions and hallucinations

Now it is known this is not an accurate description. BPD is best understood as a disorder of mood and interpersonal function (how a person interacts with others).

BPD is a common personality disorder seen by healthcare professionals. Although BPD is said to be more common in women, this is probably because it is recognised less frequently in men, who may be less likely to seek treatment.

Read more about how borderline personality disorder is diagnosed.

How does BPD develop?

The causes of BPD are unclear. However, as with most conditions, BPD appears to be the result of a combination of genetic and environmental factors.

Traumatic events that occur during childhood are associated with developing BPD. An estimated eight out of 10 people with BPD experience parental neglect or physical, sexual or emotional abuse during their childhood.

Read more about the causes of borderline personality disorder.

Outlook

BPD can be a serious condition and many people with the condition self-harm and attempt suicide. It is estimated that 60-70% of people with BPD will attempt suicide at some point in their life.

However, for many with BPD, the outlook is reasonably good over time, and psychological or medical treatment may help.

Treatment may involve a range of individual and group psychological therapies (psychotherapy) carried out by trained professionals working with a community mental health team (CMHT). Effective treatment may last more than one year.

Read more about treatments for borderline personality disorder.

Recent studies have suggested the majority of those with borderline personality disorder do well over time, with most experiencing sustained relief from symptoms, and around half being completely free of symptoms and able to function well in life.

Additional treatment is recommended for people whose symptoms return.




Page last reviewed: 02/08/2012

Next review due: 02/08/2014

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Comments

The 26 comments posted are personal views. Any information they give has not been checked and may not be accurate.

mumma D said on 24 September 2014

hi recently been diagnosed with personality disorder very scared my whole life fallen apart also suffer with clinical depression and im also physically disabled can i get better mentally with the right help ?

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j_titania said on 18 September 2014

It's very upsetting to hear that so many of you have had poor experiences with your local health service. I have studied psychology for over four years now and i also have experience in working with people with mental health issues.

I see that some people here are struggling for support so i'd just like to give some suggestions and ideas that might help some of you who feel so let down.

Firstly, if you are really worried about your behaviours and scared for your own safety or of others there is help available. Many secure hospitals will take self referrals and your local crisis team wil be able to visit you at home >>
http://www.rethink.org/about-us/our-mental-health-advice/crisis-contacts

I have had personal experience of using the crisis team for a close family member and although the service was not incredibly quick it was very helpful and we were able to develop a crisis plan and the next stages for the sufferer. We were given lots of advice and reassurance.

Some of the treatments for BPD are relatively recent advances which is also why you may not have been offered it previously - do check again.

Anyone in crisis who wants help can get it, unfortunately there are a large sample of people who suffer from mental health issues and sometimes help can be slow (but this is the same for many other health issues too!).

I'd urge you to research charities and organisations such as MIND or steps to wellbeing. If you cannot get direct help through your GP there are other routes to treatment.

If anyone believes they are sufferers of BPD please contact somebody, there are many who want to help even if you don't feel worthy of help yourself. The presence of a personality disorder is not your fault and you should never feel ashamed.

I hope this is helpful, even for just one of you.

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ellenor_09 said on 29 July 2014

I am a hypochondriac so I am not sure if this is just a phase but my parents have started to noticing my fear of abandonment. I have always had this fear but it has been getting more destructive.
My moods seem to change frequently but the most worrying thing for me is my uncontrollable anger. It comes out of nowhere and lasts for about three seconds. I have usually shouted at someone or punched someone in the face. After my outburst of anger I get a buzzing feeling in my head and more recently the thought that everyone's going to try and kill me.
I am worried in case my family leave me or I end up stabbing someone next time I have an outburst.

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Clinton1986 said on 19 July 2014

Hello everyone. I'm clinton and I am 28. I have not yet been diagnosed with any condition but I have come across BPD and I am certain that this is what I have. I am really reaching out for support.

General symtomps:

*Constant feelings of insecurity, loneliness and emptiness: i feel disconnected from my family and loved ones. I feel out of touch with my environment.

*Identity confusion: Dont know who I am or what i want. I mimic the behaviours of others and base my actions and beliefs around their opinions and experiences.

*Unable to determine what is reality/fantasy: I have a distorted view of reality but only notice this after a negative experience that has surprised me. I don't see things for what they are but rather for what I wan't them to be which is often not the case.

*Mental confusion: I spend most of my time trapped in negative thinking patterns. I am usually only present to the point where i can get the essential things done in my life. There is no room for organization, planning or progress. This affects my work and keeps me in a futile and stagnant frame of mind.

*Unstable relationships: I have been in relationships constantly since the age of 16. I can't trust or love freely. I feel like i am going to be abandoned or let down and I always feel that there is something "that I am supposed to feel" to validate the relationship. If I don't have the re-assurance I need on a constant basis, I feel that the relationship is bad and I feel empty and alone. I either want contant hugs or to be left alone. I can't sit in a room and share a silence with a partner and I can't connect with my emotions towars them.

*Distorted perceptions: I think I know what people are thinking and base my beliefs on that alone. I play devil's advocate constantly and believe in my thoughts which are often wrong and distorted

*Stress: The smallest things drive me mad and cause me extreme anxiety which leads to depression

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madgirl1991 said on 10 July 2014

I, myself, have no time or respect for people who diagnose over the internet, but also I was not brave enough to walk in at my NHS office and just tell somebody. Instead I have been googling the way I feel for months, reading articles, sufferers’ accounts, self-help sites until things clicked. I might be emotionally unstable or have BPD. I need somebody to speak to me, help me, tell me if I am wrong and what to do to have a life…
• Instability in relationships:
I have 3 broken relationship due to arguments, neediness, and clinginess caused by fear of abandonment and its impending related emotional crisis and also the idea I am always underappreciated and unloved. No reassurance is enough. Even small things trigger extreme jealousy. Everything is a threat to be abandoned- including the fact my ex liked black interiors and didn’t want his children to speak my mother tongue. There is little I want more than being loved… forever. I am as clingy, manipulative and pathetic as they get and would do anything to prolong the relationship no matter what its state is. I have a limited relationship with my parents, who are otherwise loving and relatively caring- I feel mostly ashamed by them and sometimes even angry. I suspect people dislike me. I tend to have conflicts with boyfriends mostly over silly things.
• Self image:
I have no real interests, there are very few hobbies I stick with. Not even music. I enjoy life alone without a boyfriend to an extent, but not constantly. I would sometimes adopt the interests of my boyfriends and sometimes even close friends. I like books and movies only… I adore animals. I have aspirations, though, yet uncertain. I do get good marks at university, doing an engineering degree, but I am currently finding it hard to cope with my internship while my relationship is falling apart as my boyfriend is graduating, moving away and leaving me (he says he could not imagine living with the drama forever).

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Anomalies said on 10 June 2014

I too was disappointed by the services of the NHS. I know use a private psychiatrist funded by Bupa insurance and finally got my diagnosis I had been searching for. I was told my primary problem is drug and alcohol abuse which was just not true at all. The drug and alcohol abuse was self-medicating. Maybe the problem was I only saw a very blunt mental health nurse and a Junior psychiatrist who I add was very nice but couldn't seem to ascertain the root of my problem. It was making me worse being told booze and drugs were my only problem... If only.

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BlackMamba said on 09 April 2014

In 2012 I was given a diagnosis of having BPD traits without having the full blown condition by a mental health professional, although another via the same service told me she didn't agree. I think it probably is accurate to a certain degree though.

Still, I already tried the route of being referred to my local mental health services via my GP, and ultimately the standard of care wasn't all that good. With my local IAPT service, they couldn't offer me long term therapy sessions because of government financial cuts. Although they referred me to a local similar service who works alongside them, it ended up the mental health professionals involved in my care treated me badly and as a result I had to leave the therapy I was partaking in and needed to lodge a formal complaint. Not altogether surprisingly, the professionals involved started to bully me just as I was lodging the complaint, and this continued while I followed the patient complaints procedure and I've now had to get my MP and the Parliamentary Health Service Ombudsman involved. Although right now they are refusing to allocate me elsewhere within the NHS for further mental health treatment, and I'm currently fighting to get it, I'm actually wondering if at this stage I'd just be better off changing my mind and forgetting it. I've lost a lot of good faith and trust in my local NHS mental health services by this point, and I think there's most likely a lot of abuse and bullying that goes on with staff and patients alike. I don't trust them anymore, and for good reason. I'd rather have no therapy treatment at all than bad therapy treatment. I get the idea this sort of thing goes on a lot within social services too. It's seriously not right!

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Misfit2014 said on 03 April 2014

I have been diagnosed with Borderline Personality Disorder. I struggle daily with inter personal skills and relationships. I get on with everybody but then i shut myself away and tell everyone that they don't care. I flit from different moods throughout the day. I have no-one steady in my life. My head feels like its full of traffic. Im indecisive but have no imagination to think. I'm awful with money. Very Impulsive and destructive. I have held down a job for years, however, I am finding it more difficult now to concentrate and do my best at my job as I cannot hold back the tears. I would like physcotherapy but I do not know how to go about it. My life is upside down right now. My mum gives me positive criticism how to change my life but I just freak out and blame her for everything, infact I just blame everybody else except myself. I think of suicidal thoughts everyday. I cannot cope with my emotions. I'm either really high but wear myself out quickly or really low which makes me drained as i'm erratic. I have gone through 4 mobile phones in the past 2 months as I've threw them, I smashed my own car windscreen. I go through gambling addictions frequently. I constantly flit in and out of relationships. Nobody understands what I go through. Just call me a physco and very unsupportive. Please help me!!!!

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vthrelkeld said on 12 March 2014

It is really sad to read some of the comments on here where people have had negative experiences with NHS services.

I have Emotionally Unstable Personality Disorder, Depression and Anxiety and have received positive support from NHS services. I am currently on Home Treatment / Crisis Team receiving treatment and also awaiting DBT therapy following several weeks of assessments for it. When not in a crisis, I am seen by the Community Mental Health Team and am on a CPA plan with a care co-ordinator. I also take Quetiapine, Mirtazapine and Venlafaxine daily if that is of any help to anyone to know.

While some people have different views about BPD, things are changing. I have received some negative comments from professionals as described in the comments below, but I just continue to educate myself about the condition and challenge people (when I have the energy too, that is) in order to help bring about the change that is needed surrounding this horrible disorder.

Generally I think that the Mental Health Services in the UK are helpful and supportive, and they treat people symptomatically and according to risk. Obviously this won't always be the case as some people have described. Although at any time BPD is awful to suffer with, I find that treatment is limited and given as required eg. if someone is suicidal, experiencing psychotic symptoms. But overall BPD is something that we ultimately have to learn to live with through therapy and by the help of medications etc when needed.

Hope this helps someone.

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NELLY2014 said on 04 March 2014

This illness is one of the most degrading I can think of.
Why? Because at least with other illnesses people have compassion for you. This one, people think/say: 'he/she is made, keep away from him/her'.
Having say that, I will never medicate myself or get medicated for this, when I was being traumatized and beaten up, the damage was done without medication so to try and correct the damage with medication is a 'placebo' which might give temporary distraction from all the emotional and physical pain.

Re-programing my mind and what beliefs and thoughts were sowed in my sub-conscious is the only cure worthwhile for a long-term-permanent freedom from this awful illness.

I have pitched my tent in the land of hope and there is no way I will spend the next 5 years with this illness, I work day and night to make sure this happens and what I sow, I'll reap! I'll beat this illness not the other way around! I see it, I believe it, I feel it and I live it!

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chaos1980 said on 27 February 2014

I was recently diagnosed with BPD, I am on Setraline, Epilim chrono 800 mg, Trazodone, Quetiapine etc ..... I've basically been told that no amount of pills will help, talking won't help either will admission.... I've been very delusional and swinging from very high highs to severe lows. Getting very stuck and focussed on my delusional thoughts... I've been told it isn't going to go away, I have to learn to live with the horrible symptoms. I've been trying visualisation, mindfulness etc.... I was wondering what works for others? Thanks x

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OptimusPrimo said on 21 January 2014

About a year and a half ago I was admitted to an acute mental health ward, then the care commission rolled in, and all the psychs there got the sack. I was told I probably have bdp but as there were no psychs I would receive no treatment or diagnosis (my treatment for ptsd also halted after 2 sessions to due no one qualified for psychotherapy.)
I was given some sertraline and asked to leave, with the promise I would be contacted and outpatient treatments and support would be offered.
I'm still waiting for that phonecall.

Like most I get by using drugs and drink and I survive, but seriously, surely the NHS could at least try and help us instead of simply giving us some pills and sending us on our way?

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Kcleo14 said on 05 January 2014

All I see in comments is people being ignored and left to rot inside their own heads. Personally I don't want help. I don't want medication I don't want groups I don't feel worthy to have help off anybody, not even family. So I know I'll never get any better. Because you professionals can know everything but if someone doesn't want to be helped, you're wasting your time. Ill be like this the rest of my life. I've been put on anti depressants, mood stabilisers. I admitted myself to hospital to get away from hurting people but if anything I'm getting worse. I've accepted this is me and I won't ever live a fulfilled life all I focus on is keeping myself away from others. I see some sense in what baileysupport says. You can't help me. I don't want it, so you can't.

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WOF42 said on 29 November 2013

Jayne76 I am undiagnosed as I am afraid of exactly the things you describe, I am a student in plymouth could you possibly tell me a little bit about this support group?
hopefully you will see this, if not it was still worth trying.

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Jayne76 said on 28 November 2013

I was diagnosed with Bpd 2 years ago and basically I've been given anti psychotics and anti depressants and sent on my way. I feel completely alone and my symptoms are becoming unmanageable but i think what's the point in going to my g.p as all I'm ever given is an increase of medication!! Someone on an Internet forum suggested a Bpd support group here in plymouth so I went along to it and finally met other's who also suffer with this disorder.
It was such a relief to finally realise I'm not the only one. Although I'm grateful for this support i was shocked to find that the group is run by other Bpd sufferer's and not mental health professionals.
What I learned at this group is some people have cpn's and psychiatrist's but other's like myself are left to struggle on alone!
I would like to know why this is and how I can get more help through pct and/or nhs. Can someone please explain to me how/ why some of us are left unsupported, afraid and alone?

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Jonnib said on 11 November 2013

Reply to baileysupport said on 18 September 2013

I am not entirely sure what you are trying to say but as a health worker I think you're comments have a discriminatory edge to them. Mental health services have come along way from the dark attitudes of "BPD is not a mental illness" or "He's just wasting our time, he cannot be cured" although these attitudes still exist, things are beginning to change. I would argue that baileysupport harbours these negative attitudes towards BPD, I quote "sometimes despite how hard we can try, sometimes we can't help that person because they leave you no more avenues to explore!" with an exclamation mark as well (Disgraceful !!!!). You as a health worker have a lot to learn about this condition and I would advise you to read and learn about the latest interventions and support available to this client group. PD's should treated with sensitivity and dignity. Mindfulness guided discovery(Person centred care) and patients are required for this issue, staff are not aware of their roles in transference (freud) where the attitudes of the client transfer onto the staff and vice versa creating a cycle of negative and sabotaging behaviours. The group require specialist staff to work with their emotions, however, we who support them day to day should at least understand more, and empathise with what must be an incredibly "in your words" frustrating issue. Rant over.

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I am not broken said on 07 November 2013

I was diagnosed with bpd a few years back. It was a pretty horrendous and thrilling time all rolled into a messy party I called life. Eventually I reached breaking point and my life changed, for the better depending on my mood and level of impulsivity.
I only have one piece of advice and that is that medication will not solve things, yeah it will take the edge off if you are suffering from depression but the issue is personality and not hormones. You have to change the way you think in order to manage this disorder. Trust me I was the last person to ever advocate therapy, I mean how the hell would talking to a stanger help? A great deal actually. I was as shocked as anyone!
Am I cured? Well I guess that's a matter of opinion.
Am I stable? For the most part, yes.
Can I control my mood swings? Not so much but I am able to talk myself down from the ledge so to speak. I know that I might feel a rage so fiercr the only way to relieve it is to press self distruct, I know now that I just have to wait it out because for all I know I'll be fine in two minutes.

Learn how to manage your thoughts abd emotions and things will get easier.

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baileysupport said on 18 September 2013

Hi all, I am a mental health support worker and my sister is a mental health nurse! Plus, I've had my own share of mental health issues and my sister! First of all, I don't want to upset anyone on here but I probably will and I would like to state this isn't intentional and these are only my own personal/professional views! Bpd I appreciate is an awful thing to live with constantly and I know many people in thus situation. I know 1 person who constantly wants different medications such as anti-psychotics, mood stabilisers etc which would be of no use to this person but they will not listen to the fact the reason they have this is dye to the past they have experienced! A lot of people are under the impression you are born this way, that its ingrained, genes etc....not denying hereditary factors plat a part in some cases but its more often than not an experience or collection of abuse, in many forms, bad experiences of certain things that cause a person's personality to change! It's not something someone can just give themselves or cause of course, but the problem is there isn't a medication for personality disorder! There are medications people can use for symptoms relating to it and certinatly if they are experiencing any hallucinations etc but that's it! It's more of a work in progress which is frustrating I understand that and can empathise, but sometimes despite how hard we can try, sometimes we can't help that person because they leave you no more avenues to explore! I know someone who's tried every medication under the sun, apparently never sleeps which would kill you obviously if you literally never ever slept, doesn't eat anything at all and is obese, won't talk because they say what's the point, won't see family. It's very sad and can be a very difficult life for some, others manage quite well. Please don't tar us all with the same brush, some of us are good at our jobs and I wouldn't dream of approaching you as I would the person I know because you're you!

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isthereanybodyoutthere said on 05 September 2013

I am 42 years old & have suffered with mental illness since childhood, every doctor i see just wanted to pump me full of anti depressants which never worked just made matters worse, plus no one understanding me etc.
I am totally alone i do not have any family i choose not to have any friends as ive always been let down badly by them, i feel like im in a prison to be fair.
Finally they have diagnosed me with BPD/ emotionally unstable basically, after reading most comments on here its looking bleak to say the least.
What i don't understand is the media have invested loads of cash educating the masses about mental health but yet there is still a lot of ignorant folk about inc professionals in the said trade?
How many more individuals have to suffer. mental health is serious as in any physical illness so please invest more cash into it and understand it more .
We all have a God given right to live a normal healthy life surely?

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mustang19 said on 30 December 2012

I've suffered depression and an eating disorder in the past and I really think I have BPD. Reading through the symptoms and causes is like reading a description of me/my life. I don't really know what to do about it. Do I go and see my GP? I'm really anxious about it.

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paulus725 said on 06 September 2012

After many years of depression, suicide attempts and spells on mental health wards. Having been pumped full of almost every anti depressant on the market, I've now been diagnosed as having Dysthmia and Borderline Personality Traits. I've been placed on yet another antidepressant (Mirtazapine) and that seems to be where the story ends. I've not had a single antidep that has ever had any effect in the slightest. Whilst the new one makes me slep thats about all. Nobody seems to be refering me towards any other treatment. Is this as far as it goes for people like me. They tell me what I've got and leave it at that?

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Itsalottery said on 23 April 2012

Monster don't feel discouraged by your new GP. It's so sad but I've learned over the years that finding a GP that has even a remote understanding of BPD or helping someone with BPD is very rare. What he/she has told you is not only very unhelpful but it's also incorrect. BPD is real and widely recognised internationally. I think that GPs can do a lot of harm when they don't manage patients with any kind of mental illness effectively and sensitively. To be fair, I've even met with psychiatrists and psychologists who are pretty awful at dealing with BPD patients. Don't despair though, I've also found a couple great GPs and psychiatrist/psychologists that really know their stuff and how to help. I'd suggest asking to move to another GP who is better equipped and more knowledgable to help you with your mental health. The wrong GP can really add to your negative feelings so it's worth asking to change.

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the monster under your bed said on 19 April 2012

I've just been to a new GP and he asked me some questions about my medical conditions as he doesn't have my notes yet. I told him I've been diagnosed with depression and borderline personality disorder and he told me that borderline personality disorder is not a psychiatric diagnosis, and that it is just a category that people get put in when they don't fit any other diagnoses. Is he right? I'm really confused.

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andynoproblem said on 16 June 2011

I've had problems for most of my life with social and general anxiety, and also depression. Been reading a little about BPD recently but find the term Complex Post Traumatic Stress more helpful - there's a lot in a name, and for some reason I find CPTSD a less threatening term than BPD. It kind of reassures that the problems are 'not my fault', but are more of a product of environment than genes. There seems to be a run of this problem in my family going back four generations. While there may be a genetic suscepitibility to fear & anger, there also seems to be a chain of trauma being passed from each generation to the next. Lots of reading to do, but interested in the response of other sufferers. I found the film 'Good Will Hunting' particularly useful in unlocking the causes of my pain. I also find gardening helps with anger/fear/pain management. Cannabis is obviously illegal and mental health professionals are not allowed to recommend it. Take care of yourselves, and try not to be too hard on your loved ones and others - it's not their fault either.

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SKF1 said on 25 May 2011

Which 2010 study?

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My feeling said on 04 May 2011

Would people in the community, Mental health be more caring and stop letting me down, putting the matters with the police, i just want to get better and start a new happy life, so dont push me away,, because thats not the answer............

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