NFL Star Brandon Marshall & His Courageous Fight For Better Mental Health

Brandon MarshallCurrent NY Jets wide receiver Brandon Marshall is known as much for his headline-grabbing troubles off the field as he is for his standout play on it. If he has his way, he’s about to be famous for something else entirely.

In a press conference, Marshall told reporters that he suffers from borderline personality disorder (BPD), a mental illness marked by intense anger, impulsivity, and turbulent interpersonal relationships.

The 32-year-old wide receiver—who received his diagnosis this spring, after seeking treatment at McLean Hospital, in Belmont, Mass.—told reporters he wants to be the “face” of BPD. “My purpose moving forward is to raise awareness of this disorder—how it not only affects the patient but the families and the people in the community,” he said.

Marshall certainly has his work cut out for him. Although an estimated 2% of U.S. adults are affected by the disorder, it remains poorly understood, even among mental health professionals.

That’s partly because the symptoms of BPD can look a lot like those of other mental illnesses, such as bipolar disorder, depression, and schizophrenia. (The term “borderline,” in fact, arose because psychiatrists originally conceived of BPD as occupying the border between psychosis and neurosis, two broad categories of mental illness that aren’t as widely used today.)

BPD can be especially difficult to identify and diagnose because some of the disorder’s hallmarks—including mood swings and intense fears of abandonment—are, in less severe forms, considered to be “normal” human emotions and behavior, says Chris Cargile, MD, a psychiatrist at the Texas A&M Health Science Center College of Medicine, in Bryan.

“Most of the things we talk about in personality disorders we see in everybody,” says Dr. Cargile, who has not treated Marshall and cannot comment on the specifics of his case. “The reason we have the word ‘disorder’ is when those things become problematic. It’s when the intensity level rises to the point where you can’t hold a relationship together for more than a few hours or days, because you can’t trust anybody.”

BPD often manifests in “severe eruptions of depression,” distrust of other people that verges on paranoia, and “frantic” efforts to avoid abandonment, Dr. Cargile says.

Suicidal threats and attempts are common; the completed suicide rate in people with BPD is as high as 10%, according to a review of the disorder, published in May in the New England Journal of Medicine, that coincidentally was written by John Gunderson, MD, a psychiatrist at McLean Hospital who has spoken with Marshall about his condition.

Underlying much of this volatile behavior are an unstable self-image and a pattern of “black-and-white” thinking, Dr. Gunderson writes, which can lead to sudden, dramatic switches between feelings of “idealization” and “devaluation” regarding others.

As Patricia Junquera, MD, an assistant clinical professor of psychiatry at the University of Miami Miller School of Medicine, puts it, “It’s either all or nothing. There are no grays: ‘If you’re not going to be with me, you’re not going to be with anybody.’ They have a lot of security issues that other people might have, but deal with them differently.”

During his press conference, Marshall alluded to the fact that his illness may have played a role in some of his high-profile off-the-field problems, including, most notably, a domestic dispute in April in which Marshall’s wife, Michi Nogami-Marshall, was arrested and charged with stabbing Marshall with a kitchen knife. (Marshall defended his wife and denied press reports about the incident without providing specifics.)

BPD usually has its roots in early childhood abuse, abandonment, and neglect, and it manifests in poor coping techniques. People with BPD “just don’t know how to deal with their feelings,” says Dr. Junquera, who has not treated Marshall.

Men and women with BPD often deal with strong emotions in different ways, she adds. Men represent about one-quarter of all people with BPD, and their inability to manage their feelings sometimes manifests as violence and drug and alcohol abuse.

Women, on the other hand, tend to turn their feelings on themselves, cutting themselves repeatedly or threatening to kill themselves if they believe someone’s going to leave them, she says.

BPD can be very difficult to treat. The remission rate is extremely high, and only about 25% of people with the diagnosis manage to remain employed full-time, according to Dr. Gunderson’s review.

Unlike schizophrenia, bipolar disorder, and depression, BPD (and many other personality disorders) tend not to respond to medications, although doctors do sometimes prescribe antidepressants, atypical antipsychotic drugs, and mood stabilizers to BPD patients.

Instead, experts tend to rely on talk therapy that stresses how to cope with the feelings of abandonment and other symptoms of the disorder. “You can treat some symptoms with medications, but the way to truly improve…functioning is with psychotherapy,” Dr. Cargile says.

Marshall said he underwent both individual and group therapy at McLean, and seems optimistic about his own prognosis.

“I am not saying that I am cured,” Marshall told reporters during the press conference. “What I am saying today is that I am confident today that with the skills that I have learned and the intensity of the program that I went through that I am in a position where I can live an effective and healthy life.”

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How To Be Healthier In Tough Economy

african female patient visiting doctor(BlackDoctor.org) — You’ve probably figured out by now that times these days are a little less kind to your wallet. Many people find themselves considering scaling back on things like health insurance and prescriptions in order to better balance their budget.

But this is a mistake – no matter how tight money is, you need to take care of your health. Why? Because, ironically, not doing so can actually be the most expensive choice of all.

See Your Doctor Regularly

Keep up to date on screenings. Mammograms, cholesterol level checks, and colonoscopies can catch serious problems. If medical conditions are caught early, they can be less complicated to treat and, as a result, less expensive.

Keeping up with treatment, medication, and healthy habits is especially important if you have a chronic condition such as diabetes, asthma, or heart disease. Why? This can keep your health from getting worse and requiring more costly treatment.

Get Your Shots to Prevent Illness

Vaccines aren’t just for kids. Immunizations can help keep you and your loved ones healthy. Most vaccines are covered by insurance — and many are affordable without it. Plus, they save you the cost of medical care, treatment, and sick days off work by preventing illness.

Talk to your doctor or another medical professional to find out which shots you should get to prevent illness.

Cut Prescription Drug Costs

Ask your doctor if you could safely split some of your pills. If so, your doctor can prescribe a higher-dose, and have you take 1/2 a pill at a time to save money. Or you may be eligible for drug company “prescription assistance” programs.

Shop for low prices. Mail-order pharmacies may offer 3 months worth of a drug for a discounted price. Doctors can sometimes offer free samples.

Embrace a Healthy Lifestyle

Healthy habits like eating well, exercising, and getting enough sleep can decrease your risk of disease and illness. If you smoke, consider quitting. Overweight? By becoming more active you may help cut your risk of chronic diseases like diabetes, heart disease, and arthritis.

Open a Flexible Spending Account (FSA)

FSAs cut costs by saving you taxes. Pre-tax money is taken from your pay and put into an account for you to spend on health care not covered by insurance. Put only what you’ll spend on medicine and co-pays in your FSA. Save receipts to prove you’re meeting FSA rules, in case asked. Spend all your FSA money before the year is up. What you don’t use, you lose!

Preserve Coverage with Low-Cost Plans

A “catastrophic” or “high-deductible” insurance plan can be a cheap option if you’re healthy. Bought through your employer or on your own, monthly payments are low. But you and your family may pay $5,000 or more of medical bills out of pocket before insurance pays.

Save for Emergencies

Broken or lost glasses. A chipped tooth. Emergencies can and do happen. And putting medical bills on high-interest credit cards can bury you in debt.

Starting an emergency medical fund can help. Sock away $100 or $200 a month into savings. Most banks will let you set up automatic deposits online. Can’t afford that much? Put aside what you can to help lessen debt from an unexpected bill.

Pick Only Necessary Procedures

Sometimes you are offered products or procedures that are not medically necessary.

Beware the up sell on teeth whitening at the dentist, or new frames from the optometrist, or a neck adjustment at the chiropractor. These often aren’t covered by insurance.

Take Care of Your Teeth

Get a dental checkup and regular cleanings. It costs about $200 to fill a cavity caught early. Untreated, you may later need a root canal, which can cost $2,000 for the operation and crown.

Laid off? Try COBRA

The hitch? Cost. Before, your company likely paid part of your premium. Under COBRA, you pay the whole cost, plus a 2% fee. Laid off since late 2008? Financial help may be available, visit www.dol.gov/cobra.

Or ask an insurance agent about a short-term individual policy. They can cover you a month at a time and may be cheaper than COBRA.

Help When You’re Uninsured

Community health clinics often offer some health care at reduced cost or for free based on your income. Contact your local health department. If you have a limited income and meet other requirements set by your state, you may be eligible for Medicaid coverage. Find your local Medicaid office at www.benefits.gov.

Get the Most from Doctor’s Visits

When you do go to the doctor, write down all your questions ahead of time. This can cut down on follow-up visits. Once there, ask your doctor to help you decide which care or procedures are really necessary, and which are elective.

Be sure your doctor understands your financial situation. Tell her if you’re thinking of skipping a procedure or dropping a medicine because of cost. She may be able to help you manage your medical care on a budget.