BPD. Why Borderline Personality Disorder is Difficult to Diagnose
Schizotypal disorder refers to a group of schizophrenia-like diseases, including schizophrenia itself, schizotypal and other delusional disorders. Schizotypal disorder is somewhat similar in its manifestations to schizophrenia. Its symptoms include behavioral abnormalities, emotional inadequacy, and eccentricity. Obsessive ideas, avoidance of communication, and paranoid disorders are common. Delusional and hallucinatory episodes are possible. However, there are no obvious signs of schizophrenia.
The main difference between schizotypal disorder and schizophrenia is the predominance of positive symptoms. It is characterized by delusions, hallucinations, and obsessions without the development of a personality defect. There are no symptoms characteristic of schizophrenia, such as emotional flattening, decreased intelligence, and sociopathy.
Diagnosis of schizotypal disorder
To establish this diagnosis, a long-term (more than two years) presence of characteristic symptoms in the absence of personality deficit is necessary. The diagnosis of schizophrenia should also be excluded. Information about illnesses of close relatives can help in establishing a diagnosis - the presence of schizophrenia in them serves as confirmation of schizotypal disorder.
It is important to avoid both over- and under-diagnosis. An erroneous diagnosis of schizophrenia is especially dangerous. In this case, the patient will receive unreasonably intensive treatment, and, when information is disseminated among friends, social isolation, which contributes to the aggravation of symptoms.
There are a number of methods that help clarify the diagnosis of schizotypal personality disorder. The SPQ (Schizotypal Personality Questionnaire) test is one of the easiest ways to do this.
Test description
The test for schizotypal personality disorder includes 74 questions that cover 9 main signs of this disease according to ICD-10. A score of more than 41 points is considered a sign of schizotypal disorder. More than half of respondents who exceeded the diagnostic level on the test were subsequently diagnosed with schizotypal disorder.
There are also separate tests for diagnosing the level of psychoticism authored by Eysenck, scales for assessing general and social anhedonia, possible disturbances of perception and a tendency to schizophrenia. However, only in the SPQ are all the signs of schizotypal disorder collected together and presented in an easy-to-use form.
The questions in the test for schizotypal traits are divided into the following scales:
- impact ideas,
- excessive social anxiety,
- strange ideas or magical thinking,
- experience of unusual perception,
- strange or eccentric behavior
- lack of close friends,
- unusual sayings,
- reduction in emotions
- suspicion.
This test demonstrated good reproducibility and reliability of results in different groups of subjects.
The SPQ test can be used both to confirm the diagnosis of schizotypal disorder and for screening healthy people at risk. This is a fairly reliable and psychologically comfortable way to identify the presence of a disorder at its first symptoms.
The test is also convenient for dynamic monitoring to identify worsening or alleviating symptoms. The test questions can be used by patients for self-control - patients do not always perceive their condition as pathological and make corresponding complaints, but with the help of the test they can be easily identified.
Borderline personality disorder is characterized by emotional instability, impulsivity, a high degree of anxiety, an unstable connection with reality, and problems building relationships with other people.
An increased level of desocialization is accompanied by low self-control and sudden mood swings. A person can behave aggressively and recklessly, but at the same time, have an acute need for the support of loved ones and be afraid of loneliness. As a rule, borderline personality disorder manifests itself in childhood, has a stable course and accompanies a person throughout his life.
Borderline personality disorder - description of pathology
Psychiatrists qualify borderline personality disorder as a mental illness bordering on neurosis and psychosis, and classify it as a form of psychopathy. In fact, this definition is controversial, since personality disorder is a mixed condition that manifests itself by building psychological defenses against changes at the neurotic level.
This mental disorder is difficult to attribute to any specific disease, so it is separated into a separate category. Disputes regarding the classification of borderline disorders have been ongoing in the scientific community for a long time, and the similarity of symptoms with other mental illnesses leads to frequent errors in making the correct diagnosis.
According to statistics, people with borderline personality disorder make up up to 3% of the adult population, and in the vast majority of cases, this type of disorder is diagnosed in women. In reality, this percentage is even higher, since diagnostic errors by clinicians distort the data downward. But even such statistical percentages are a high indicator that requires the close attention of specialists.
Borderline personality disorder is accompanied by other mental disorders, a tendency to,. Failures in personal life, social and professional unfulfillment, fear of loneliness - all this leads to depression, causes suicidal tendencies and pushes a person to commit rash acts.
Causes of the disease
Experts still do not have a consensus on the causes of this pathology. Many are inclined to think that borderline disorder develops under the influence of a number of provoking factors, and put forward several main hypotheses that explain the origins of mental deviation:
Like most mental disorders, this disorder is more common in families where close relatives or previous generations had borderline mental disorders.
Biochemical factor
Followers of this theory believe that the deviation is caused by an imbalance in the balance of brain neurotransmitters. As you know, human emotional reactions are regulated by three main substances: serotonin, dopamine and endorphin. Deficiencies or excess production of one of them upsets the balance and leads to mental disorders.
Thus, depressive, depressed states develop with a deficiency of serotonin, a lack of endorphin leads to a decrease in resistance to stress and increased psycho-emotional stress, and insufficient production of endorphins deprives a person of the joy of life, turning it into a meaningless existence.
Social factor
Researchers have noticed that this type of mental disorder is more common among those who grew up in disadvantaged social environments. Parents who abuse alcohol or drugs, demonstrate antisocial behavior, practically do not care for the child, who copies their behavior on a subconscious level and subsequently cannot adapt to normal life.
Against the backdrop of such unfavorable conditions, personality deformation occurs, self-esteem decreases, generally accepted norms of behavior are distorted, and a person has difficulty fitting into society.
Defects in education
A full-fledged personality is formed only with proper upbringing, which maintains a balance between rigor, love and respect for the little person. If a healthy, friendly microclimate is maintained in the family, then the child receives plenty of love and support.
In cases where a child is faced with the oppressive dictates of his family, an anxious personality may eventually develop. And, on the contrary, against the background of permissiveness and the absence of restrictive frameworks, a demonstrative personality grows up, who does not take into account the people around him and puts his own interests above all else.
Many experts believe that a traumatic situation experienced in childhood plays an important role in the development of the disease. This could be the departure of one parent from the family, the loss of loved ones, physical, emotional or sexual abuse.
Representatives of the fairer sex suffer from borderline disorders much more often than men. Experts explain this pattern by a more subtle mental organization, low resistance to stress, increased anxiety and low self-esteem.
Symptoms
Borderline personality disorder has no specific symptoms and can manifest itself in different ways, which makes diagnosing the disease much more difficult. Psychiatrists identify the following signs that may indicate the presence of a mental disorder:
- decreased self-esteem;
- fear of change;
- impulsiveness, loss of control and lack of “brakes” in behavior;
- manifestations of paranoia bordering on psychosis;
- life according to the principle “I want here and now”;
- instability of mood, problems with building interpersonal relationships;
- categoricalness in judgments and assessments;
- fear of loneliness, depressive or suicidal feelings.
Self-destructiveness is an important trait characteristic of individuals with borderline personality disorder. Against the background of emotional instability, a person is prone to unjustified risks, alcohol or drug abuse. This type of personality can commit any actions associated with the destruction of health or posing a threat to life. For example, racing a car, participating in risky activities that could end fatally.
People with borderline personality disorder experience a fear of loneliness that dates back to early childhood. Hence impulsive behavior, low self-esteem, and instability in relationships. Fearing being rejected, a person is often the first to interrupt communication or, on the contrary, strives to be close at all costs, falling into psychological dependence. In this case, a person with pathological deviations either idealizes the partner and places unrealistic hopes on him, or becomes deeply disappointed and completely stops communication.
With borderline disorders, a person cannot cope with his emotions, often conflicts, gets irritated and angry, and then feels remorse and emptiness. He can start a quarrel out of the blue and even provoke a fight, and when exposed to strong stress factors, he can cling to paranoid ideas.
Characteristic statements with a borderline state
What typical statements does a borderline person use to describe their feelings? Here are the basic settings:
- No one needs me and I will forever remain lonely. No one will protect or take care of me.
- I am unattractive, no one wants to know about my inner world and become close to me.
- I cannot cope with difficulties on my own, I need a person who will solve my problems.
- I don’t trust anyone, people can set me up and betray me at any moment, even those closest to me.
- I have lost my individuality and have to conform to other people's desires to avoid being rejected.
- I am afraid of losing control over my emotions; I cannot fully discipline myself.
- I feel guilty for doing something bad and deserve to be punished.
Such attitudes are formed in early childhood and consolidated in adulthood, first as stable patterns of thinking, which then turn into patterns of behavior. The world around them is seen as hostile and dangerous, therefore, people with borderline disorders experience fear and powerlessness in front of it.
Diagnostic methods
Diagnosis of borderline personality disorder is complicated by unstable and varied symptoms. An experienced psychiatrist makes a preliminary diagnosis after a conversation with the patient, based on his complaints and test results.
This takes into account the feelings that the patient characterizes as emptiness, resistance to change, and expectation of a special approach. A tendency to self-destructive behavior, feelings of guilt, and inappropriate reactions (anger, unreasonable anxiety) are revealed.
Good to know
The final diagnosis is made based on the results of a psychological test for borderline personality disorder, which takes into account 9 main signs of the disease:
- fear of loneliness;
- a tendency to enter into unstable, tense relationships, accompanied by sharp changes from devaluation to idealization;
- instability of one’s own self and one’s image;
- impulsiveness aimed at causing harm to oneself (bulimia, alcoholism, drug addiction, sexual promiscuity, dangerous antics associated with risk to life);
- suicidal thoughts, threats or hints of suicide;
- sudden mood swings;
- feeling of emptiness, lack of joy in life;
- Difficulties with self-control, frequent outbursts of anger;
- paranoid ideas in stressful situations.
If 5 or more of the listed symptoms are observed and persist for a long time, the patient will be diagnosed with borderline personality disorder.
The patient's condition with this disease can be complicated by additional disorders, which are expressed by panic attacks, depressive states, attention deficit disorder, eating disorders (overeating, anorexia). Sometimes such patients experience excessive emotional reactions, antisocial behavior or anxiety disorders, which force them to avoid contact with other people.
Treatment for Borderline Personality Disorder
Treatment for this condition is carried out on an individual basis and is symptomatic. That is, medications are selected taking into account the manifestations of the disease in order to stabilize the patient’s condition. The dosage of medications, the choice of a specific drug, the optimal regimen and duration of treatment should be dealt with by a psychiatrist.
For concomitant depression, suicidal tendencies or eating disorders, therapy is longer and can take several years. But even after a positive result has been consolidated, relapses of the disease often occur. First of all, the patient needs the help of a psychotherapist and psychological support from loved ones.
Psychological assistance
Conversations with a psychotherapist or psychologist are aimed at understanding and rethinking existing problems, as well as developing skills to control behavior and emotions. The main task of the doctor and the patient is social adaptation, establishing interpersonal relationships, forming defense mechanisms that help overcome panic fears, anxiety and develop resistance to daily stress.
Cognitive-behavioral or dialectical therapy methods are the best way to change your way of thinking and develop optimal patterns of behavior in society. They are aimed at developing the ability to adapt to any unpleasant and uncomfortable situations. Family and psychodynamic therapy aimed at overcoming internal conflict and increasing self-esteem gives good results. The psychologist suggests that many patients attend classes in support groups. Basic psychotherapeutic techniques:
- Dialectical behavior therapy. This direction is most effective in the presence of self-destructive symptoms in behavior. Helps to get rid of bad habits, rethink behavior, and avoid unjustified risks in actions. The therapeutic effect is achieved by replacing negative attitudes with positive thinking patterns.
- Cognitive-analytical method. It consists of creating a certain model of behavior that excludes manifestations of borderline disorder (anxiety, irritability, anger). During the treatment process, methods are developed to stop attacks of aggression and other antisocial habits. A person is taught to think critically about what is happening, control his behavior and independently deal with the symptoms of the disease.
- Family therapy. This method is more often used in the rehabilitation process, after completing a course of treatment. The process involves the sick person’s relatives and friends, who take part in psychotherapy and jointly solve the accumulated problems.
Drug therapy
The following groups of medications are used in the treatment of borderline personality disorder:
- Neuroleptics. Antipsychotics are prescribed in combination with psychotherapy methods to control excessive impulsiveness and prevent attacks of anger and aggression. First-generation antipsychotics are now rarely used because they do not provide the required effectiveness. Of the latest generation of drugs, Risperidone or Olanzapine are most often prescribed.
- Antidepressants. The action of medications is aimed at stabilizing the emotional background, relieving a depressed state, and improving mood. Of the broad group of antidepressants, selective serotonin reuptake inhibitors are best suited to eliminate the symptoms of borderline disorders. The main representatives of this category are the drugs Sertraline, Paroxetine, Fluoxetine.
Taking such medications helps eliminate neurotransmitter imbalances and helps correct mood swings. Treatment with such drugs is long-term, the therapeutic effect develops gradually, the dose of drugs must be adjusted taking into account many factors, starting with the minimum. Such drugs have an extensive list of contraindications and can cause serious adverse reactions, so treatment is carried out under the supervision of a doctor.
Normotimics- a group of drugs whose action is aimed at stabilizing mood in mental disorders. These include several groups of medications - based on lithium salts and carbamazepine derivatives. New generation drugs - valproate, Cyclodol, Lamotrigine are easier to tolerate by patients, cause fewer side effects and can be used for a long time without causing addiction. For borderline personality disorders, doctors recommend taking such medications from the first days of the disease.
Borderline personality disorder is a fairly common but rarely diagnosed pathology. The disease significantly complicates the patient’s life, creates difficulties with social adaptation and problems in personal relationships. Therefore, it is necessary to make a correct diagnosis as early as possible and promptly begin comprehensive and effective treatment.
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Borderline personality disorder is a serious mental illness, less known than schizophrenia or bipolar disorder (manic depression), but no less common. Borderline personality disorder is a form of pathology on the border of psychosis and neurosis.
The disease is characterized by mood swings, an unstable connection with reality, high anxiety and a strong level of desocialization. As a result, borderline personality disorder can disrupt families, careers, and an individual's sense of self. As a disorder of emotional control, borderline personality disorder often leads to suicide attempts.
Individuals suffering from this illness have a very complex relationship with reality. It is difficult to help them, but it is possible - modern psychiatry is capable of doing this.
This test will help you preliminarily assess the possible presence or absence of symptoms of this disease. Answer “yes” or “no” depending on whether the symptoms described correspond to your condition.
Dear visitors, psychological assistance office psychologist-psychanalyst Oleg Matveev, you are offered a complex Ammon Self-structural test to determine whether a person has a personality disorder or mental disorder. (treatment of personality disorders Matveev O.V.)
Simply put, by taking the Ammon Personality Disorder Test, you can determine whether a person is mentally healthy, borderline, or ill.
If you want to change yourself, your personality and life, you can undergo psychoanalytic consultations online,
Ammon's self-structural test: personality disorder, psyche determines constructiveness, destructiveness, deficiency of aggressiveness, fear (anxiety), self-delimitation, narcissism and sexuality
There are 18 scales in total: constructive, destructive, deficit aggression, fear (anxiety), external and internal self-separation, narcissism, and human sexuality in general make up the whole personality structure.
Instructions for the Ammon Self-structural test - personality disorder, human psyche
Below, in the Ammon structural test, you will see a number of statements about certain ways of behavior and attitudes of a person, and you will find out whether you have any personality or mental disorders.You can answer: agree - disagree (true - false).
Please note: There are no right or wrong answers in the I-structure test, because Every person has the right to their own point of view.
Answer as you think is right for yourself, without adjusting to someone else's opinion.
Otherwise, you will not be able to accurately determine what personality and mental disorders you have, and accordingly, it will be difficult to choose methods of psychocorrection.
Be sincere and honest with yourself.
Don’t think for a long time, answer quickly, preferring the first answer that comes to mind.
Questions, statements of the Ammon test for determining personality disorders and human psyche
- If I start something, I finish it, regardless of whether anything gets in the way or not.
- If I was offended, then I try to take revenge
- Most often I feel alone (lonely), even among other people
- When I'm angry, I take my anger out on others
- I have a great sense of time
- As a rule, I work under high pressure
- If someone makes me wait, I can't think of anything else
- I get along with people easily
- What I really feel and think is essentially of no interest to anyone.
- I am often accused of being an insensitive person
- I enjoy it when other people look at me
- Often I find myself thinking somewhere else
- As a rule, in the morning I wake up cheerful (cheerful) and rested (rested)
- All I want is for others to leave me alone
- Sex puts me in a happy mood for the whole day
- I hardly dream at all
- I can't interrupt a boring conversation for me
- I am happy to invite guests to my home
- What I really think about I cannot share with others
- People often pester me with sexual offers.
- More often I am happy than angry
- When it comes to sexuality, I have my own fantasies
- I willingly help others, but I do not allow myself to be used
- What I do often gets no recognition
- When I feel angry it makes me feel guilty
- I am attracted to new challenges
- When I go away for a few days, hardly anyone is interested
- Difficulties immediately unsettle me
- I attach great importance to having everything in order.
- Even a few minutes of sleep can make me rested (rested)
- I can only show completed work to others.
- I don't feel comfortable being alone with anyone
- I willingly come up with erotic situations that I would like to experience with my partner
- I expect a lot from life
- Often my interest overpowers my fear
- In any company I remain myself (myself)
- My problems and worries are just my worries
- The most beautiful thing in life is sleep
- Life is pure suffering
- I enjoy spending the whole night with my sexy partner
- I often feel insufficiently included (included) in what is happening
- In my daily life, I experience joy more often than disappointment
- In an erotic mood, I don’t need to invent topics of conversation with my partner (partner)
- I willingly tell others about my work
- I often have days when I spend hours occupied with my thoughts.
- I rarely find anyone sexually attractive (attractive)
- I feel that my anxiety is very restrictive in my life.
- I like to find things that give my partner sexual pleasure
- I always forget something
- My fear helps me sense what I want and what I don't want.
- I have a lot of energy
- I often dream that I am being attacked
- More often than not, I am underestimated in my abilities.
- Often I don’t dare go out alone
- There is no room for feelings while working
- I am grateful whenever I am told exactly what I should do
- I am often guided by other people's opinions
- For me, a good mood is contagious
- Fear often paralyzes me
- When my partner wants to sleep with me, I feel embarrassed
- Most of the time I put off making decisions until later.
- My sexual fantasies almost always revolve around how well my partner treats me.
- I'm afraid that I might (might) hurt someone
- No one notices whether I am there or not
- I experience internal discomfort if I have not had sexual relations for a long time
- Basically my life is just waiting
- It often happens to me that I fall in love with someone who already has a partner.
- The responsibility I bear is often overlooked by others.
- In most of the threatening situations that have happened in my life, I was drawn into it against my will.
- Sometimes I want rough sex
- I often feel insecure about life
- If I am "attacked" I "swallow" my anger
- Thanks to my abilities, I always make contacts easily
- I enjoy every new acquaintance I make
- I find sex with strangers extremely exciting
- Sometimes I have suicidal thoughts
- Often my thoughts are in the clouds
- I can give myself completely sexually
- I'm often forgotten
- I don't like games
- In my relationship with my partner (partner), sexuality does not play a big role
- I get lost in the group
- I am not shy about showing sexual desire to my partner
- I always let everything fall on me
- I enjoy choosing gifts for my friends
- I can be easily impressed
- I notice that I often talk about the bad and forget about the good.
- I hate it when someone talks about their feelings
- I manage my time well
- I sleep the time I need
- If I have to speak in public, I often lose my voice
- I enjoy making fun of others
- I enjoy arousing sexual interest in women (men), even if I actually don’t want anything from them
- I have already experienced many crises that prompted me to further development
- In most situations I can be myself
- I laugh a lot
- When I get angry, it takes a lot of effort to control myself
- I have a rich sensual life
- I can completely trust the friendly disposition of others
- I often have a feeling of not belonging
- What I do is not that important
- I may not show my annoyance and irritation to others
- When I speak I am often interrupted
- I often imagine how bad things must have been for those who were unfair to me
- I like to joke and laugh a lot with my partner during sex
- I enjoy choosing clothes for the day in the morning.
- I can always find time for important things
- It often happens that I forget something important
- When my boss criticizes me, I start to sweat
- When I'm bored I look for sexual adventures
- My daily life has no ups or downs
- Difficulties spur me on
- Most people have no idea how important the things I'm interested in are to me.
- Basically, sex isn't particularly interesting to me.
- I am happy to introduce my new colleagues to my work
- I often turn others against me
- Even minor criticism makes me lose confidence
- Sometimes I am tormented by thoughts of causing physical pain to people who irritate me terribly
- Often my fantasies haunt me
- I need to think about decisions over and over again because I have doubts.
- Until now, I have never experienced complete satisfaction from sexual relations
- I am much more sensitive (sensitive) to pain than others
- I often feel too open (open)
- What I do, almost anyone could do
- The feelings I experienced in childhood haunt me to this day.
- The unknown beckons me
- Even when I am in fear, I am fully aware of what is happening.
- I often get into such a panic that I can’t even do important things.
- Often I want to have another partner (partner) in order to overcome my sexual inhibitions
- I can get really passionate about something
- I put everything on the shelf
- I can get terribly worried about little things
- In my sexual relationships, I felt that they became better and more intense over time
- I often feel superfluous (superfluous)
- You shouldn't have sex too often
- When I have difficulties, I quickly find people who help me
- I don't allow other people to easily disrupt my life.
- I can concentrate well
- I willingly seduce my (my) partner (partner)
- If I made a mistake, I can easily forget about it
- I rejoice when unexpected guests come to me
- Almost all women (men) want only one thing
- Even in a state of fear I can think clearly
- I have not had sexual relations for a long time and have not felt the need for them
- If someone offends me, then I pay him the same
- If someone tries to compete with me, then I quickly give up
- I can keep myself busy
- In order to avoid unnecessary worries, I avoid disputes
- When I am in a state of rage, I can easily hurt myself or have an accident.
- Often I can't decide to do anything
- After sexual contact I am especially efficient all day long (efficient)
- Most of the time I am satisfied with erotica, sex is not that important to me
- I feel especially bad on weekends
- I don't want to show others my feelings
- People often pick on me even though I don't do anything bad to them
- I find it difficult to start a conversation with people or find the right words
- If I like someone, I start talking to her (him) to get to know her better
- I believe that always being in control of your feelings is a goal worth striving for.
- During vacations and holidays I often have sexual adventures
- I dare to express my opinion in front of the group
- Most often I don't express my gene
- Nobody knows how often I get bullied
- When someone looks at me askance, I immediately begin to feel anxious.
- When someone is sad, I quickly become sad too.
- In my fantasies sex is more beautiful than in reality
- I find it difficult to decide to do anything because I am afraid that others may criticize me for my decision.
- My fantasies make me happy
- I don't know why, but sometimes I wish I could smash everything to pieces
- During sexual relationships, I am often mentally somewhere far away
- I have often been in risky situations
- If something worries me, I share it with others
- I often think about the past
- I maintained friendly relations even during crises
- I get bored at almost all holidays and parties
- When I'm angry, I easily lose control and yell at my partner.
- I don't let myself get confused easily
- Sometimes I drown out my fears with alcohol or pills
- I'm a timid person
- I'm very afraid of my future
- What gets me most excited is when my partner doesn't want to have sex with me
- There are days when I constantly break something or hurt myself on something.
- I rarely have sexual fantasies
- I have many dreams and I put a lot of effort into making them come true.
- I'm always happy when I can meet a new person
- Personally, fairy tales don’t tell me anything important.
- Most often I have sexual partners (partners) with whom I am not the only one (the only one)
- If someone breaks up with me, I strive to ensure that nothing reminds me of her (him)
- I am often confused when communicating with people
- I willingly talk about myself and my experiences
- I often indulge in thoughts
- I prepare thoroughly and in a timely manner for difficult tasks.
- I usually know the reasons for my poor health
- If I plan something good for myself personally, I often don't implement it.
- Direct sex is more important to me than just communication with my partner (partner)
- Often in a group I take the lead
- The most attractive people to me are the ones who always remain calm and act confident.
- Often my fantasies revolve around sexual activities that are not usually discussed
- I enjoy everything I can do
- When others unexpectedly catch me doing something, I get startled easily
- You achieve more with your mind than with your feelings
- If I'm interested in something, nothing can distract me
- I am rarely completely satisfied (satisfied) with absolutely everything
- It happens that I really “get” someone
- If people who are important to me talk to others for a long time, I literally go crazy
- Basically, sex disgusts me
- When others laugh, I often can't laugh with them.
- I am primarily interested in those sports that involve risk.
- I don't have a high opinion of psychology
- I often don't understand what's going on
- I'm very curious (curious)
- Fantasizing distracts me from work
- I experience sexual relationships as a painful duty.
- I volunteer to take on even important tasks that make me afraid
- I will probably never find a suitable (suitable) partner (partner)
- I often miss
- Whether I exist or not is not that important
- Giving answers to questions related to sexual relationships gave me pleasure
- I often feel crushed (crushed) by demands
- I often manage to involuntarily encourage others to take on tasks that I dislike
- “Pre-launch” excitement can give me wings