Mental Illness and BDSM (safety, correlation, positive and negative effects, etc.)

TW: self-harm, blood play, sexual assault

I am so curious...1) has anyone seen evidence that correlates BDSM with particular mental illnesses? 2) anecdotally, do you see BDSM and mental illness as related? 3) in what ways have you safely navigated mental illness in the BDSM space? 4) does BDSM give you a safe outlet for your mental illness? or, has BDSM provided a dangerous outlet for your mental illness? are there lines you do not cross because of mental illness?

A bit about what has prompted me to ask this question...

I see my personal interest in BDSM as deeply correlated with the symptoms I experience because of my mental illness. As someone with "quiet" BPD (the "quiet" part is not a DSM-V designation, but basically means I seem very high-functioning from an outsider's perspective), I sometimes think BDSM helps mitigate my BPD symptoms. At other times, I think BDSM can feed a dangerous part of myself.

I've been "sober" from cutting myself for the last eight years, and have really gotten a strong handle on my BPD thanks to dialectical behavioral therapy. I am able to somewhat satisfy my self-harm urge in a safe and positive way thanks to BDSM, which still gives me that self-harm high without the self-degradation. I think it can be particularly helpful that I am being physically harmed by a person who loves me and wants me to experience pleasure. It's such a different scenario from sitting in my bathtub alone, cutting myself because I believe I'm worthless. Instead, I'm being elevated and praised while experiencing pain.

I've only had the opportunity to engage in knife play a couple times pre-sobriety. It was ambrosia. But for my husband, blood play is a hard line, in part because he associates it with times when I have been deeply unwell. I sometimes still get the urge to self-harm, and part of me thinks knife play could help quell this urge, but another part of me wonders if I'm trying to justify a dangerous behavior, like an alcoholic who says, "Just one drink won't hurt."

Take care, everyone. A reminder that 988 is the suicide and crisis hotline. https://988lifeline.org/get-help/