Borderline Personality Disorder (BPD) is a personality disorder that affects the regulation of emotions, behaviour, and thoughts. It is a disorder that affects how you relate to yourself and others. It is characterized by unstable moods, behaviour, and self-image, leading to distress and difficulty functioning. Destructive behaviour caused by BDP can strain interpersonal relationships and negatively interfere with close relationships and the relationship with oneself.
People living with BPD suffer from emotional dysregulation where moods can easily shift to extremes (anger to hatred) or from one extreme to the other (happy to distraught). Managing emotions can be difficult, particularly in relationships, where the emotional state of someone with BPD is strongly dependant on the actions and reactions of another person.
People with BDP often fear separation and can react with self-destructive behaviours if they feel like they have been rejected. Guilt and shame may follow these outbursts and lead people with BPD to feel like a bad or evil person, negatively affecting their self-image. This disorder is often stigmatized and paints individuals with BPD as clingy and manipulative. However, Borderline Personality Disorder is treatable and symptoms, like emotional outbursts, can be managed.
BPD is often underdiagnosed or misdiagnosed; it is estimated that up to 40% of individuals with BPD were previously misdiagnosed. When we consider this, it is crucial to understand the signs and symptoms commonly associated with BDP.
And how it plays a role in other mental illnesses.
Symptoms typically start manifesting in adolescence and early adulthood. There are nine criteria listed in the Diagnostic Statistic Manual. For someone to be diagnosed with BPD, they must have at least five of the following:
Chronic feelings of emptiness
Emotional instability in reaction to day-to-day events (e.g., intense episodic sadness, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
Frantic efforts to avoid real or imagined abandonment
Identity disturbance with markedly or persistently unstable self-image or sense of self
Impulsive behaviour in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
A pattern of unstable and intense interpersonal relationships characterized by extremes between idealization and devaluation (also known as "splitting")
Recurrent suicidal behaviour, gestures, or threats, or self-harming behaviour
Transient, stress-related paranoid ideation or severe dissociative symptoms.
Symptoms are often paired with other illnesses such as depression, anxiety, eating disorders, post-traumatic stress disorder, substance abuse disorder, and bipolar disorder, which can contribute to its misdiagnoses.
There is no particular cause for BDP, but there is a link between first-degree biological relatives suggesting a genetic aspect. Trauma has also been shown to have a part to play in symptoms as well. Diagnosing any mental illness can be challenging because there are no simple tests. To diagnose BPD, a mental health professional must study the long-term patterns of symptoms and functioning.
BPD is often misunderstood but is treatable. Treatment consists of a mixture of medication, peer and family support, and psychotherapy. Several types of therapy are commonly used:
· Cognitive Behavioural Therapy (CBT)
· Mentalization-Based Therapy (MBT)
· Transference-Focused Psychotherapy (TFP)
· Schema-Focused Therapy
· Dialectical Behavior Therapy (DBT)
· Good Psychiatric Management (GPM)
Good self-care can also help manage symptoms, including exercise, eating well, good sleep habits, and healthy stress management and coping skills. Avoiding drugs and alcohol may help manage emotional balance and keep symptoms from worsening.
Creating a healthy emotional support system is also beneficial. Having family and friends who know what you are going through will help remind you that you are not alone and can help you recover. Peer groups and online forums/groups can help you find others who understand what it is like to live with BPD.
It is important to remember that BPD is not a personal defect. Self-destructive behaviours do not make you a bad person or evil; they are just symptoms that require care and attention. If you are struggling with BPD, remember that the symptoms are not your fault and that it is okay to seek support and treatment.
At Nōmina Integreated Health, we are highly skilled at treating BPD. Give us a call and see how we can help.