In life, we’re constantly doing the dance between controlling what we can to have a safe and stable life and accepting and learning to live with what we can’t control.
In the area of disability, you don’t have much control over what disability you have, how you attain it or how severe it is. But to a large extent, you do have control over how you deal with it and learn to live alongside it.
But what if your disability directly affects your ability to control how you deal with it? And what if it’s intangible and hard to diagnose?
Mental health issues affect millions of people and this month, we’re looking at a lesser understood and often stigmatised mental health issue: borderline personality disorder (BPD).
BPD can be debilitating in many areas of life – the inability to hold down a job, take care of yourself, feel joy, regulate emotions, and have relationships.
To help those who have this condition understand it themselves as well as be understood, here’s everything you need to know about borderline personality disorder.
In this article, you will learn:
What is borderline personality disorder?
What are the signs of borderline personality disorder?
What causes borderline personality disorder?
What treatments are available for borderline personality disorder?
How can you live alongside borderline personality disorder?
Let’s dive in.
What is borderline personality disorder?
Borderline personality disorder (BPD) is a condition that causes a person to be unable to regulate their emotions, which has a domino effect on many areas of life. This dysregulation of emotions causes the person to be very impulsive, have unstable reactions to people and situations, have an unclear sense of self and go from one extreme emotion to the next in a short space of time.
BPD is often confused with bipolar disorder and dissociative identity disorder (DID – previously referred to as multiple personalities). The difference is that bipolar is a mood disorder that goes between manic moods and low moods and these usually last for a day or more. BPD, on the other hand, is a personality disorder that can cause a person’s mood and emotions to change instantly or in short intervals. BPD involves emotions, behaviours and ways of interacting that primarily affect the way a person relates to others.
The difference between BPD and DID is that a person with BPD does not have multiple personalities. They just have an unstable sense of who they are.
9 signs of borderline personality disorder:
You need to show at least 5 out of 9 of these signs to be diagnosed with BPD. People are usually diagnosed in their late teens or early adulthood.
- A strong fear of abandonment. Because of this fear, a person with BPD is always mentally preparing themselves for the worst, which can result in clingy behaviour that then becomes a self-fulfilling prophecy when someone leaves.
- Unstable, intense relationships. There is often no middle ground, and a relationship is either ideal and perfect or terrible and traumatic. Relationships are often intense, volatile, and short-lived.
- Unclear sense of identity. People with BPD can switch from feeling good about themselves to feeling self-hatred very quickly and may not know who they are. This can lead them to change their style, sexual orientation, partners, beliefs, jobs, friends, and life goals frequently.
- Impulsivity. People with BPD may often act without thinking of the consequences in an attempt to soothe or distract them from their emotions. This can include self-destructive behaviours like binge drinking or eating, taking drugs, reckless driving, or risky sexual activity.
- Recurrent suicidal behaviour or thoughts, or self-harming. People with BPD have a high rate of suicide attempts, which may be to escape their emotions or as attention-seeking behaviour due to their fear of abandonment. This is a very dangerous position to be in because a cry for help may result in death, even if that’s not what they really wanted. Cutting and burning can also be used as an emotional release or a cry for help.
- Affective instability. This means that someone has extreme mood swings in a short space of time. People with BPD often are unable to inhibit these feelings and can appear to overreact to things because their reaction is in line with the strength of their emotions rather than the actual situation.
- Chronic feelings of emptiness. People with BPD often feel like there is a hole inside and they need to fill it, either with relationships or through impulsive actions. When this doesn’t work, it can lead to panic and further self-harming behaviour.
- Explosive anger. Some people (not all) with BPD may blow up at the slightest thing because they feel things so intensely. This can either be external at other people or internal at themselves. This is often followed by shame, self-loathing, and sometimes self-harming behaviours.
- Transient stress-induced psychotic ideation. In layman’s terms, this means paranoia, hearing voices, and sometimes even dissociation – where they retreat from current reality and feel like they’re outside of their body.
What causes borderline personality disorder?
According to the experts, there’s no one cause of BPD. What has been observed is that it’s often (but not always) a combination of biological vulnerability and childhood abuse. Biological vulnerability means they are naturally more susceptible to emotional dysregulation. Sexual, physical, and verbal abuse and a hostile, invalidating environment when growing up can also be risk factors. A family history of mental illness may also put a person at a higher risk of BPD.
What treatments are available for borderline personality disorder?
There is no medication for BPD specifically. Medication is given to treat co-occurring conditions of the disorder such as depression and anxiety.
The only effective treatment (so far) is life-long psychotherapy.
Two types main of psychotherapy that are used for borderline personality disorder are:
Dialectical Behaviour Therapy (DBT): This focuses on awareness of your emotional state and present situation, so you can better control your emotions, behaviours, and reactions.
Cognitive Behavioural Therapy (CBT): This looks at your core beliefs, self-perception, and habitual behaviours so you can reduce your mood swings and negative, impulsive behaviour.
How can you live alongside borderline personality disorder?
If you have borderline personality disorder, the most important way to help yourself is to find a therapist you trust and keep going to appointments. The sooner you start going, the better.
Other suggestions:
Include your family and friends. Opening up to loved ones about your diagnosis can help them to better understand what you’re going through and take the steps to learn what they need to do to help you.
Join a support group. Having the support of people who understand what you’re going through can be a great comfort and remind you that you’re not alone.
Build a calming toolbox. Try different things to calm the mind until you find one or more that work for you. Some ideas are meditation, tai chi, exercise and listening to music.
Find healthy distractions. If your calming strategies aren’t working, try to distract yourself with an activity you enjoy like reading a book, watching a series, building a puzzle, doing something creative, or getting out in nature.
Borderline personality disorder is a chronic disorder, but your symptoms can be improved with time and therapy and you can go on to have healthy relationships and a happy life. Just be sure to do the work with your therapist, stick to it, and be patient with yourself.