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Borderline Personality Disorder

What is Borderline Personality Disorder?

Borderline Personality Disorder (BPD) is a disorder of emotion regulation, Up until a few decades ago, those diagnosed with the disorder were thought to be untreatable. Despite this shift, individuals living with BPD continue to face surplus stigma. Evidence-based treatments, however, have helped change the narrative for people living with BPD to one of recovery and hope.

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BPD can affect anyone, but it is often diagnosed in late adolescence and early adulthood. The prevalence of BPD in the general population of adolescents is around 3%. The clinical prevalence of BPD ranges from 11% of adolescents consulting at an outpatient clinic to 78% in suicidal adolescents visiting emergency departments. Up to 10% of individuals with BPD will die by suicide.

Did you know?
5.9% of the population displaying a characteristic at some point in their life (lifetime prevalence) and accounting for 20% of the psychiatric inpatient population. (NIH)

What Causes BPD?

The cause of borderline personality disorder is still unclear. Studies suggest that genetics, environmental, and social factors may have an impact on developing BPD. Family history, brain structure and function, traumatic life events such as abuse, abandonment, or hardship during childhood might all contribute to the development of BPD.

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What are the Symptoms

The symptoms of borderline personality disorder can be summarized as instability in mood, thinking, behavior, personal relationships, and self-image. Many symptoms of borderline personality disorder are similar to those found in other disorders, such as anxiety disorder, schizophrenia, and other personality disorders. Some of the most common signs or symptoms of BPD include:

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  • Intense mood swings, quick changes in values or interests, and impulsivity or recklessness

  • A distorted self-image or sense of self, making it difficult to find a clear sense of purpose and direction

  • Excessive self-criticism, including struggling to remember their own positive qualities

  • A pattern of intense and unstable relationships with family, friends, and loved ones

  • Impulsive and often dangerous behaviors, such as spending large amounts of money, unsafe sex practices, substance abuse, reckless driving, and binge eating

  • Self-harming behaviors, such as cutting, burning, skin-picking, scratching, punching or hitting, biting, pinching, or bone-breaking

  • Feelings of emptiness, intense sadness, or loneliness

  • Frequent, prolonged, or intense anger that can contribute to feelings of shame, regret, or self-loathing

  • Feelings of dissociation, such as feeling disconnected from oneself, observing oneself from outside one’s body, or feelings of unreality

 

It is important to recognize that not everyone with borderline personality disorder may experience all of these symptoms. The frequency, duration and type of symptoms can depend on the person and their condition.

For a diagnosis, individuals must meet at least five out of the nine criteria according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V):

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  • Perceived or real fears of abandonment

  • Intense mood swings, or brief periods of severe depression or anxiety

  • Impulsivity

  • Unstable or changing relationships

  • Self-injury, suicidal ideation, or suicidal behavior

  • Chronic feelings of emptiness

  • Inappropriate, intense anger and rage

  • Unstable self-image

  • Stress-related paranoia or severe dissociative symptoms

 

There is high co-morbidity (more than one disorder occurring at the same time) with other disorders such as depression, substance abuse, eating disorders, and other personality disorders. This often makes BPD more challenging to diagnose and treat.

 

If you're aware that you have any of the symptoms above, talk to your doctor or other regular healthcare professional or see a mental health professional.

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Complications

Borderline personality disorder can damage many areas of your life. It can negatively affect close relationships, jobs, school, social activities and how you see yourself.

Also, you may have other mental health conditions, such as:

  • Depression. (link)

  • Alcohol or other substance misuse.

  • Anxiety disorders. (link)

  • Eating disorders.

  • Bipolar disorder.

  • Post-traumatic stress disorder (PTSD).

  • Attention-deficit/hyperactivity disorder (ADHD).

  • Other personality disorders.

 

Individuals with BPD traits can develop behaviors that can be difficult for friends and families to understand, often resulting in conflict or instability within relationships. People with personality disorders often use “defense mechanisms,” or coping strategies, that allow them to deny responsibility for their feelings and actions. One defense is called “splitting” – putting some people on a pedestal while devaluing others.

 

Another defense is called “projective identification” – which involves denying one’s feelings, attributing them to someone else, and then behaving in a way that causes the other person to respond in kind. For example, when someone with borderline’s hostility is reciprocated, they can think and/or act as though it were not their own action.

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Families of people who suffer from the disorder are often at a loss in knowing what to do and where to turn. People with BPD who stay healthily emotionally involved with their family members are more likely to have better outcomes. Obtaining help and treatment for the entire family is fundamental to individual and family well-being.​

 

If you need Support

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org. Text MHA to 741741 to connect with a trained crisis counselor from Crisis Text Line. Call 911 or go to the nearest emergency room.

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If you are in need of support, but not in crisis

Consider reaching out to a warmline. Warmlines offer a place to call when you just need to talk to someone. Speaking to someone on these calls is typically free, confidential, and run by people who understand what it’s like to struggle with mental health problems. Find a warmline at mhanational.org/warmlines.

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If you have suicidal thoughts

If you have fantasies or mental images about hurting yourself, or you have thoughts about suicide, get help right away by taking one of these actions:

  • Call 911 or your local emergency number right away.

  • Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.

  • U.S. veterans or service members who are in crisis can call 988 and then press "1" for the Veterans Crisis Line. Or text 838255. Or chat online.

  • The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).

  • Call your mental health professional, doctor or another member of your healthcare team.

  • Reach out to a loved one, close friend, trusted peer or co-worker.

  • Contact someone from your faith community.

If you notice symptoms in a family member or friend, talk to that person about seeing a doctor or mental health professional. But you can't force someone to change. If the relationship causes you a lot of stress, you may find it helpful to see a therapist.

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At Wise Mind Counseling, PLLC

We are committed to helping you work successfully through complex mental health challenges such as Borderline Personality Disorder. We have a dedicated and experienced staff who can provide a wide range of therapeutic options to enable you to deal with challenges and live your best life. Reach out to us today for more information or a consultation.

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Sources/Resources

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