By Paula Durlofsky, PhD
Borderline Personality Disorder (BPD) is a serious psychiatric condition marked by a pattern of unstable and stormy relationships, an unformed sense of identity, chronic feelings of emptiness and boredom, unstable moods, and poor impulsive control in areas such as spending, eating, sex, and substance use.
Fear surrounding real or imagined abandonment from loved ones is a profound concern for people with BPD and often is what underlies their destructive behaviors. Some people with BPD will go to dangerous lengths to avoid this fear, for example, by becoming suicidal or engaging in self-mutilation.
Below are five of the more difficult symptoms of BPD:
- problems with relationships (fear of abandonment; unstable relationships)
- unstable emotions (frequent emotional ups and downs; high emotional sensitivity)
- unstable identity (unclear sense of self; chronic feelings of emptiness)
- impulsive and self-damaging behaviors
- unstable thinking/cognition (suspiciousness; tendency to dissociate when under stress)
Although this disorder may appear easy to self-diagnose, a valid diagnosis of BPD involves an extensive evaluation. BPD is a complex condition, but with appropriate treatment most people will show improvement within a year.
Here are some facts and myths concerning BPD:
MYTH: People diagnosed with BPD are always difficult to deal with, likely to be physically aggressive, untreatable, depressed, or unable to live fulfilling and productive lives.
These symptoms usually vary in their intensity. The majority of people diagnosed with BPD are genuinely very passionate, courageous, loyal, sensitive, thoughtful and intelligent individuals.
FACT: BPD usually develops during adolescence or early adulthood. Trauma may be a factor in its development. Parental neglect and unstable family relationships also have been shown to contribute to an individual’s risk for developing this disorder. Other studies suggest BPD may also have a genetic component. It is thought that individuals may inherit their temperament along with specific personality traits, particularly impulsiveness and aggression.
MYTH: BPD is untreatable. This is one of the most harmful misconceptions about BPD. In fact, the opposite is true. Current studies indicate that rates of recovery from BPD are much higher than previously thought.
Dialectical Behavioral Therapy is one of the most common and effective treatment approaches for BPD. This modality teaches mindfulness (paying attention to the present), interpersonal effectiveness, distress tolerance, and emotion regulation.
Other treatment options include cognitive-behavioral therapy, transference-focused psychotherapy (TFP), mentalization therapy (MBT) and schema-focused therapy. Additionally, family members of individuals diagnosed with BPD may also benefit from some kind of therapy. Family therapy can educate family members and loved ones about BPD and it can educate them about ways in which they can reduce their loved one’s symptoms.
Developing a strong therapeutic relationship with a therapist that one trusts and feels safe and secure with is crucial for effective treatment of BPD. The therapist should make him- or herself available by phone, text, e-mail. or other means of communication in between sessions.
Below are a few tips for coping with BPD:
- Seek professional help and try to stick with treatment even when you feel discouraged.
- Exercise regularly. Exercise has been shown to improve mood, decrease anxiety, and reduce stress.
- Get a minimum of seven to eight hours of sleep per night. Getting proper rest helps with mood regulation and decreases mood swings.
- Educate yourself about the disorder. Consider joining a support group.
- Set realistic goals for yourself. Be patient and compassionate with yourself as you work on achieving your goals.
- Identify and seek out comforting situations, places, and people.