What People Get Right — And Decidedly Wrong — About Borderline Personality Disorder
BPD is a serious mental health disorder, but it may not be what you think.
Photo by pawel szvmanski on Unsplash Public discussion and dissection of personality disorders is a more popular pastime than ever, so much so that it can be hard to discern the facts about these very real mental health conditions from the myths.
According the definition offered in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5), "A personality disorder is a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time."
To meet the criteria for diagnosis of a personality disorder, the presenting issues cannot be due to alcohol or substance use or any other medical condition.
One of the most commonly discussed, and often misunderstood, personality disorders is borderline personality disorder (BPD).
What is borderline personality disorder (BPD)?
BPD is a serious mental health disorder that impacts the way an individual thinks and feels about themselves and others.
Men and women with this condition experience challenges with daily functioning, such as, engaging with others, dissociating, having a distorted view of self, extreme fluctuating emotions (not associated with negative events or external stimuli), engaging in risky impulsive behavior, or having a pattern of intense unstable relationships.
Many people who struggle with BPD also struggle with intense fears of abandonment, loss of love, and instability.
Borderline personality disorder typically begins by early adulthood; however, some signs of the disorder can be present in adolescence.
The condition seems to be worse in young adulthood and may gradually get better with age. Unfortunately, those that struggle with being alone have a history of being abandoned, feeling unloved, or feeling unable to truly connect with someone else.
It is for this reason some people with BPD will have difficulty recognizing the signs that they are “suffocating” a partner in the relationship. He or she attempts to consume all of their partners time and energy, leaving what they hope is nothing else for others.
In an attempt to find and secure love people with BPD will often and erroneously associate sex with love. However, once the sex act is done and they find there is no love, it can lead to additional impulsive behaviors and insecurities.
Common signs and symptoms of borderline personality disorder may include:
- An intense often irrational fear of abandonment
- A pattern of unstable intense relationships that do not last
- A distorted view of self or self-image, e.g., seeing one’s self as bad or unworthy
- Risky behavior or impulsivity, e.g., promiscuous sex, gambling, excessive spending, quitting, getting fired, or starting multiple jobs
- Dissociative episodes, experiences described as "a disconnect between your thoughts, emotions, behaviors, perceptions, memories, and identity"
- Paranoia
- Suicidal thoughts or ideations in response to fears of abandonment or isolation
- Fluctuating mood swings not associated with events or external stimuli
- Ongoing feelings of emptiness
- Inappropriate, intense anger, or difficulty managing one’s temper
Borderline personality disorder can be very difficult to understand for both the individual with the disorder and the people who love them.
Because of the fluctuating moods associated with borderline personality disorder, it can look like bipolar disorder for some. However, the essential features associated with borderline personality disorder and bipolar disorder are different.
Some of the most common misconceptions about borderline personality disorder include:
1. People with BPD will never lead a stable life.
2. Only women suffer from BPD.
3. Historical trauma is the cause of BPD.
4. There is no active or successful treatment for BPD.
5. People with BPD are incapable of being in healthy relationships.
6. People with BPD are unable to love someone else freely and genuinely, they love out of fear of being alone.
7. People with BPD are flawed.
8. People with BPD are consciously manipulative and calculating.
9. All people with BPD are attention seeking.
10. All people with BPD actively choose to engage in reckless behavior, e.g., they choose to fly off the handle or do not want to get their mood/emotions under control.
11. All people with BPD crave stability.
12. All people with BPD are highly intelligent.
What causes borderline personality disorder?
Previous research conducted on BPD suggests multiple factors may be responsible for development of the disorder. A family history of serious mental health issues and trauma can predispose someone to develop BPD.
Although, childhood trauma has been associated with some people’s development of the disorder, it is important to recognize that not everyone with BPD has experienced childhood trauma.
The development of BPD and the onset of symptoms can be triggered by environmental factors such as attachment, childhood trauma, temperament, biological factors such as genetics and neurobiology, and sociocultural factors. A combination of these factors are often experienced by people diagnosed with BPD.
Is treatment available for people with BPD?
Borderline personality disorder is mainly treated using individual psychotherapy, but medication may be used in combination with treatment. Treatment can help individuals with the disorder learn how to manage and cope with the disorder.
It's also necessary to get treated for any other mental health disorders that often occur along with borderline personality disorder, such as depression or substance misuse.
The most commonly used therapy for BPD is Dialectical Behavioral Therapy (DBT), which was developed to assist people experiencing chronic suicidality and difficulties with regulating or managing emotions.
There are also several other therapies that are used in the treatment of BPD and sometimes a combination of these therapies can be helpful.
Dr. Tarra Bates-Duford is a psychologist who focuses on relationships, dating, and personality issues, as well as a Certified Relationship Specialist with Diplomate Status, and an expert with the American Psychotherapy Association.