Introduction

If you are living with Borderline Personality Disorder (BPD), you may feel as though you are constantly on an emotional roller coaster ride. This is because emotions and relationships can be unstable, meaning there’s a shift in how you feel about yourself.

Suddenly and without warning, your self-image, goals, preferences, etc. can change in a way you do not even know or are unfamiliar with which causes confusion and uncertainty.

People with BPD tend to be extremely sensitive. Even small things can trigger intense reactions; once upset, they may have trouble calming down.

This emotional volatility and inability to self-soothe can lead to relationship troubles and impulsive or reckless behaviour.

When experiencing overwhelming emotions, thinking clearly or remaining grounded can be challenging. One might say or do hurtful things that could lead to feelings of guilt or shame later on.

However, effective BPD treatments and coping mechanisms are available to help people feel better and regain control of their thoughts, feelings, and actions.

What is Borderline Personality Disorder (BPD)?

Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), is a mental health condition characterized by a persistent pattern of unstable interpersonal relationships, distorted self-image, and intense emotional reactions. 

People with this disorder often struggle with regulating their emotions and may engage in self-harm or other risky behaviours as a result. They may also experience dissociation, feelings of emptiness, and a fear of abandonment.

Types of BPD

There are four widely accepted types of borderline personality disorder:

Impulsive: Impulsive behavior is a primary symptom of BPD. A person with BPD can act in impulsive and often dangerous ways. They can do that without regard to the consequences for others, or possible effects.

Discouraged: This is also known as quiet borderline personality disorder. People with this type are afraid of being abandoned. They may take extreme actions to prevent real or imagined abandonment.

Self-destructive: People with this type of BPD struggle with self-hatred and often feel bitter.

Petulant: People with this type of BPD may be angry one moment and sad or sulky the next. They may swing unpredictably between one emotion and another. They may also feel unworthy and unloved. This can lead to relationship challenges and an unhealthy desire for control.

Causes of Borderline Personality Disorder (BPD)

The exact cause of borderline personality disorder is still unknown to researchers. However, studies indicate that genetic, environmental, and social factors may increase the risk of developing it.

These factors may include:

Family history: People who have a close family member with the condition (such as a parent or sibling) are more likely to develop borderline personality disorder due to shared genetic characteristics.

Brain structure and function: Research shows that people with borderline personality disorder may have structural and functional changes in the brain,

Neurotransmitters: Regulation of emotional states is a core problem in borderline personality disorder. Neurotransmitters have been implicated in the regulation of impulses, aggression, and affect.

Serotonin has been the most extensively studied of these, and it has been shown that there is an inverse relationship between serotonin levels and levels of aggression.

Neurobiology: Evidence of structural and functional deficits in brain areas central to affect regulation, attention and self-control, and executive function have been described in borderline personality disorder.

Environmental, cultural, and social factors: Individuals with BPD report having witnessed terrible experiences in their lives, such as being abused, abandoned, or being abused as a child. They may have experienced unstable, devaluing relationships and conflicts.

Risks associated with BPD:

Many people with BPD also have another mental health condition or behavioural problem, such as:

• misusing alcohol
• generalised anxiety disorder
• bipolar disorder
• depression
• misusing drugs
• an eating disorder, such as anorexia or bulimia
• Other personality disorder, such as antisocial personality disorder

BPD can be a serious condition, and many people with the condition self-harm and attempt suicide.

Signs and Symptoms of BPD

Borderline personality disorder (BPD) is a complex condition that showcases a diverse range of symptoms. These symptoms must last for a period of time, and most aspects of your life are affected as early as adolescence.

Here are 9 of the most common symptoms of borderline personality disorder:

Fear of abandonment: People with BPD may have a very strong fear of losing the people they care about. It can make them behave in ways that force people away, for example by being clingy or possessive.

Unstable relationships: People with BPD may have difficulty in maintaining stable relationships. At first, they might idealize their partners, and then quickly lose interest and abandon them. They may also be having difficulty with friends, often feeling that they're either ignored or rejected.

Extreme emotional swings: People with BPD may experience extreme mood swings, going from feeling happy and euphoric (extremely happy) to feeling angry, sad, or empty. There may be a lot of sudden and intense mood swings.

Unstable sense of self: People with BPD may have a difficult time knowing who they are. They're capable of changing moods, interests, or objectives in a hurry. It can make it hard for them to accept that they have a stable identity.

Impulsive behaviour: People with BPD may engage in impulsive behaviours, such as spending unwanted money, having unsafe sex, or using drugs or alcohol.

Suicidal thoughts or behaviours: People with BPD may have thoughts of suicide or engage in self-harm, such as cutting or burning themselves. This is a common way of dealing with intense emotions.

Chronic feelings of emptiness: People with BPD may often feel empty or incomplete inside. This feeling of emptiness can be very distressing and can lead to other symptoms, such as self-harm or substance abuse.

Intense anger: People with BPD may experience intense anger that is difficult to control. The anger can be directed at others, themselves, or objects.

Dissociation: People with BPD may experience dissociation, which is a feeling of being disconnected from oneself or one's surroundings. This can be quite a terrifying experience.

Diagnosis of BPD

A mental health professional, such as a psychiatrist, psychologist, or clinical social worker, can diagnose borderline personality disorder through a comprehensive study of the individual's symptoms, experiences, and family medical history.

A thorough medical examination can also help eliminate other potential causes of the symptoms.

A borderline personality disorder is typically diagnosed in adults, not in children or teenagers, as the signs and symptoms may diminish as children mature.

Sometimes, individuals under 18 may receive a diagnosis of borderline personality disorder if their symptoms are substantial and persist for at least 1 year.

Treatment for Borderline Personality Disorder

A borderline personality disorder is primarily treated with psychotherapy, although medication may be included. If your safety is in danger, your doctor might also advise hospitalization.

Psychotherapy

Psychotherapy is the primary treatment for individuals with borderline personality disorder. It is also called “Talk Therapy”. 

Most psychotherapy takes place with a trained mental health professional in one-on-one sessions. Group sessions can assist individuals with borderline personality disorder in learning how to interact with others and express themselves effectively.

Two psychotherapies commonly performed in the treatment of borderline personality disorder are:

Dialectical Behavior Therapy (DBT): DBT incorporates mindfulness and emotional awareness, as well as skills to manage intense emotions, decrease self-destructive behaviours, and enhance relationships.

Cognitive Behavioral Therapy (CBT): These therapies can help people understand and change their basic beliefs and behaviours that are caused by incorrectly perceived experiences of themselves or others.

It may help people reduce mood swings and anxiety symptoms and may reduce the number of self-harming or suicidal behaviours.

Medications

The effectiveness of medication for borderline personality disorder is not clear, so medications are not usually the main treatment method.

However, in certain situations, a psychiatrist may suggest medications to address particular symptoms or concurrent mental disorders like mood swings or depression.

Hospitalization

At times, you may require more intensive care in a psychiatric hospital or clinic. Hospitalization can also ensure your safety from self-harm or address suicidal thoughts or behaviours.

Managing Borderline Personality Disorder

Borderline personality disorder (BPD) is a challenging condition to handle, for both the person experiencing it and those around them.

However, there are effective ways to manage the symptoms and improve overall well-being. Here are some strategies:

Practice self-care: Prioritizing self-care is crucial for managing BPD symptoms. This involves ensuring adequate sleep, maintaining a healthy diet, regular exercise, and participating in enjoyable activities.

Develop healthy coping mechanisms: Explore healthy strategies for managing challenging emotions and situations. This could involve mindfulness practices, controlled breathing methods, writing, or immersing yourself in nature.

Build strong relationships: Developing supportive relationships can provide valuable strength and stability for individuals with BPD. Make an effort to connect with loved ones who are understanding and patient.

Communicate effectively: Effective communication is crucial in any relationship, particularly for individuals with BPD. Discover how to articulate your needs and emotions constructively, and be open to hearing others.

Avoid substance use: Alcohol and drugs can worsen BPD symptoms and make it more difficult to manage them. Avoid using these substances as a way to cope.

Educate yourself: Learning about BPD can help you understand your symptoms and develop effective coping strategies. There are many resources available online and in libraries.

Be patient: Recovery from BPD is a journey, not a destination. It takes time and effort to develop the skills and strategies necessary to manage the symptoms. Be patient with yourself, and celebrate your progress along the way.

FAQs

What is the difference between borderline personality disorder and bipolar disorder?

Bipolar disorder involves extreme mood swings between highs (mania or hypomania) and lows (depression).

Borderline personality disorder (BPD) primarily involves unstable emotions, relationships, and self-image, marked by an intense fear of abandonment and impulsive behavior.

The nature and pattern of mood changes and other symptoms differ, although they are associated with mood fluctuations.

Can borderline personality disorder be prevented?

Unfortunately, there’s no way to prevent borderline personality disorder. But it's important to remember that there are ways to manage and overcome borderline personality disorder.

BPD can sometimes be inherited, which means you have to overcome the challenges that may come your way, even if there is a family history of BPD.

Empower yourself by asking your healthcare provider about the signs of the disorder, so you can take control of your health and seek treatment as early as possible.

Can borderline personality disorder coexist with other mental health conditions?

Yes, BPD often coexists with other mental health disorders such as depression, anxiety disorders, substance abuse, or eating disorders.

This may mean that diagnosis and treatment can become more difficult, requiring a comprehensive approach to the management of several symptoms.

Does BPD get worse with age?

In general, older people are less impulsive, even if they do not have BPD. This is consistent with the observation that impulsivity symptoms of BPD are most likely to decline over time.

Conclusion

It is important to understand that borderline personality disorder (BPD) is a type of mental health condition that does not determine your worth or potential.

As with any mental health issue, seeking help as soon as you notice symptoms can help you to reduce its impact on your life.

Mental health professionals know to provide effective treatment plans that empower individuals with BPD to manage their thoughts and behaviours positively.

For those family members and loved ones supporting individuals with borderline personality disorder, it is important to have the strength to navigate through challenges, find resilience in the face of stress, cultivate hope in times of sadness, and foster connection amidst feelings of isolation. 

References

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