Understanding Borderline Personality Disorder
Out of all of the mental disorders that I or individuals I know live with I have to say that borderline personality disorder is one of the most misunderstood. More often than not, individuals with borderline personality disorder are painted as heartless, cheating, malevolent individuals. We are treated as though we are dangerous and should be avoided at all costs. Not only is this portrayal painfully flawed, but it helps add to the stigma that keeps others from understanding us as individuals rather than a diagnosis.
Before I was diagnosed with Borderline Personality Disorder at the age of 18 I had no idea what it was. I had never heard of it and had nothing to base my impression of the diagnosis on. Later in college, I came across the movie Girl, Interrupted that portrayed the life of a woman with Borderline Personality Disorder and was shocked that not only was it incredibly relatable but that there were people out there who were just like me in all of the weird ways that I thought nobody ever would be.
Now that I have been hospitalized for three separate suicide attempts I can relate even more to that movie. Although they aren’t very long lasting, the friendships you make while in-patient in a psychiatric facility can be some of the most rewarding because for once you have individuals around the completely understand the things that you are dealing with in ways that others simply can’t grasp. Unfortunately, suicidal ideation can be common among those living with Borderline Personality Disorder so there was no shortage of individuals with this condition while I was hospitalized.
Much like Bipolar Disorder, those living with Borderline Personality Disorder have difficulty in regulating their mood which leads to insecurity and extreme instability. Many who have borderline personality disorder have much more intense emotions than others and experience them for longer periods of time. Often, there is no in between for those with Borderline Personality Disorder. There is either extreme negative feelings or extreme positive ones.
Although just under 2% of the world’s population has a borderline personality disorder diagnosis there are some estimates that put that number well over 5% because it is often untreated or misdiagnosed. Up to 75% of those living with borderline personality disorder are female. This figure too, however, may be due to misdiagnosis.
Signs and Symptoms of Borderline Personality Disorder
- An intense drive to avoid abandonment (either real or imagined)
- distorted self-image
- impulsive and sometimes dangerous behaviors (such as reckless driving, excessive spending, or unsafe sexual relationships)
- inappropriate or intense anger (often uncontrollable)
- self-harm or suicidal behavior
- long-lasting periods of depression, anxiety, or irritability
- constant feelings of emptiness or boredom
- inappropriate feelings of shame or guilt
- unstable interpersonal relationships (often these will switch quickly between idolization and devaluation)
- dissociated feelings (feeling as though one is on the outside of the body looking in)
- antisocial behavior or social isolation
Some of the more commonly seen symptoms of Borderline Personality Disorder are a lack of self-worth or poor self-image, impulsive behaviors that lead to a feeling of guilt or anger, inability to regulate or control anger which leads to violent verbal or physical outbursts, and instability in personal relationships.
From the viewpoint of someone who has lived with this disorder all of their life, the symptoms can be put simply. It is a constant battle between having a sense that one is less than the rest of society or not worthy of happiness or love and trying to make up for this by going above and beyond to make a good impression or hang on to those we think are just one instance away from leaving us in the dust. In some cases, we can trick ourselves into thinking that even minimal rejection means that a person is no longer interested as us in a friend or love interest, or that they are out to get us or fool us in some way. These feelings can lead to impulsive or suicidal behavior on some days. On others, it can lead to a sense of “why bother” that ends up in reckless behavior or even anger at the rest of the world for (often imagined) feelings of being an outcast or loser. In all, it can just be downright exhausting. We try to do the right thing but our brains just aren’t wired in a way that makes this easy for us.
For some, there may be a knowledge that there is a dysfunction in our thoughts or actions. For other, there can be no realization that the things we imagine aren’t exactly real or that there is an issue with our way of going about life. I have been on both sides of this. When I was first diagnosed it wasn’t exactly explained to me what Borderline Personality Disorder was. It was just more of a “you have this take these” kind of thing. Now that I am older and have made a habit of reading as much as I can to help my daughter I have learned a great deal about myself and my disorder. I have also had the benefit of a few fantastic therapists who have helped me to understand the error in my train of thought sometimes. For a very long time, I just thought that everything was “normal”. That I was just this monster who wasn’t deserving of a good life because I was angry or ugly or whatever else I wanted to use to put myself down any particular day. Of course, I still have rough days and negative self-talk but I have worked very hard through mindfulness to really analyze my thoughts and stop them before they get too far out of hand.
The Causes of Borderline Personality Disorder
There are three main factors that are believed to contribute to a diagnosis of Borderline Personality Disorder. An individual may have one factor or any combination of the three. Many experts believe as well that certain childhood experiences such as trauma, abuse (physical, emotional, or sexual), or neglect play a role in the development of Borderline Personality Disorder.
Brain Function: Scans of the brains of individuals with and without Borderline Personality Disorder have show that there is an increase in structural changes in individuals with BPD. Many of these changes involve the areas of the brain that help us to regulate emotion, impulsivity, and aggression.
Genetic Factors: Although there has yet to be a gene or gene profile linked to the development of Borderline Personality Disorder there does seem to be a strong hereditary link. Individuals in families with a history of BPD or other mental illness appear to have a higher likelihood of developing the disorder.
Environmental Factors: Children who are exposed to a hostile family life or who have suffered a traumatic event are more likely to develop BPD than those who have not. This could take the form of abuse, neglect or the emotional or physical separation of a child from their parents.
Living on the Borderline
It is an unfortunate error that this disorder has been named Borderline Personality Disorder. This unusual and mysterious name has given the condition a much more ominous feel than it deserves. It brings up images of an individual on the border of insanity, ready to snap into a dangerous beast at any moment. While many of us do deal with anger and instability this couldn’t be further from the true meaning of the name.
In the early years of the diagnosis, it was believed that individuals with this disorder were on the border of both psychosis and neurosis. Psychosis is a severe form of mental disorder in which thoughts are so dysfunctional that they lose touch with reality. Neurosis, on the other hand, is more or less a very extreme form of anxiety or obsession.
To an extent, this is a fair description of our disorder. Indeed those with Borderline Personality Disorder can deal with dissociative instances in which they feel as though they are someone else looking in on their life. As well, those with this disorder deal with a high level of anxiety due to a variety of symptoms such as self-loathing, guilt, and many others. It is important to note, however, that in Borderline Personality Disorder the anxiety experienced is not related to or caused by any other factors but more of an underlying problem.
Dissociation is defined as a wide array of experiences from mild detachment from immediate surroundings (such as daydreaming) to more severe detachment from physical and emotional experiences. It may or may not be accompanied by amnesia.
Supporting Your Loved One With Borderline Personality Disorder
Relationships that involve an individual with Borderline Personality Disorder are definitely not easy. With a little work and a lot of patience, however, they are very doable! Most importantly, make sure that you understand that you are dealing with an individual with a disorder rather than the disorder itself.
Often, we think of things such as Autism as being on a spectrum. As an Autism mom, I am very familiar with mental health spectrums. However, it is important to understand that ALL mental illness is on a spectrum. Regardless of diagnosis, no individual with a mental illness will be an exact textbook representation of that diagnosis. We all experience things differently and have different external factors in our lives. We also each have an individualized brain chemistry. Although they are made of the same components, one individual may have a little less of one neurotransmitter and more of another. Another individual may have the exact opposite or completely different levels of each.
Don’t Take it Personally: When in a relationship with someone who has Borderline Personality Disorder it is important to not take things too personally. There will be instances where we will say things out of hurt (real or imagined), jealousy, or other emotions that we can’t completely control. Although it may be frustrating, and even hurtful, it will be helpful to give everything time to cool down without reacting. Of course, this isn’t to say that it is ok for anyone to be abusive, mean, or violent with others. If things get out of hand it is important to remove yourself from the situation and return when cooler heads prevail.
A Little Goes A Long Way: Taking a few moments to show your love or care for someone with Borderline Personality Disorder can go a long way. For many of us, there is a constant underlying feeling that we are unworthy or undeserving of love. We feel that we are replaceable or easily cast aside. Although these feelings may be hard for someone who doesn’t suffer from this type of mental illness to understand, they can be very damaging to any relationship we are in. Showing us that we are important to you through a few simple words or a kind gesture every now and then can help to solidify a relationship and keep negative thoughts at bay.
Accepting An Apology: While it may not make everything ok it is important to know that apologies are often important to those of us living with Borderline Personality Disorder. Often, we will feel guilty after having an outburst and saying or doing something irrational because of our heightened emotional state. This guilt can be unbearable as our disorder can cause us to magnify it to levels that make not only the act improper but our very being. Of course, some acts truly are unforgivable. However, for the others at least give the person with BPD a chance to get their apology out. From there you can decide what to do with it.
Understanding But Not Enabling: Much like with Bipolar Disorder it is important to understand the difference between understanding and enabling. Those of us who deal with issues in emotional regulation and impulse control do need individuals in our lives that understand that at times we are unable to control the way we think or act in the heat of the moment. However, it is just as important that we do not have individuals in our lives that will take advantage of this impulsiveness or allow us to put ourselves into dangerous situations.
Knowing When to Say No: Another one that I discussed in regards to Bipolar Disorder that has even more importance with BPD. While every individual with mental illness deserves love and compassion from others there are some personalities that simply will not work well together. Even as someone with mental illness myself there are individuals that I have had to remove from my life because I realized that they were simply toxic people to me. Any time that a relationship becomes verbally, physically, or emotionally abusive it is important to recognize and deal with the issue. Mental illness is never an excuse to be abusive or to allow yourself to be abused by others.
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If you have anything you would like to add about living with Borderline Personality Disorder or managing a relationship with someone who has Borderline Personality Disorder be sure to leave us a comment! We would love to hear your take on things. Be sure to join us next Monday as we take a look at another mental health topic.