Borderline Personality Disorder

Borderline Personality Disorder

Borderline personality disorder (BPD) is a mental illness characterized by difficulty regulating emotions, leading to mood swings, tumultuous relationships, and impulsivity. The causes are unknown, as is its exact prevalence in the United States. It is estimated that between 1.6% and 5.9% of American adults suffer from BPD.

It took decades in the psychiatric world for borderline personality disorder to be considered a mental illness of its own. Before it was recognized in the DSM-III in 1980, it was considered on the borderline of other mental illnesses, which is how it got its name.

What is Borderline Personality Disorder (BPD)?

In order to understand BPD a bit better, we need to first discuss what exactly constitutes a personality disorder.

Personality disorder or mood disorder?

Mood disorders, such as depression and bipolar disorder, are characterized solely by the impact they have on a person’s emotions. For example, someone suffering from depression will exhibit symptoms related directly to their mood. While this may affect how they interact with others, when not experiencing a depressive episode, they are able to relate and socialize as normal.

Personality disorders, on the other hand, are characterized by behavioral, social, and cognitive symptoms in addition to emotional symptoms. Individuals suffering from personality disorders often also suffer from co-occurring mood disorders.

Borderline personality disorder fits into the latter. While people suffering from BPD generally suffer from depression at some level, their symptoms go beyond those of the mood disorder.

Borderline personality disorder vs bipolar disorder

There is a common misunderstanding that BPD is the same or similar to bipolar disorder. Someone suffering from BPD may also suffer from bipolar disorder, but they are two very different illnesses. Bipolar disorder is strictly a mood disorder.

Furthermore, while someone suffering from bipolar disorder will cycle between highs and lows, each episode will last weeks at a time and are very different to mood swings. Sufferers of BPD tend to experience mood swings, in that they may feel good at one moment before swinging to a state of anger or depression or vice versa.

Symptoms of BPD

Many of the symptoms of BPD are related to a difficulty regulating emotions. Unlike others, who may experience strong emotions from time to time, the emotions of someone with BPD will spiral to extremes more often than not. They are therefore likely to:

  • experience regular mood swings
  • suffer from chronic boredom or emptiness
  • feel and act on uncontrollable anger
  • act impulsively
  • dissociate – feeling disconnected from themselves and the real world
  • self-harm
  • threaten suicide
  • attempt suicide

Sufferers of BPD also experience symptoms of great insecurity in their personal and social lives. They may struggle with:

  • feelings of worthlessness
  • intense fear of abandonment
  • cycle between feelings of love and hate for friends, lovers, and family members
  • distorted and unstable self-image

These symptoms include and lead to a range of unhealthy behaviors. Individuals with BPD struggle to maintain a sense of control or balance in their lives, and often land up creating self-fulfilled prophecies. They may sabotage their own relationships, as well as create conflict or problems with their jobs or career opportunities.

Some sufferers of BPD attempt suicide unsuccessfully multiple times. This may be because they don’t know how else to ask for help or ensure their loved ones don’t leave them. That does not mean those around them should not take their suicide attempts seriosuly. It is not a matter of gratuitously wanting attention.

On the other hand, loved ones of people with BPD often struggle to find a balance between supporting their loved one and enabling destructive behavior. They come up against a catch-22 of appearing to confirm their loved one’s fears or acting in a way that only bolsters their unhealthy relationships. For this reason, family should be included in treatment.

How we treat Borderline Personality Disorder

Borderline personality disorder can lead to a lot of pain and distress, but it can be treated successfully with medication, therapy, and lifestyle modifications.

Medication

There is no specific medication designated for treating BPD. Rather, antidepressants and mood stabilizers help reduce the symptoms of depression and mood swings. These medications are generally prescribed on a chronic basis and help the individual regulate their emotions.

Therapy

As with most mental illnesses, individual therapy is very helpful and effective in treating symptoms of BPD. In the case of BPD, specific therapies work better than others. For a long time, cognitive-behavioral therapy (CBT) was the first port of call for treatment of BPD. CBT trains patients to identify and challenge distorted thinking, as well as separating emotions from fact.

More recently, dialectical behavioral therapy (DBT) has emerged as a particularly effective treatment for BPD. DBT training includes aspects of CBT, with reality testing especially important in challenging distorted thinking. However, the program is structured around a core of mindfulness. Mindfulness techniques are incredibly helpful in learning to regulate one’s emotions before they spiral out of control.

Techniques such as body scans give individuals practical, grounded methods to check in with their feelings. By simply monitoring their emotions, without trying to change them, the emotions diminish in power on their own. Instead of becoming unmanageable, they come and go without major consequence.

DBT is also commonly taught in group therapy. Group therapy is a crucial aspect of treating borderline personality disorder, as individuals are able to practice better interpersonal skills with others in a safe space.

Finally, family therapy may be a necessary treatment module, as an individual may struggle to go back into a previously unhealthy environment. Furthermore, families often struggle to find the right balance in supporting their loved one with BPD.

Lifestyle Modifications

Exercise and diet are very important for people with borderline personality disorder. A healthy, balanced life is necessary in order for someone to maintain mental health. When feeling unwell physically, a person’s emotions can more easily begin to spiral.

Outcomes

Borderline personality disorder is a very treatable condition. At Gooden Treatment Center we expect the best possible outcomes for our patients. With the right medication and therapy, as well as guidance for continued care, we see people with borderline personality disorder successfully learn to navigate their lives every day.

If you or a loved one may be suffering from borderline personality disorder, contact Gooden Wellness Center today to start your journey to better mental health.

References:

  1. National Alliance on Mental Illness (NAMI): (Website)
  2. Ripoll L. H. (2013). Psychopharmacologic treatment of borderline personality disorder. Dialogues in clinical neuroscience, 15(2), 213–224.
  3. Davidson K., Norrie J., Tyrer P., Gumley A., Tata P., Murray H., & Palmer S. (2006). The Effectiveness of Cognitive Behavior Therapy for Borderline Personality Disorder: Results from the Borderline Personality Disorder Study of Cognitive Therapy (BOSCOT) Trial. Journal of Personality Disorders: Vol. 20, No. 5, pp. 450-465. (Website)
  4. O’Connell, B. and Dowling, M. (2014), DBT in BPD. J Psychiatr Ment Health Nurs, 21: 518-525. doi:10.1111/jpm.12116