Borderline Personality Disorder or BPD is a mental illness best indicated by an instability in mood, interpersonal relationships, and behaviour.
BPD influences how you perceive yourself, your abilities, appearance, and achievements.
‘Instability’ is key in BPD. An indication of this is that you have trouble regulating your emotions and it interferes with your relationships with your family and friends. This can be seen by either an intense attachment and idealization of someone or experiencing the complete opposite towards the person post separation or conflict. These changes in how you feel can be so drastic that when on one end of the spectrum, you can’t remember feeling any other way. These negative emotions towards other people often arise from a ‘fear of abandonment’ which can be a result of difficulties feeling emotionally connected to people, especially with physical distance.
Impulsive behaviour is a key symptom of BPD, such as substance abuse, reckless driving and spending, unsafe sex and binge eating. Sometimes along with symptoms of BPD, you can experience symptoms of other mental conditions or even another disorder entirely in addition to BPD. Some of these include anxiety disorders, depression, eating disorders and substance abuse. Many times, people suffering from BPD don’t even know it. Some write it off as mood swings and others have no idea their symptoms are recognised and treated as a mental health disorder.
There is no specific method of testing for BPD and so it is usually diagnosed by a mental health professional after interacting with you. They can sometimes conduct a comprehensive clinical interview that includes talking to previous clinicians, reviewing previous medical evaluations and even talking to your family and friends. This process can be quite extensive and therefore the diagnosis of BPD usually takes some time. This can also be attributed to the fact that the symptoms of BPD can often overlap with other mental health conditions and just periods of high stress.
According to the National Institute of Mental Health, BPD tends to be more common in females than in males and accounts for 20 percent of psychiatric hospitalisations.
While there has been no mention of a direct cause of borderline personality disorder, both environmental and genetic factors are said to play a role in its occurrence. Some common environmental factors are emotional, physical or sexual abuse. Unresolved feelings of fear or anger in one’s childhood later results in distorted thinking patterns which is a chief characteristic of BPD. One’s family also plays an important role in the causation of BPD such as being neglected by one or both parents or being exposed to chronic fear or stress because of family issues.
The National Institute of Mental Health also states that there is an apparent predisposition for BPD and therefore symptoms and traits of BPD are much more common among people who have close biological relatives with BPD.
BPD is most commonly treated through psychotherapy along with medication. Psychotherapy is especially effective with group, peer and family support. Psychotherapy includes Dialectical Behavioural Therapy (DBT), Metallisation Based Therapy (MBT), Cognitive Behavioural Therapy (CBT), Dynamic Deconstructive Psychotherapy (DDP) and the Dissociative and Conversational Model for Borderline Personality Disorder.
DBT uses techniques of mindfulness while ‘being aware’ of your current situation and emotional state. MBT helps with rationalising your thoughts, values, and beliefs and linking these to your actions and behaviour. Lastly, CBT helps identify your core beliefs and behaviours that underlie your perception of yourself and others and encourages you to create necessary changes.
Psychiatric treatment is often prescribed based on specific symptoms and alleviating those. Antidepressants or mood stabilizers will help with depressive symptoms and antipsychotic drugs are used with distortions in thinking patterns. Sometimes in times of heightened stress, hospitalization of individuals suffering from BPD is necessary to prevent their suicidal behaviour and ensure their safety.
While borderline personality disorder can feel extremely overwhelming and frightening, it can be effectively managed. Therapeutic interventions along with medication can help you cope better.
Author: Divina Tejwani