“I don't know what it's like to not have deep emotions, even when I feel nothing, I feel it completely." - A.R. Asher
Borderline Personality Disorder (BPD) is a disorder of the mind which impacts the way a person thinks about themselves and others which results in problems in functioning during their everyday life. Many of the problems include issues in self-image, difficulty in managing behavior and emotions, and a recurring pattern of unstable relationships.
People with BPD have a crippling fear of instability and/or abandonment, and may have difficulty tolerating being alone, but at the same time push away other people due to impulsiveness, frequent mood swings, and misplaced anger even though they want their relationships to last.
Symptoms
BPD mainly affects how a person feels about themselves, how they behave, and how they relate to others. The major signs and symptoms are:
Intense fear of being abandoned may cause them to take drastic steps to avoid real or perceived separation.
A pattern of unstable relationships which are very intense in which they may idealize their significant other one moment, and think they are uncaring the next moment.
Paranoia is related to stress, and losing contact with reality which may last from a few minutes to a few hours.
Constant changes in their own goals, and self-identity include changing, or shifting their values and goals, and perceiving themselves as bad or non-existent.
Very risky and impulsive behavior, for example, reckless driving, gambling, substance abuse, or sabotaging their success by ending a good relationship or leaving a successful job suddenly.
Threats of suicide and/or self-harming in response to being rejected or the fear of separation.
Ongoing or recurring feelings of emptiness.
Unpredictable and intense mood swings can last from a few hours to a few days, these mood swings may include irritability, happiness, anxiety, and shame.
Misplaced or inappropriate anger and losing temper frequently, being sarcastic or bitter the whole time, and getting into physical altercations.
Causes
Like most other mental disorders, the causes of BPD aren’t exactly understood. BPD may be connected to:
Genetics: Studies conducted of families and twins suggest that certain personality disorders are inherited, or heavily connected with other mental disorders among the various family members.
Brain abnormalities: Research has shown that the brain shows changes in certain areas involved in the regulation of emotions, aggression, and impulsivity. Additionally, certain brain chemicals such as serotonin which help regulate mood, may not function properly.
Environmental Factors: Factors surrounding the person's environment during their growth can contribute to the development of BPD. Many people diagnosed with it have a history of parental neglect, child abuse, etc.
Complications
BPD is a mental illness that can damage many aspects of your life which includes your close relationships, school life, jobs, social life, and self-image which would result in:
Not being able to complete their education.
Self-harming such as burning or cutting, and being hospitalized frequently.
Constant changing, or being fired from jobs.
Getting into various legal issues, such as going to jail.
Being involved in abusive relationships.
Relationships filled with conflict, stress from marriage, and divorce.
Sexually transmitted diseases, vehicle accidents, physical fights, or unplanned pregnancies.
Attempt to suicide or suicide itself
Additionally, it is possible to develop other mental health disorders such as:
Substance abuse
Eating disorders
Anxiety disorders
Depression
Bipolar disorder
Attention-deficit/hyperactivity disorder (ADHD)
Post-traumatic stress disorder (PTSD)
Other personality disorders
Risk Factors
Certain factors which are related to personality development may increase the risk of developing BPD. Some of those include:
Stressful childhood: Many people diagnosed with BPD report that they have been abused physically, or were neglected during their childhood. Some of them even say that they were separated from their parents at a young age, or their parents had substance abuse problems. Multiple others have faced unstable family relationships, or hostile conflict in their close relationships.
Hereditary predisposition: A person would be at higher risk of developing BPD if they have close relatives like mother, father, sister, or brother who is also diagnosed with the same or similar disorder.
Treatment
There are multiple forms of treatment for Borderline-Personality Disorder, these are:
Psychotherapy
Psychotherapy is one of the major ways of treating BPD. Mental health professionals may suggest one of the major types of therapies which are:
Cognitive behavior therapy helps to identify, and to change beliefs, inaccurate perceptions a person may have about themselves or others, and behaviors that are unhealthy.
Dialectical Behavior Therapy teaches the person how to be aware of, recognize and accept their behaviors and beliefs. The mental health professional will also teach them to respond healthily to these behaviors.
Schema-focused therapy helps the affected person to view the world positively.
Mentalization-based therapy (MBT) is a talk therapy that helps people in identifying their thoughts and feelings at any given point in time, and to create an alternative perspective on the issue.
Transference-focused psychotherapy (TFP), also known as psychodynamic psychotherapy aims to help people understand their interpersonal difficulties and emotions through developing relationships between the person and the therapist. These insights are then applied in real-life situations.
Systems training for emotional predictability and problem-solving (STEPPS) is a treatment that usually lasts 20 weeks, and it involves working in groups that incorporate the affected person’s friends, family members, significant others, or caregivers into the treatment. It is used in addition to other forms of treatment.
The psychiatric management approach to treatment is a treatment that depends on case management and being able to anchor the treatment in expectation of school or work participation. This focuses on being able to make sense of emotionally tough moments by considering interpersonal contexts for the feelings. This may involve or integrate medications, family education, group and individual therapy.
Medication
Medication does not cure BPD completely but it does help in relieving the symptoms. Mental health professionals may prescribe medication along with psychotherapy. They may prescribe:
Antidepressants for depression.
Anti Anxiety Medication for anxiety.
Antipsychotics to treat symptoms of aggression.
In extreme cases, your doctor may also recommend that you get hospitalized for treatment, or for exhibiting suicidal thoughts and behaviors, or for engaging in self-harm.
Alternative Therapy
Certain people take products that contain Omega-3 fatty acids as it is said this reduces symptoms of aggression and depression in people. It should be noted that there is not enough research to confirm that Omega-3 fatty acids are beneficial in curing symptoms of aggression and depression.
Conclusion
Borderline personality disorder develops around early adulthood. It is usually at its peak in young adulthood, but it may get better as the person gets older. If a person gets diagnosed with BPD, they should not get discouraged as it is treatable. Many people with BPD have gotten better over time with appropriate treatment, and they have gone to lead very fulfilling lives.
References
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