Understanding the Signs of Borderline Personality Disorder
Understanding the signs of borderline personality disorder
Borderline personality disorder (BPD) is a serious personality disorder that causes intense mood swings, severe problems with self-worth, and impulsive behaviors. The main feature of this disorder is a pervasive pattern of instability in interpersonal relationships, self-image, and emotions. The significant emotional instability associated with this disorder can lead to a number of other stressful emotional, cognitive, and behavioral problems. Men and women with borderline personality disorder tend to have severely distorted images of themselves; they feel worthless and terribly flawed. Due to the anger, impulsiveness, and frequent mood swings exhibited, individuals with this disorder often push others away, even if they desire long-lasting relationships.
Mostly occurring in early adulthood, those with BPD will make frantic efforts to avoid any real or imagined abandonment. Any perceptions that may suggest impeding separation or rejection, or the loss of external structure, can cause an individual to have prevailing changes in self-image, affect, cognition, and behavior. Due to their intense fear of abandonment, people with BPD have a pattern of unstable and intense relationships; often idolizing caregivers or lovers, demanding to spend a lot of time with them, and sharing their most intimate details early in the relationship. However, they may quickly (and without warning) switch from idealizing that person to devaluing them, feeling that the other person doesn’t give enough or is not there for them enough.
Identity disturbances are extremely common for those who have borderline personality disorder, and are marked by an unstable self-image and sense of self. People who struggle with BPD experience sudden and dramatic changes in self-image, including rapidly shifting goals, values, and vocational ambitions. In addition to an unstable self-image, these individuals experience impulsivity in at least two different areas of their lives that put them in danger of potential harm. They may engage in a variety of risky behaviors such as substance abuse, spending recklessly, or binge eating. They may tend to display recurrent suicidal behaviors or threats and, in some cases, these may be accompanied by non-suicidal self-mutilation.
Maybe someone exhibits the signs of BPD but is not aware of the symptoms or actively decides not to seek treatment. Over the course of this person’s life, he or she might experience the following:
Relationship Troubles
People with BPD have a black-and-white view of the world: Things (and people) are either good or bad, and how someone with BPD is feeling can change almost instantly. (1) Relationships in particular can be problematic. Hooper says people with BPD commonly have a love-hate approach to others. One day, a person with BPD might view their partner, friend, or family member as the best person in the world. The next day, he or she might do a 180 and decide that that “best person in the world” is now the worst.
Some of this can be traced back to the fact that people with BPD tend to fear abandonment. For instance, they might cut off communication with a loved one if they feel they’re at risk of being left behind. (1)
This, of course, can lead to lots of interpersonal conflict and chronic difficulties with relationships, Ackerman says. Hence relationship turmoil, divorce, and trouble maintaining positive relationships with family and friends can be common among people suffering from BPD. (2)
Job Loss
These interpersonal conflicts can also affect someone’s ability to maintain a steady job, especially if they take that love-hate approach with their boss or coworkers. (2) “Their life is in disarray,” Hooper says. The symptoms of BPD can be severe and debilitating, to the point where being unable to regulate emotions can “almost certainly wreck their life,” Hooper says. “What you begin to see is a life described as instability.”
But that doesn’t mean everyone with BPD will fall into this camp. “There are some people with BPD who function quite well,” Ackerman says. “I wouldn’t say the diagnosis alone means someone might not be able to hold a job or get married if they wanted to.” (For example, Dr. Linehan, mentioned above for her pioneering work in treatment of BPD, has acknowledged having BPD herself.) But should the relationship problems be severe, job loss could be the ultimate result.
Hospitalizations Due to Self-Harm
Many people with BPD harm themselves, such as by cutting, to try to deal with their overwhelming feelings. (1) Some may even attempt to take their own lives.
Suicide attempts are so common among people with BPD that they are considered a symptom of the disorder. Up to 10 percent of the people who qualify for having BPD die by suicide, which is 50 times the rate of the population as a whole. (7)
Generally, this self-destructive behavior starts up when a person’s mood is down. “That’s where the self-mutilation comes in, the really impulsive behavior comes in,” Hooper says. Suicidal thoughts that become overwhelming may lead a person with BPD to seek help through hospitalization or by entering an inpatient treatment center, according to a study. (8)
Often, this kind of behavior serves as a wake-up call for the person suffering. “For a lot of clients, the suicide attempt scares them, and it wakes them up to how threatening this is to their life,” Hooper says.
Borderline personality disorder is often misunderstood. It’s time to change that.
Borderline personality disorder — sometimes known as emotionally unstable personality disorder — is a personality disorder which affects how you think and feel about yourself and others.
People with borderline personality disorder (BPD) often have a strong fear of abandonment, struggle to maintain healthy relationships, have very intense emotions, act impulsively, and may even experience paranoia and dissociation.
It can be a scary illness to live with, which is why it’s so important that people with BPD are surrounded by people who can understand and support them. But it’s also an incredibly stigmatized illness.
Due to an abundant of misconceptions around it, many people with the disorder feel scared to speak out about living with it.
But we want to change that.
That’s why I reached out and asked people with BPD to tell us what they want other people to know about living with the condition. Here are seven of their powerful responses.
1. ‘We’re scared you’re going to leave, even when things are good. And we hate it too.’
One of the biggest symptoms of BPD is fear of abandonment and this can occur even when things in the relationship seem to be going well.
There’s this pervasive fear that people will leave us, or that we aren’t good enough for that person — and even if it seems irrational to others, it can feel very real to the person who’s struggling.
Someone with BPD would do anything to stop that from happening, which is why they may come across as being “clingy” or “needy.” Though it can be difficult to empathize with, remember that it stems from a place of fear, which can be incredibly hard to live with.
2. ‘It feels like going through life with third-degree emotional burns; everything is hot and painful to touch.’
This person says it exactly right — people with BPD have very intense emotions that can last from a few hours to even a few days, and can change very quickly.
For example, we can go from feeling very happy to suddenly feeling very low and sad. Sometimes having BPD is like walking on eggshells around yourself — we never know which way our mood is going to go, and sometimes it’s hard to control.
Even if we seem “overly-sensitive,” remember that it’s not always within our control.
3. ‘Everything is felt more intensely: good, bad, or otherwise. Our reaction to such feelings may seem out of proportion, but it’s appropriate in our minds.’
Having BPD can be very intense, as though we’re vacillating between extremes. This can be exhausting for both us and for the people around us.
But it’s important to remember that everything the person with BPD is thinking is more than appropriate in their mind at that time. So please don’t tell us we’re being silly or make us feel as though our feelings aren’t valid.
It may take them time to reflect on our thoughts — but in the moment things can feel scary as hell. This means not judging and giving space and time where it’s warranted.
4. ‘I don’t have multiple personalities.’
Due to it being a personality disorder, BPD is often confused with someone having dissociative identity disorder, where people develop multiple personalities.
But this isn’t the case at all. People with BPD don’t have more than one personality. BPD is a personality disorder in which you have difficulties with how you think and feel about yourself and other people, and are having problems in your life as a result of this.
That doesn’t mean that dissociative identity disorder should be stigmatized, either, but it certainly shouldn’t be confused with another disorder.
5. ‘We aren’t dangerous or manipulative… [we] just need a little bit of extra love.’
There’s still a huge stigma surrounding BPD. Many people still believe that those living with it can be manipulative or dangerous due to their symptoms.
While this can be the case in a very small minority of people, most people with BPD are just struggling with their sense of self and their relationships.
It’s important to note that we’re not dangerous people. In fact, people with mental illness are more likely to harm themselves than they are others.
6. ‘It’s exhausting and frustrating. And it’s really hard to find quality, affordable treatment.’
Many people with BPD are untreated, but not because they’re unwilling. It’s because this mental illness isn’t treated like many others.
For one, BPD isn’t treated with medication. It can only be treated with therapy, such as dialectical behavioral therapy (DBT) and cognitive behavioral therapy (CBT). There are no drugs known to be effective for treating BPD (though sometimes medications are used off-label to relieve symptoms).
It’s also true that due to stigma, some clinicians assume people with BPD will be difficult patients, and as such, it can be difficult to find effective treatment.
Many people with BPD can benefit from intensive DBT programs, but these aren’t the easiest to access. Which is to say, if someone with BPD isn’t “getting better,” don’t be quick to blame them — getting help is hard enough on its own.
7. ‘We aren’t unlovable and we love big.’
People with BPD have a lot of love to give, so much that it can be overwhelming.
Relationships can feel like a whirlwind at times, because when someone with BPD — especially those grappling with chronic feelings of emptiness or loneliness — makes a real connection, the rush can be just as intense as any other emotion they experience.
This can make being in a relationship with someone with BPD difficult, but it also means that this is a person that has so much love to offer. They just want to know that their feelings are returned, and may need a little more reassurance to ensure that the relationship is still fulfilling for you both.
If you’re in a relationship or have a loved one with BPD, it’s important to do your research into the condition, and be wary of the stereotypes you may come across
Chances are, if you read something about borderline personality disorder that you wouldn’t want said about you, a person with BPD won’t benefit from having that assumed about them, either.
Working to gain a compassionate understanding of what they’re going through, and how you can help both your loved one and yourself cope, can make or break a relationship.
If you feel like you need some extra support, open up to someone about how you’re feeling — bonus points if it’s a therapist or clinician! — so they can offer you some support and tips on how to improve your own mental well-being.
Remember, the best support for your loved one comes from taking the best possible care of you.
Hattie Gladwell is a mental health journalist, author, and advocate. She writes about mental illness in hopes of diminishing the stigma and to encourage others to speak out.
