Borderline personality disorder (BPD) can be challenging to understand and often accompanies various unhelpful stigmas. For that reason, it may be beneficial for those looking to understand borderline personality to examine the DSM-5, the current diagnostic manual for mental health conditions, including BPD.
Why Is The Word "Borderline" Used In BPD?
The term "borderline" in BPD was an early name given to the disorder as it was understood when it was first outlined in 1938. People with borderline personalities were thought to be on the "borderline" of neurosis and schizophrenia, and the two conditions were linked.
However, since the 1970s, further investigation into BPD has revealed that this old name may be inadequate to describe the condition. Although the label is still used in the DSM-5, a debate continues in the psychiatric community about whether a renaming would be appropriate. If you or someone you love has been diagnosed with BPD, know that the term "borderline" is purely for diagnostic purposes and does not necessarily describe your personality or who you are as a person.
What Is A Personality Disorder?
Borderline personality disorder is a cluster B disorder in the DSM-5. As a personality disorder, the traits and behaviors accompanying BPD are often rooted in the personality. About 30% of those seeking mental healthcare have one or more personality disorders, which can be challenging to cope with.
Someone with a personality disorder may have problems with their self-concept and trouble relating to others healthily. Anyone could have thoughts or behaviors that typify a personality disorder. However, if these behaviors only happen once or rarely, they might not fit the diagnostic criteria. Personality disorders are long-term, persistent, and challenging conditions that might cause marked functioning difficulties in relationships.
Symptoms Of Borderline Personality Disorder
Borderline personality disorder is one of the ten listed personality disorders in the DSM-5. Two common symptoms associated with BPD are an unstable sense of self and dysfunctional interpersonal relationships. Both components of the condition may show up in thoughts and behaviors. Below are further examinations of these symptoms.
Unstable Sense Of Self
People with BPD might not see themselves as others do, and their self-concept might be distorted and negative. They might have periods of high self-confidence followed by periods of low self-esteem, which occur within proximity to each other. These changes in opinion and esteem can also be directed at other people, which may be called "splitting."
Difficulty With Self-Direction
If you are living with borderline personality disorder, you might have trouble making concrete plans and following through with them. Your career path might involve false starts and lengthy detours, or you may let others determine your life course.
Impulsive And Self-Damaging Behaviors
Dangerous behaviors and risk-taking are symptoms of BPD. An individual living with this condition might drive recklessly, go on wild spending sprees, have unprotected sex, use substances, binge eat, or impulsively take part in any other dangerous behavior. They may also threaten harm, attempt suicide, or engage in self-harm.
If you are experiencing suicidal thoughts or urges, call the 988 Suicide & Crisis Lifeline at 988 or text 988 to talk to a crisis provider over SMS. They are available 24/7 to offer support. 988 also offers an online chat for those with an internet connection.
If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.
Intense And Rapidly Changing Moods
Unlike some mental health conditions, borderline personality disorder can feature intense moods that can change within the hour or the same day. Many people with BPD may also experience anxiety, depression, and co-occurring mental illness.
Feelings Of Emptiness Or Anger
A pervasive feeling of emptiness often occurs with BPD, and secondary anger can also occur if one isn't in touch with their emotions. This type of anger may be difficult to control and impact those around them. For people with BPD, anger might arise in situations that others may see as "trivial" or "unimportant."
Paranoid Thoughts When Stressed
Paranoia might occur with BPD and often occurs when an individual is stressed. Stress can be common due to poor self-esteem, interpersonal challenges, profound emotions, and intense desires.
As borderline personality disorder is often caused by trauma in childhood, symptoms related to a prolonged fight or flight response or traumatic memories may occur. These memories or experiences can cause dissociation, which might make an individual feel that they are "out of their body" or that they or others around them are "not real." Their memories may seem "above them" instead of from their own point of view.
Fear Of Abandonment
People with borderline personality disorder may fear abandonment to such a degree that they feel desperate or panicked in trying to avoid it. Efforts to avoid abandonment may lead to abandonment, potentially perpetuating a cycle. A few behaviors that might be connected to this fear could include the following:
- Checking a partner's phone or computer
- Sending hundreds of messages when someone doesn't respond
- Asking for constant reassurance that someone won't leave
- Calling someone to check up on them throughout the day
- Breaking up with a person to see if they'll ask you to stay
- Running away to see if someone will come to get you
For someone with BPD, relationships may be intense and unstable. The individual might experience extreme emotions, switching between idealizing it and criticizing the person they're with. In addition, fear of abandonment can lead to anxious attachment or pushing others away to avoid eventual rejection.
Difficulty Managing Anger
Since extreme, sudden, and frequent anger is often a part of borderline personality disorder, those who haven't learned how to control their anger might struggle with anger management. They may get into physical fights to the extent that their actions constitute assault or may notice that they yell at their partners or say phrases they don't mean.
Excessive anger may not be conducive to healthy interpersonal relationships and can lead to a more intense fear of abandonment. Although those with BPD recover from anger quickly, others might not recover from their words or actions as quickly, leading to potential relationship changes.
Misinterpreting Facial Expressions
People with BPD may misinterpret the emotions of others through their facial expressions, seeing unwanted emotions when others don't. The person they interact with may not express any emotion, but the individual with BPD might see sadness, disgust, anger, or fear in that person. Misinterpreting someone else may lead to requests for reassurance or insistence that someone is feeling what they are not feeling, which might lead to anxiety for both people.
What To Do When You Recognize BPD Traits In Yourself
If you suspect you might have BPD or have been told by a partner, friend, or family that your behavior is concerning, consider contacting a therapist. You're not alone, and speaking to someone can allow you to be heard, validated, and supported as you work through your challenges.
Types Of Therapy For Borderline Disorder
Many therapies have been tried for people with BPD, but the two that have proven most effective are cognitive-behavioral therapy (CBT) and dialectic behavior therapy (DBT). Cognitive-behavioral therapy examines your thoughts and helps you replace faulty perceptions with reality-based ones.
DBT uses four modules, including mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness, to help you experience life at the moment, reduce your distress, manage your emotions, and keep your relationships healthy. Developed by a psychologist with BPD, DBT is a therapy specifically made for the symptoms many people with BPD experience. In addition, the therapy can be graduated, allowing you to move forward with a unique set of skills and the knowledge that you could complete the sessions and take control of your symptoms.
What To Do When You Recognize BPD Symptoms In A Loved One
When someone you care about seems to show signs of borderline personality disorder, support them in seeking professional help. However, note that someone may not reach out for help until they're ready, and many people with personality disorders feel shameful about their symptoms. Instead of shaming or blaming someone else, let them know how much you care about them and are concerned about their well-being.
Since a diagnosis is a complex decision based on an objective evaluation, it must be done by a professional. A person must meet borderline personality disorder criteria to get a diagnosis. These criteria are outlined in detail in the DSM-5, and although anyone can read this diagnostic manual, it is used alongside the therapeutic knowledge and educational experience that psychologists and counselors have.
If you know someone with symptoms of BPD who refuses to reach out for help, it may be up to you how to respond. Some people choose to leave relationships that have become unhealthy for them, and it is healthy and normal to break up with someone or leave a friendship if it isn't serving you. However, if you decide to stay in this individual's life, know it isn't your responsibility to treat them, "fix" their problems, or convince them they need support. Each person is responsible for their own healing, so try to focus on yourself as much as possible and ask yourself what you need as you cope.
You might also consider counseling if you're struggling with your relationship with this individual. Talking to a therapist about your experiences and ensuring you also have support can be beneficial. Your therapist can help you learn effective ways to communicate with this individual and move forward if you struggle to do so.
Many forms of counseling are effective for BPD or the loved ones of a person with this condition. However, for many people experiencing a mental health challenge, it can be difficult to leave home or seek support in an area with limited options for personality disorder care. In these cases, speaking to a specialist in personality disorders may be more convenient online.
Studies have found that online counseling is effective in treating the symptoms of personality disorders, anxiety, and depression. Online therapy may also allow you to control your treatment, allowing you to choose between phone, video, or live chat sessions. The counselor may use one or more proven effective techniques, including DBT or CBT. One study found that online DBT was more effective than in-person DBT for many people with BPD, with more people staying in the intervention until the end of treatment.
If you're interested in receiving support from an expert in personality disorder treatment, consider talking to a therapist through a platform like BetterHelp for individuals or Regain for couples. Both platforms offer flexibility to thousands of therapists, and the option to specify your therapy needs when you sign up.
Some commonly asked questions on this topic can be found below:
What are the 9 criteria for BPD?
What can BPD be mistaken for?
Can you self diagnose yourself with BPD?
What does being borderline feel like?
Do I have BPD or am I just sensitive?
What does a BPD episode look like?
What is a favorite person BPD?
What famous person has borderline personality disorder?
Who famous has BPD?
Do borderlines cry a lot?
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