What are good factors to identify if i have borderline personality disorder ?

I have noticed that slowly I’ve started to remember memories from my past that I had forgotten. These are traumatic memories that I start to remember out of no where, one got triggered by eating a certain cookie that was linked to the memory. That along with always feeling I have two sides of myself the one that cares for me and is perceived as mean to the world and the one that is kind to everyone but is always scared of being hurt or abandoned. I also always feel a fear of abandonment and I don’t know how to stay committed because I would rather leave before I’m left. I don’t want to hurt people but always find myself in these situations where I get in a relationship and run. I always feel that I won’t be enough and sometimes I just randomly shut down. I have battled with anorexia and bulimia before and have been diagnosed with severe depression, but I feel that there’s something more. I just know that it’s not normal to be happy and then out of nowhere feel like I’m not enough and then be angry for a reason that wasn’t in context(memories).
Asked by Sol
Answered
12/06/2021

Dear Sol,

 

I can tell from the details in your question that you are already well informed about the characteristics that make up borderline personality disorder (BPD). It is healthy and appropriate to make an educated guess about your own symptoms as you try to better understand what is going on with you. However, I need to start by stressing the importance of not making assumptions or forming any conclusions based on what you’ve read, or on anything I say here. If you are currently under the care of a mental health professional, I strongly encourage you to have this discussion with them.

 

That being said, here is a brief overview of BPD. Your experience is consistent with it, as you are already aware. Its characteristics include rapidly shifting moods, insecurity, fear of abandonment, feelings of worthlessness and guilt, impulsive behavior driven by emotions, irritability, and frequent emotional outbursts. BPD is often associated with severe childhood trauma. Working with a trauma specialist to heal the wounds of the past is often the most effective way to ease BPD symptoms and gain a greater sense of security and stability.

 

Fear of abandonment plays out in several ways. It can mean being excessively dependent on a partner and terrified of losing them. This can lead to clinging and a need for constant reassurance. But there is a flip side to this fear, and you illustrate it perfectly when you say, “I would rather leave before I’m left.” Sometimes it is just too scary to feel like your life, happiness, and security depend on this one person. So people with BPD may want to trust and commit to a relationship, but may find themselves inadvertently sabotaging it and pushing the person away.

 

People with BPD tend to view things in extremes – black or white, all or nothing, good or bad – with a limited ability to see the gray areas that are such a big part of life. Please note, however, that this kind of thinking is by no means limited to those with BPD traits. It seems to be human nature for everyone to get stuck at times in an “either/or” mentality, despite the fact that we live in a complex world where “both/and” is applicable to a far greater range of situations. From my experience, this is one of the most common issues addressed in therapy in general. Being more extreme (and therefore more distressing) is what distinguishes BPD. Because of this commonality, the methods of treatment I describe below are likely to be effective for anyone who struggles with extreme emotions, whether or not they meet the full criteria for a diagnosis of BPD.

 

Before I discuss treatment options, I would like to specifically address a couple of things you say in your message. First, the sudden and vivid memories you describe. That experience is incredibly normal and expected for trauma survivors. The example you give of the cookie is perfect – you might think it sounds weird, but sensory experiences – of taste, smell, and texture – are deeply encoded in memory. This is true for everyone. It’s not uncommon to hear someone remark, for example, that upon smelling a certain perfume, they were instantly transported back to their third-grade classroom. The same thing goes of the smells of cooking in a home, etc.

 

These sensory memories are especially intense when it comes to traumatic experiences. Traumatic memories are encoded in the brain in a different way than average, neutral memories are. When one of them is triggered by a taste or smell, it can literally put your nervous system in the state it was when you were traumatized. This can be terrifying – bringing not only feelings of sadness, but of truly being in danger. The automatic “fight, flight, or freeze” response can lead to anger and aggression, running away, or shutting down.

 

Also, you described “always feeling I have two sides of myself – the one that cares for me and is perceived as mean to the world, and the one that is kind to everyone but is always scared of being hurt or abandoned”. This is also consistent with trauma. Everyone’s personality is made if up different parts in a sense, and this can be especially true for trauma survivors. It sounds like your experiences have taught you that you can either be self-protective and harsh with others, or kind to others and sacrifice yourself. This might have been true at one time when you were in a dangerous situation. Therapy for trauma involves identifying and questioning such beliefs. They might have been useful and helped you survive at one time, but now remain even though they are outdated, only to be harmful in your present life.

 

In addition to therapy that addresses trauma directly, there are other therapeutic models designed to help individuals with BPD increase their ability to manage their emotions and get some relief from the suffering that comes from such extreme fluctuations in mood, self-image, and sense of security in relationships. One is called Dialectical Behavior Therapy (DBT). It shows evidence of decreasing the symptoms of BPD by challenging the extreme, all-or-nothing thinking that characterizes it. The word “dialectical” refers to the concept that two opposing ideas can be true at the same time. Developing the capacity to recognize this and integrate it into one’s thinking and belief system is a huge step toward being able to see all the shades of gray that get lost in black and white thinking.

 

DBT is made up of four main components: distress tolerance, emotion regulation, mindfulness, and interpersonal effectiveness.

 

People with BPD traits feel emotions more strongly. It can be compared to a radio turned up to maximum volume. When an emotion is triggered, it is like turning the radio on. For the “average” person, the volume is set to something mid-range and comfortable, so “on” just means you can year it now; the sound is present. For those with BPD traits, it is more like someone cranked the radio up to maximum volume before you even turned it on. That is jarring. Emotions feel like huge waves rather than being consistent with how triggering they are – some small, some medium, some large.

 

Because this is a factor, a primary goal of DBT is to build distress tolerance skills. This means that you acknowledge that yes – emotions are going to be outsized and upsetting. Before even trying to bring them down to size (emotion regulation) you want to develop your ability to weather the storm, no matter how big it is. Yes, the wave might be huge, but you can learn to not allow it to knock you down. This sometimes involves simple distraction or re-directing of your attention. This is not about suppressing or denying your feelings, it is about acknowledging that they are there and deliberately choosing to focus your attention elsewhere so you can regain your bearings.

 

Mindfulness – People with BPD often describe a sense that their thoughts are spiraling, their minds working so fast that what they are experiencing moment to moment has more to do with the scenarios playing out in their minds that what is actually happening. Mindfulness is the ability to maintain nonjudgmental awareness of the present moment, just as it is. I like to use the word grounding – the sense that I am here, I feel my feet on the ground, what is really going on in this moment?

 

Emotion regulation – While distress tolerance can be compared to increasing one’s ability to tolerate the blare of the radio being turned up to max volume, emotion regulation is more like the ability to turn the volume down, even slightly.

 

Interpersonal effectiveness – Everyone can benefit from improving their communication skills – the ability to listen deeply and express oneself in a way that is both clear and kind. In DBT, these skills augment the other three components, increasing mutual understanding with others.

 

I hope this answer has given you a clearer picture of what BPD looks like and given you some hope that relief from its emotional intensity is possible. If you are not already receiving therapy, I highly recommend that you pursue it. I wish you healing and happiness.

 

Julie

 

 

 

 

(LCSW)