Borderline personality disorder (BPD) is one of the most misunderstood mental illnesses. There are a lot of stigmas and misinformation surrounding it because of how it has been portrayed in movies such as Girl Interrupted. Because of this, how to deal with borderline personality disorder can be quite difficult. There is hope and with hard work, dedication, and the right therapist, if you or someone you know is dealing with this, recovery is possible.
In the following article, I will try to explain BPD from a personal and professional point of view, explain the symptoms and causes of BDP, and finally give you some tips that I have found helpful in my personal life.
What is BPD?
The scary thing about BPD is that even a lot of mental health professionals don’t understand it. I have a bachelors degree in social work and concentrated a lot of my learning on mental illness by doing my thesis on it, and doing my work placement at the Canadian Mental Health Association. After graduation, I became a counsellor in a mental health crisis center for over four years.
With all that experience in the field, even I didn’t truly understand BPD. When I first got diagnosed in 2012, I refused to accept it. When my psychiatrists asked me what BPD was, I said it’s someone that does stuff for attention. I knew that it was more than that, but that was the first thing that came to mind and the same can be said for a lot of professionals.
I was hospitalized in psychiatry when I first received the diagnosis. As soon as that label was attached to me I got treated differently by some of the staff, almost like they weren’t taking me seriously anymore.
Many professionals will see us as difficult, attention-seeking individuals who can’t be treated. Because of this I never really accepted my diagnosis – I kept telling myself I wasn’t “that borderline” that nobody wants to deal with.
Just a few months ago, I finally saw a mental health nurse who truly understood it, and that made me feel like there is hope and that I am not a monster for having BPD. One of the things she told me is that someone with BPD struggles daily because in the end, all they want is for people to like them.
Yes, we have some behaviors that can be hard to deal with, but it’s because we never learned how to process our emotions in a healthy way.
According to the Mayo Clinic, “Borderline personality disorder is a mental health disorder that impacts the way you think and feel about yourself and others, causing problems functioning in everyday life. It includes a pattern of unstable intense relationships, distorted self-image, extreme emotions and impulsiveness”.
One of the reasons we may not understand the illness well could be in the name. What does borderline even mean? In the past, they used this term because the patient was said to be in between a psychosis state and a regular mental illness, but this is not really what it is. In the UK, they have started using the name emotionally unstable personality disorder (EUPD). To me, this new term defines it much better and makes it easier to understand.
How to Recognize BPD
According to the DSM-V, which is what psychiatrists use to make a diagnosis, you must present five of the nine symptoms below:
- Fear of abandonment: because of this fear, a person with BPD will do anything to avoid being abandoned. These clingy behaviors can come across as controlling as the person with BPD may need to know everything their partner does daily. In turn, these behaviors have the opposite effect by pushing them away.
- Intense emotions: strong emotions that can change in the blink of an eye. One moment the person may feel very happy then something happens that most people would simply brush off, and that sends them into a dark hole of sadness or rage.
- No sense of identity: because a person with BPD just wants to be accepted by everyone, they have a tendency to change their behaviors, views, and opinions based on the person they are close to.
- Difficulty maintaining healthy relationships: They will normally fall in love very quickly, but this can dissipate very fast as well.
- Impulsive behaviors: this can include anything such as gambling, over spending, binge eating, and substance abuse.
- Suicidal behaviors and/or self-harm: suicidal behaviors are thoughts of suicide, making suicidal plans or threats, and suicide attempts. Self-harm can include hitting, scratching, cutting, and burning themselves.
- Feeling lonely and empty: they can feel like there is something missing inside to make them feel whole, feeling like they are “nobody”.
- Extreme anger: This rage can seem impossible for them to control. They can throw things, yell and scream, break things, or even hit the person they are angry with.
- Being out of touch with reality: feelings of paranoia or being suspicious of others and their motives. The person may feel like they’re in their own world, or spaced out. They may even feel like they’re outside of their body.
Causes of BPD
As with most mental illnesses, it is hard to pinpoint the actual causes of BPD. Although more women than men are diagnosed with it, it can affect anyone no matter their gender, race, or background. Research shows that it can be a combination of a difficult childhood and biological factors.
Most people who are diagnosed with BPD will have had a traumatic or very difficult childhood, this includes:
- Always being scared or feeling in distress
- Having instabilities within the family, like alcoholism or mental illness
- Sexual or physical abuse
- Physical or emotional neglect
- Death of a parent or abandonment
Tips on How to Cope with BPD
Unlike other mental illnesses, the go-to treatment for BPD is not medication. However, a lot of people with BPD will also experience episodes of depression and anxiety. Natural supplements can be beneficial to treat these symptoms combined with psychotherapy for BPD.
You can also find some of the best tips on anxiety, stress, and depression. These can help you cope with daily stressors in your life that may have a stronger effect on you than other available treatments.
The most renowned treatment for Borderline Personality Disorder is Dialectical Behavioral Therapy (DBT). This treatment combines cognitive and behavioral modification therapy to change negative thoughts and behaviors into something more positive. DBT is designed to help people manage their emotions in a healthier way.
Normally, DBT treatment is composed of a weekly individual session and a weekly group session. During the individual sessions, the therapist will go over the week’s events beginning with any self-harm or suicidal behaviors. As most people with BPD have experienced trauma in their life, a portion of the individual sessions will go towards dealing with post-traumatic stress disorder (PTSD).
During the group sessions, they will be taught skills on how to deal with their illness. There are 4 main modules of skills which are:
- Interpersonal effectiveness
- Distress tolerance
- Emotion regulation
While this therapy is great, the unfortunate circumstances is that there can often be a long waiting list, such is the case for me in New Brunswick, Canada. This leads us to try and find healthy coping mechanisms of our own in the meantime.
Personally, I had to wait a few months to see someone, and I’m not even following the DBT program – I am just getting bi-weekly sessions with a counselor. Because of this I have decided to take matters into my own hands and try to find coping strategies on my own.
- Educate yourself: read articles from professionals or people who have BPD and how they perceive it. Learn about the various DBT skills and try practicing them on your own.
- Define what BPD means to you: of course, you want to read about it from other people’s perspectives, but not everyone is the same. It’s important to for you to pinpoint how BPD affects YOU.
- Embrace it: BPD diagnosis can be hard to accept, it took me 5 years, but once you embrace it, it helps you better understand certain behaviors and actions and learn from them.
- Don’t let it define you: although you want to accept it and learn to deal with it, you are not your illness. Your illness does not define you.
- Think things through: especially when it comes to making decisions, think them through rather than acting on impulse. This can be hard, because all of our lives we have been impulsive, so it really requires you to take a step back and rationalize the decision before making it.
- Keep your mind busy: find something you enjoy doing. If you enjoy writing or drawing, you might want to keep a notebook or sketchbook on you so that you have something to focus your attention on when emotions are running high.
- Talk about it: don’t be afraid to talk about your illness. This can help loved ones understand you better. This can also help you better understand it as you will have to explain to others what BPD means to you.
- Create a safe space: have people around you who understand you and will be there to support you in difficult times.
- Remember, there is hope: it is not true that there is no cure for BPD – with the right treatment, you will get better.
I came across this video on how to deal with extreme emotions while doing my research for this article. I had never seen it before and I find that she gives great tips on how to deal with immediate intense emotions. It also gives a tiny insight on skills that you would learn in DBT.
In the end, borderline personality disorder can be very scary when first diagnosed. However, if you take the time to understand it and work through it, it can make your life much easier. From personal experience, embracing the illness has not only led me to better understand myself but has also allowed me in in the process to build better coping mechanism to try and avoid the negative behaviors.
If you have any questions or comments please leave them below, I will answer as best I can. Also, if you would like to share some of your coping strategies I would love to hear them!