Borderline Personality Disorder

Borderline Personality Disorder

The percentage of people affected or diagnosed with BPD in Australia is 2-6%. Seventy-five percent of these cases are female and generally, it is the result of childhood trauma, however not in every case. For some people, this is a frightening diagnosis, and they frequently struggle to get the mental health services that they need to find some support and stability.

So, what are the traits of BPD?

According to the Diagnostics and Statistical Manual for Mental Disorder DSM-V, there are many factors that impact a person with such a diagnosis. I have provided a set of questions and answers to provide an idea of what someone with BPD might experience.

Inclusion criterion: requires a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, as indicated by at least 5 of the following manifestations. 

Frantic efforts to avoid abandonment!
  • Q:  Do you sense that someone close to you is going to abandon you, do you try frantically to ensure that you are not left alone?
  • A:  You believe that significant people in your life will eventually leave you, you will try to ensure that they don’t by being overly helpful or generous, even if this causes you harm or emotional pain
Unstable interpersonal relationships.
  • Q:  Are most of your close relationships intense and unstable? Do you alternate between feeling as though the people in your life are really good and really bad? Do you expect the worst of people?
  • A:  In some instances, you may have been a needy child, you may require intense emotional and physical validation which can lead to formulating unhealthy relationships with others. If you don’t get what you need from your relationships, you may feel significantly let down and retaliate with negative behaviours. Generally, relationships are passionate and intense.
Identity disturbance
  • Q:  Do you have a very unstable or poorly developed sense of who you are? Do your aspirations, goals, opinions, and values change suddenly and frequently?
  • A:  This is a common trait, people tend to lose focus frequently and are inconsistent in many aspects of their life e.g. they may dress and do their hair and makeup dramatically one day and the next day be mainstream. In some aspects, people who experience these traits feel that they also suffer from Attention Deficit Hyperactivity Disorder. You may lose focus on tasks that were interesting one minute and then bore you the next.
Self-damaging
  • Q:  Do you experience impulsivity in at least two areas that are not suicidal or self-mutilating behaviour? Do you often act on the spur of the moment, without a plan or consideration for the outcome? Do you frequently engage in dangerous, risky, and potentially self-damaging activities without regard to their consequence?
  • A:  In many cases, this includes substance use/abuse which can be risky and self-damaging. Equally, it can involve engaging in sexual relations with unknown people on the spur of the moment or speeding in your car, texting while driving, the list is endless. This usually occurs in the pursuit of feeling something perceived as positive.
Parasuicidal or suicidal behaviour
  • Q:  Do you frequently threaten to harm yourself or even kill yourself? Have you made recurrent attempts to hurt, harm, or kill yourself? 
  • A:  Sadly, this is a common trait in people experiencing BPD, self-harm is commonplace and is a technique used to dissociate from uncomfortable feelings. Suicidal ideation is also common as the emotional irregularity is all-consuming and painful.
Affective instability
  • Q:  Are your emotions easily aroused or intense? Do you often have intense feelings of sadness, annoyance, or worry that usually only last a few hours and never more than a few days? 
  • A:  This occurs most often in relationships where the person is not achieving what they desire. For example, someone not being available when the person would like them to be! The person affected by BPD can exhibit intense anger and/or sadness and feel rejection. They frequently worry about saying the wrong thing and can ruminate for hours over past conversations. These feelings can result in dietary restriction or staying in bed for long periods of time.
Chronic emptiness
  • Q:  Do you chronically feel empty? 
  • A:  This can look like never feeling fulfilled despite having close and loving friendships, having enough money, studying something they are passionate about. A common statement we hear is ‘I don’t know what happiness feels like, I don’t think that I have ever experienced this’!
Transient paranoia or dissociation
  • Q:  At times of stress, do you ever feel like other people are conspiring against you or that you are an outside observer of your own mind, thoughts, feelings, and body? 
  • A:  Often these people feel like observers in their own lives, sometimes with happy surprises such as completing a university assignment however on some occasions they can find themselves acting out risk-taking behaviour and have no control over the process. 

Frequently the person will have chunks of time missing due to the dissociative nature of the disorder and they can be particularly paranoid in regard to other people not fulfilling their needs when they require it. Frequent storytelling e.g. my friend did not answer my call so I must have done something wrong!

Summing Up

Borderline personality disorder is pervasive and causes the person to suffer on a number of levels, however psychological treatment can go a long way to help the person to achieve stability and balance. A number of psychological treatment modes are available, these include however are not limited to: Schema Therapy, Dialectical Behaviour Therapy and Acceptance Commitment Therapy.

If you feel that you are experiencing BPD or that you are living with someone experiencing this disorder, psychological therapy can help, either to assist yourself or to teach you ways in which to create healthy relationships and improve your day-to-day life.