I was a mental health nurse and also have family who are diagnosed as having a borderline personality disorder. Over the years, I’ve heard all the unacceptable terms being bandied around, not only by the general public but actually by mental health professionals too. Nurses said “she’s just being manipulative,” or “he’s doing his usual, attention seeking,” “She’s just playing up ‘cos she’s got ward round and doesn’t want to go home.” Support staff have been overheard, “bloody drama queen.” or “You’re overreacting again, stop it, calm down.”
I suspect many of you’ve heard of Borderline Personality Disorder (BPD)? Do you know what it is?
Borderline Personality Disorder
Borderline personality disorder is a severe mental illness marked by an ongoing pattern of varying moods, self-image, and behavior. These symptoms often result in impulsive actions and problems in relationships with other people.
It’s called ‘borderline’ because doctors previously thought that it was on the border between two different disorders: neurosis and psychosis. It’s sometimes called emotionally unstable personality disorder (EUPD).
A person with borderline personality disorder may experience episodes of anger, depression, and anxiety that may last from a couple of hours to days. Recognisable symptoms typically show up during adolescence (teenage years) or early adulthood, but early symptoms of the illness can occur during childhood.
- BPD can be highly distressing for the person affected, and often for their family and friends too.
- It can be confusing and easily misunderstood, but BPD is a very treatable condition. With the right treatment and support, people with BPD can lead full, productive lives.
- Around 1 in 100 people have BPD. It is believed to affect men and women equally, though women are more likely to be given this diagnosis.
- Think of it as emotional dis-regulation. When an air conditioning system is having problems, it may make your home too hot one minute and too cold the next. The temperature regulator within the air conditioning unit clearly has issues if this is happening. BPD is kind of like that when it comes to regulation of emotions.
Borderline Personality Disorder Criteria
The borderline personality criteria are listed in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition:
- Significant impairments in function of personality (i.e. poorly developed sense of self, poor self-direction)
- Impaired interpersonal function – poor ability to empathise and impaired ability to form lasting intimate relationships
- Pathological personality traits – frequent, intense mood swings; separation insecurity; frequent, short-lived bouts of anxiety and depression. Impulsivity, hostility toward others, recklessness.
- These impaired abilities and pathological traits occur consistently over time regardless of circumstance or situation.
What symptoms could you expect in borderline personality disorder?
Everyone’s experiences of BPD are different, but you may have problems with some (but not all) of the following:
- Feeling empty, low self-esteem
- Feeling isolated or abandoned by others
- Paranoia or emotional detachment
- Getting on with other people
- Impulsive, risky behaviour
- Misusing alcohol, drugs or prescription drugs
- Understanding other people’s point of view
- Anxiety about relationships, efforts to avoid being abandoned
- Self-harming or suicidal thoughts
- Coping with stress
- Strong emotions that you find difficult to manage
- Maintaining relationships, work and home
Causes of Borderline Personality Disorder
The exact causes of borderline personality disorder are unknown. As with most mental illnesses, experts believe genetic, familial, and social factors all play roles in its development. People may have a greater chance of developing the disorder if:
- One of both parents have borderline personality disorder
- Disrupted and dysfunctional family life
- Poor communication within the family
- Close family member (father, mother, sibling) with BPD or another personality disorder
- Sexual, emotional, or physical abuse in childhood or adolescence
How do I know if I (or someone I know) have borderline personality disorder?
A mental health professional—such as a psychiatrist, psychologist, or clinical social worker—experienced in diagnosing and treating mental disorders can diagnose borderline personality disorder, based on a thorough interview and a discussion about symptoms. A careful and thorough medical exam can also help rule out other possible causes of symptoms.
The mental health professional may ask about symptoms and personal and family medical histories, including any history of mental illness. This information can help determine the best treatment.
Treatment for borderline personality disorder
Treatment for BPD in the UK might involve individual or group psychotherapy, carried out by professionals within a community mental health team (CMHT). The goal of a CMHT is to provide day-to-day support and treatment, while ensuring you have as much independence as possible.
Treatment for BPD usually involves some type of psychological therapy which can help you learn to better understand and manage your feelings, responses and behaviour. There are lots of different types of psychotherapy, but they all involve taking time to help you get a better understanding of how you think and feel.
As with any health problem, seeing an understanding GP is a good start. A GP can refer you to a mental health professional or a public mental health service.
Is someone asked you, do you think you could explain Borderline Personality Disorder now? What do you think about the term Personality Disorders?
***Please take any comments about suicide or wishing to die seriously. Even if you do not believe your family member or friend will attempt suicide, the person is clearly in distress and can benefit from your help in finding treatment.
I’ve worked with a lot of people over the years that have had negative attitudes towards BPD. The people who were most judgmental tended to lack skills for dealing with patients with BPD, and they would essentially blame the patient because their own approach wasn’t as effective as they thought it should be.
Woohoo! I would like to print this out on a big billboard and place it in front of my formal work (ahum boss).
Of course it’s not all people working in MH but it is also not uncommon.
Lol
Haha, I get it. And there were many topics I’d like to put on big billboards outside my old workplace 🙂
Imagine if people would start doing that! I would help against burnout in organizations who are not willing to listen to their employees!
Yep, totally agree they lacked the skills. They would have been more empathic and compassionate had they tried to improve by either asking more experienced nurses or for more training.
I feel bad that people with borderline get a bad rap. I hate narcissists and psychopaths (antisocial personality disorder), but I don’t think people with borderline have the same internal urge to hurt others that narcissists and psychopaths have. I think with borderline, it’s more about what you said–no emotional regulation–which is sad and shouldn’t be held against someone who’s trying their hardest.
In my own experience, a really bad psychiatrist diagnosed me with it at age fifteen and gave me the book, “I Hate You; Don’t Leave Me”. That book scared me to death. I still remember ripping it into book chunks and hurling it across the room. I later learned that borderline is a common adolescent phase, which is why personality disorders shouldn’t be diagnosed in teens necessarily.
Great article! It’s odd I don’t know anyone who has borderline (that I know of!). Huh.
I love it – ripping the book up. You’re right though, I don’t think a teenager would be able to grasp the context of bpd as yes, they have that adolescent phase anyway and they’d see it as this rather than bpd.
I do know a few people who have actually been labelled by friends or family as ‘drama queen’ etc — because they lack they education and I’m fed up explaining! (It’s not me by the way – as if I need bpd on top of everything else lol).
Huh, I never thought of the drama queen connection! So if I know someone who’s a drama queen, that person could have BPD? Interesting! I’m going to give that some thought!!
Lol – be careful Meg 😉 x
Try facebook, there’s tons of groups for BPD there. I’m in an few and I have BP.
I’ve heard of Borderline Personality Disorder before, but it’s nice to get a clear and thorough explanation of its symptoms from someone who understands it on a personal and professional level. It must be really tough for people with BPD, being labeled as if they are choosing to act emotionally unstable when they just need some help.
Yes, for many years it was a little understood illness and these patients got a bad rap. I do hope it’s moved on since I left 10 years ago. I see the pain my sister experiences day in and day out. I have to admit that it’s tiring to be around but at least we’ve got to the point now where she understands this and doesn’t fly off the handle when I say so. 🙂
There are effective therapies for BPD, like DBT and schema therapy. Personally I believe a lot of people with BPD have a childhood abuse history.
Oh definitely, I agree — a lot of it comes from childhood. And yes, my sister went into a DBT programme for one year. She really found it beneficial 🙂
I lost insurance and was told it didn’t have DBT providers available. So because of my extensive background
And education got the DBT workbook and started it in my own.
Even insurance issues won’t stop me this time.
Brilliant. Well done to you. Oh, the self-help books I’ve bought over the years 🙂 But they have been great, I must say. I’m delighted to read that nothing’s going to stop you now!
I’m trying a new direction and road. Make life with BPD matter. In a positive way. When you truly want to get better. Even a little step in that direction means everything.
Every journey starts with that first step…..
I had a childhood filled with abandonment, neglect, and many firms of abuse. It led to all kinds of future adult bad decisions and trauma. Without help I’d have killed my self.
Oh I get you. It feels like suicide is the only way out sometimes. But I’m really happy to read that you were able to find and accept help. Did you have DBT, out of interest? Caz x
Suicide wasn’t an option only because I have 4 kids. I find that you can get help in so many ways once you know the illness. Accept the diagnosis. And for me being able to say out loud to people I have BPD. I never got to have DBT because my insurance didn’t cover “extreme” therapy. However, I had been going to colleges for 20 years following, learning, and watching the psychology field grow. I already practiced positive psychology daily. I have desensitized myself to certain phobias. So I knew what DBT entailed. I bought the workbook and am applying what I haven’t already been doing. Truthfully my last two therapists said I already know what I need to do. I know what a psychologist will say, so just do it.
So, I just do it. I see a doctor. And I want to have a shrink but just too confide in. See if I’m missing a piece of the puzzle.
I found talking publicly, participating in online group therapy, writing, and sharing is my healing. It’s what makes me try harder tomorrow.
I have two smashing now-grown up boys so suicide wasn’t an option for me. Oh, don’t get me wrong, I had the constant thoughts – which were awful bit I didn’t have the intent.
Wow, ‘Extreme’ Therapy, that’s a new one on me.
When I first felt ill I went to my library (before computers lol) and read all kinds of self-help and psychology books, then I got help and got better for a long while (the anxiety never goes – or negative thoughts etc) but I was able to function better. So I went to study for 3 years to become a mental health nurse, which I loved.
I still never felt I knew enough and continued to study (all paid for by the NHS
and it kept me well, by studying.
Yep, online bloggin and the community support is great too 🙂 x
I started college in 1997…BPD plus military wife life and many moves etc…finally graduated in 2016. So I studied extensively. Wanted to be a career student I couldn’t get enough. The fields growth from theory to scientific engaged me. I took every class they could offer at every school I attended. Plus online and engaging any professional. My extreme therapy was that entire time I was learning. I probably have more education that five people with bachelor degrees lol. I feel in control though with that knowledge.
Brilliant. Someone once told me “If you don’t know what you want to do — study.” So that’s what me and both my sons did. There’s 8 or 9 degress between us, 3 masters and 1 Phd lol. They now both work in the neurological/muscular/medical field now too 🙂
Personally for me, schema therapy is really helping my avoidant personality disorder. I believe I’m better off having sought help. Good therapy saves lives and the stigma against BPD is really unfortunate.
I never did try that therapy
It’s one of the better, newer ones for BPD but of course not everyone’s cup of tea. It’s flexible, and centered around client needs. It’s entire premise is on limited reparenting, and nurturing and healing one’s inner child(ren) together with the therapist. I wouldn’t call it a miracle (some people don’t like it) however studies show a lot of improvement and people can cease to meet BPD criteria after a year or two. It’s long term therapy. I lucked into my therapist.
I took a class in private college “theories of personalities and counseling.” I’d have to refresh my memory on that
I was diagnosed with BPD 12 years ago; the stigma attached had me hide my illness and reject my diagnosis. My psychologist said “You don’t want BPD. You can’t take meds for that. Psychologists will turn you away because it’s not treatable.”
Just last year I finally spoke up and said, much like someone at AA, “My name is Abby and I have Borderline Personality Disorder.” I spoke up to the world.
I also have a Bachelors Degree in Organizational Behavioral Psychology and spent 20 years in higher education institutions nationwide; simply to follow the progression of the Psychology field.
I am learning to convey in words what goes on inside my head. To explain the cascades of emotions I endure. To talk about self harm and suicidal ideation in the mind of someone with BPD.
We don’t need a cure. We need to be understood. Every time I see someone writing on the illness, I am grateful. It’s spreading awareness. When I was diagnosed I didn’t have public awareness. It made it impossible to live in “their” world.
Thank you for shedding light on this beautiful disaster of a mental illness. My worst nightmare has slowly become my positive identity. It’s what made me into who I am today.
I am stronger because I have BPD.
Thank you for sharing your ‘story’ and you’re right, people with BPD need to be listened to, understood and be accepted.
This ‘beautiful disaster’ creates havoc for the person with it and often for those around them. Some people don’t even bother to find out why. My sister has a really compassionate husband who accepts her as she is.
Since she’s had the diagnosis and attended DBT for a year, she’s so much happier – because she now understands her BPD she and takes medication.
I’m really happy to hear you also have a positive outcome and yes, it’s made you into who you are today. Thank you for sharing, your wording is beautiful — and shows your strength.
Caz x
It means so much to hear that! My own family has isolated me and labeled me. I’m only attention seeking and lazy lol.
Thank you for sharing and I wish positive vibes to your sister! She is so lucky to have you.
It’s a shame your family have isolated you. Perhaps they could do with educating themselves.
I can’t fully blame them. I now know what BPD can seem to others. And my behaviors, wether illness or not, caused some isolation. It’s just I want others to not have that same struggle. Not to feel that judgement. Not have to fight against an illness others perceive as other things. It’s not easy living and surviving and embracing our illness. The more acceptance others have; maybe that can turn the tide of BPD sufferers and getting better.
The more we write about it and share our experiences, the more it’s out there — raising awareness and reducing stigma 🙂 x
You’re worth it 🙂
Awe that made my day!! I was about to have a breakdown and that triggered me in a good way. Thanks!!
I suffer from BPD and I am happy to hear that you are also trying to eradicate the awful stigma surrounding this illness. Thank you for your post.
Thank you Ann and I hope you have the support you need 🙂
Thanks for sharing!
You welcome 🙂