Borderline Personality Disorder
Borderline personality disorder (BPD) is not quite as well known as other types of personality disorders, as its prevalence in the population is quite low. Persons diagnosed with BPD experience an overwhelming sense of instability in their lives, intense emotions that seem unmanageable, and regular paranoia.
However, with help, people with BPD can learn to manage their symptoms and live healthy lives.
What is Borderline Personality Disorder?
Borderline Personality Disorder (BPD) is a mental health condition, associated with individuals who have difficulty controlling their emotions, have extreme mood swings, are impulsive, have unstable relationships, and can be self-destructive in their behaviour, with a higher risk for suicide.
They have an unhealthy way of looking at themselves and others, and have a strong fear of abandonment and rejection. This can have an adverse effect on their relationships with partners, family members, friends, classmates, and co-workers. This in turn, can push people away, further reinforcing their feelings of rejection and abandonment.
Alternatively, BPD can negatively impact many areas of their lives, including dropping out of school, multiple job losses, abusive relationships, divorce, violation of the law, unplanned pregnancy, and self harm.
According to the Canadian Mental Health Association (CMHA), approximately 1% to 2% of the general population has BPD and it is more prevalent in young adults. With aging, there is a decrease in intense emotions, impulsiveness, and self-destructive behavior, however the fear of abandonment and self worth can still persist.
Research suggests – though this is not conclusive – that more women are diagnosed with BPD, than are men. However this may be due to women seeking help more often than men for different symptoms.
Men tend to display externalizing symptoms of BPD, such as impulsiveness and aggression, along with comorbid disorders, such as depression, anxiety, and substance abuse. Women tend to display internalizing symptoms of BPD, self-harm, unstable relationships, self identity issues, dissociation, etc), along with comorbidity.
Recognizing the Symptoms of BPD
BPD is characterised by these symptoms:
- A strong fear of abandonment
- Unstable relationships
- Quick changes in how they see themselves
- Paranoia and loss of contact with reality
- Impulsive and risky behaviour
- Threats of suicide or self-injury
- Wide mood swings
- Feelings of emptiness
- Strong anger
What Causes BPD?
Healthcare professionals believe the cause of BPD may stem from childhood abuse/trauma, genetics and/or brain changes.
The Cleveland Clinic estimates that up to 70% of persons with BPD have experienced sexual, emotional, or physical abuse as a child, stemming from parental neglect, detachment, and parental use of substance abuse, to name a few.
With respect to genetics, family history of BPD increases the risk of developing this condition.
Researchers believe that the brain functioning of persons with BPD may differ from those without, in that the amygdala that controls emotions is not in sync with the prefrontal cortex which controls behaviorr and impulses.
Some triggers that may cause intense emotions are feelings of rejection and/or a disconnection with a loved one, as a result of an argument, to that of divorce, death, or even a job loss. Failing grades, or situational events like forgetting a cell phone, wallet, or keys, can also trigger these intense emotions.
Diagnosis
Diagnosing BPD is done after the age of 18, since personality is still evolving during childhood and adolescence. As adults, individuals may not be aware they have BPD until they experience a negative life situation, such as a job loss or divorce, in which they may seek help for co-occurring symptoms of anxiety or depression.
With the criteria found in Diagnostic and Statistical Manual (DSM V) of Mental Disorders from American Psychiatric Association, a licensed mental health professional can diagnose BPD.
To obtain proper information, the mental health care professional will ask various questions related to the person’s and their family’s mental health history, along with job history, and impulsiveness. It is not uncommon for health care professionals to reach out to family and friends to obtain a better perspective of the person’s history and behaviour.
Treatment Options
Therapy: Psychotherapy or “talk therapy” is the most common treatment for BPD.
Psychotherapy can either be one-on-one with a therapist or in a group setting, and family members are encouraged to participate to gain a better understanding of the condition and learn skills to help cope with the person’s symptoms.
A trained psychotherapist can use one or any combination of talk therapy treatments, such as:
- Cognitive Behavioral Therapy
- Dialectical Behavioral Therapy
- Schema-focused therapy
- Systems Training for Emotional Predictability and Problem Solving, or STEPPS.
Medication: At present, there is no specific medication for BPD. However, medications can be prescribed by a physician or psychiatrist to help alleviate co-occurring symptoms such as depression, anxiety, mood disorders and/or substance abuse.
Self-Care: is also important for individuals with BPD to take good care of themselves. They can do this by keeping their scheduled therapy appointments, getting enough sleep, eating well, exercising, being educated about their condition, and noting triggers that may perpetuate negative moods and thoughts.
The good news is many people respond well to therapy and improve their quality of life as a result.
As treatment can be long term, it is important that there is a commitment to therapy and to having an open and honest, trusting relationship with the therapist.
With dedication and support, persons with BPD can successfully manage their emotions, their perception of themselves and others, and the situations they will face. This could lead to a more productive and happier life, and improved healthier relationships with their partners, family members, co-workers, and friends.
References:
https://www.hopkinsmedicine.org/health/conditions-and-diseases/borderline-personality-disorder
https://mayoclinic.org/diseases-conditions/borderline-personality-disorder/symptoms-causes/syc-20370237/
https://my.clevelandclinic.org/health/diseases/9762-borderline-personality-disorder-bpd/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9803119/#:~:text=Since%20the%20introduction%20of%20personality,BPD%20are%20females%20%5B1%5D.
https://www.psychologytoday.com/us/conditions/borderline-personality-disorder#causes
Innova Counsellors Who Treat BPD
Behi Ahani, RSW
Behi Ahani, RSW | Innova Therapy Inc Coquitlam & Online
Glory Mulera RCC
Glory Mulera, RCC | Innova Therapy Vancouver & Online