“Officially recognized in 1980 by the psychiatric community, BPD is more than two decades behind in research, treatment options, and education compared to other major psychiatric disorders. However, evidenced-based treatments have emerged over the past two decades bringing hope to those diagnosed with the disorder and their loved ones.” A.P.A
BPD (Borderline personality disorder) is the most well-known and frequently diagnosed of the AXIS II disorders. It is one of the four, “dramatic personality disorders.” (The other three being Antisocial, Histrionic, and Narcissistic)
It affects approximately 6% of the adult population (nearly 10 million adults) and although it was once considered a female disorder, it is now believed to affect men and women in equal numbers.
“People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement.” Marsha Linehan
Approximately 20% of inpatient psychiatric patients meet the criteria for borderline personality disorder.
- 85% of people with BPD also meet the diagnostic criteria of another mental disorder.
- 50% of those with BPD have substance abuse/dependence disorders.
- 75% of adults with BPD self-injure or “cut”.
- Nearly all borderlines contemplate suicide at some point.
- 10% eventually complete the act of suicide.
Although there remains considerable controversy over the exact cause of borderline personality disorder, it would appear that it is neither “all biological” nor “all parenting” but a combination of the two.
“Personality disorders, such as bpd, are sculpted by our earliest relationship experiences. Those imprints shape how we feel about ourselves, and determine the extent to which we are able to forge trust in others. Much of BPD distress occurs within the first year of life, due to inadequate bonding and emotional attunement with the mother.” Schreiber, M.A.
Borderlines are in love with the notion of love and romance; they are obsessed by it and will do anything to ensure they get it. To them it is a means of filling up their loneliness and lack of self through another person rather than an expression of regard or caring for someone as an equal partner.
Common Symptoms of BPD
Fear of abandonment. People with borderline personality disorder have a fear of being abandoned or left alone. This is the hallmark symptom of the disorder. Even perceived rejection or the expectation of being alone can drive a person with bpd to despair, panic, rage, or even a psychotic state.
Splitting. This is sometimes referred to as “black and white” or “dichotomous thinking”. People who suffer with BPD have a tendency to view themselves and others as “all good” or “all bad”. They have difficulty with the concept that good people can sometimes do bad things. A person with BPD may say that they “love you” one day and they “hate you” the next.
Anger. This is sometimes referred to as “inappropriate anger” or rage. People with borderline personality disorder are often subject to sudden outbursts of intense anger or rage. This may or may not include physical violence. Because they tend to be highly sensitive to real or perceived criticism, they react in a very emotional way when their expectations of others are not met.
Feelings of emptiness. Chronic feelings of emptiness, sometimes described as a visceral feeling usually felt in the abdomen or chest. It is not boredom, in the commonly understood meaning of the word. The feeling is associated with loneliness and neediness. BPD patients use words such as “nothingness” or “hollowness” to describe the experience.
Unstable Mood. Unlike bipolar disorder where a person will undergo a mood change over the period of weeks or months, those with borderline personality disorder can experience mood swings that occur over the course of a day or even hours. These can include feelings of depression, anxiety, anger, irritation, and even transient psychosis.
Impulsive Behavior. People with borderline personality tend to act impulsively and often recklessly. This impulsive behavior may come in the form of substance abuse, binge eating, reckless driving, excessive spending, promiscuous sex, and gambling to name a few.
Unstable relationships. Those will bpd have a very difficult time maintaining relationships with partners and family members. Their relationships tend to be very emotional, turbulent, and chaotic. A person with borderline personality disorder will often over idealize (exaggerate a person’s positives) then devalue (exaggerate a person’s negatives) the people in their life.
Poor Self Image. People with borderline personality often struggle with feelings of insecurity, low self-esteem, poor self-image, identity confusion, and at times even confusion over sexual identity.
Substance Abuse. More than half of those with BPD abuse alcohol or other substances.
Treatments for BPD have improved in recent years. Within the past 15 years, a new psychosocial treatment termed dialectical behavior therapy (DBT) was developed by Dr. Marsha Linehan specifically to treat BPD, and has shown tremendous promise in recent studies.
Pharmacological treatments are often prescribed based on specific target symptoms shown by the individual patient. Antidepressant drugs (SSRI/SNRI) and mood stabilizers are often helpful as well as anti-psychotic drugs for those who display “distortions in thinking”.
For more information on Borderline Personality Disorder, please visit the National Education Alliance for Borderline Personality Disorder.
Source Material: NIMH, Wikipedia, NEA for BPD, APA 2000, DSM-IV