Did you know that Borderline Personality Disorder (BPD) affects between 2% and 5% of Australians? Despite its prevalence, BPD still faces significant stigma and misunderstanding. In this post, we look at BPD to help shed light on this often misunderstood condition. We will explore what BPD is, what causes its symptoms, dispel some common myths and offer information on managing and finding support for those affected.
WHAT IS BORDERLINE PERSONALITY DISORDER (BPD)?
People living with borderline personality disorder (BPD) experience overwhelming negative emotions that cause significant challenges in relationships, self-care, and functioning in various aspects of life. These feelings are often driven by a very poor self-image and negative beliefs they have about themselves. These beliefs (often referred to as “schemas” or “core beliefs”) are quite entrenched and often stem from childhood traumas (eg, abuse, abandonment, neglect) that prevented the development of a healthy sense of self-worth, worth, and security. Research shows that there are also genetic and neurobiological factors that lead to the development of BPD.
Recognizing the symptoms of BPD is crucial for intervention and support, and a person must exhibit at least five of the following for a diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5):
- The fear of abandonment: Some people with BPD may feel an intense fear of being abandoned by others, which may lead them to go to great lengths to avoid it.
- Relationship challenges: People with BPD may have difficulty with relationships, alternating between extreme closeness and detachment in their relationships with others.
- Uncertain identity: People with BPD may have an inconsistent sense of who they are, which can lead to changes in their goals, values, or relationships.
- Impulsivity: Some people with BPD may engage in behaviors such as substance abuse, binge eating, or risky sexual behavior and driving.
- Self-injury or suicidal behavior: People with BPD may engage in self-injurious behaviors or suicidal thoughts, especially during times of distress.
- Emotional shifts: People with BPD may experience marked mood swings, with feelings such as discomfort, irritability, or anxiety lasting from a few hours to a few days.
- Feelings of emptiness: Some people with BPD may describe feeling empty or emotionally numb, which can be accompanied by feelings of boredom and loneliness.
- Difficulty managing disappointment: People with BPD may experience frustrations or may experience frustrations more intensely than others.
- Paranoia or dissociation: During times of stress, some people with BPD may experience brief episodes of disconnection from themselves or reality, or have paranoid thoughts.
BPD SYMPTOM ACTIVATORS
There are a number of factors that can trigger negative internal thoughts or beliefs that reinforce the self-perception that you are unworthy or unlovable. They can increase emotional distress and include the following:
- Interpersonal conflict: Arguments or disagreements can trigger uncomfortable emotional reactions and feelings of inadequacy.
- Perceived abandonment or rejection: Situations where people feel abandoned, rejected or ignored by loved ones or friends can cause feelings of fear and insecurity.
- Stressful life events: Major life changes such as job loss, divorce, or separation can overwhelm people with BPD.
- Personal and professional challenges: Any situation that can cause one to feel vulnerable, such as receiving criticism or facing failure, can cause feelings of shame, worthlessness, or self-loathing.
- Drug abuse: Substance abuse can affect a person’s perception of situations, leading to negative and distorted interpretations, emotional turmoil, and impulsive behavior.
- Social situations: Overwhelming or crowded social environments, especially those involving unfamiliar people or social pressures can cause anxiety and feelings of inadequacy or alienation.
- Trauma reminders: Reminders of past traumatic experiences can trigger distressing emotional reactions and re-traumatization.
It is important to note that while these various triggers can cause BPD symptoms, not everyone with BPD will respond in the same way to these situations.
COMMON MYTHS ABOUT BPD
BPD is often surrounded by misconceptions that contribute to stigma and misunderstanding. Here are some common ones:
Myth 1: People with BPD are attention seekers
The misconception that people with BPD are attention seekers overlooks the underlying emotional turmoil they are experiencing. Rather than seeking attention for its own sake, people with BPD often exhibit behaviors driven by a deep need for validation and support. These actions stem from genuine anxiety and challenges in regulating emotions, rather than a desire to draw attention to themselves.
Myth 2: People with BPD are manipulative
This myth fails to recognize the underlying struggles that BPD individuals face. While they may engage in behaviors that others misinterpret as manipulative or deceptive, such actions often stem from difficulties in regulating emotions. These behaviors are not driven by malicious intent, but through coping mechanisms to protect oneself from perceived threats to one’s emotional well-being and relationship stability. Compassion and understanding are vital in supporting people with BPD.
Myth 3: BPD is just extreme moodiness
While mood swings are a common symptom of BPD, this statement oversimplifies the complex nature of the condition. BPD involves pervasive patterns of abnormalities in mood, self-image, and relationships, extending beyond the typical “moody” perspective. People with BPD experience emotional dysregulation that they struggle to cope with, often caused by external stressors that significantly affect their daily functioning. This myth undermines the seriousness and depth of the condition, preventing accurate understanding and appropriate support for those affected.
Myth 4: BPD only affects women
While it’s true that BPD is more commonly diagnosed in women, it can affect people of any gender. Cultural stereotypes and prejudices may contribute to the underdiagnosis or misdiagnosis of BPD in men. It is important to recognize that BPD does not discriminate on the basis of gender.
Myth 5: BPD is just a phase, and people will grow out of it
BPD is a chronic mental health condition that usually requires long-term management. While some people may experience periods of remission or improvement in symptoms, BPD does not simply go away over time. With appropriate treatment and support, people with BPD can learn to cope effectively with their symptoms.
Myth 6: People with BPD are dangerous or violent
Violence is not an inherent feature of BPD. While people with BPD may experience emotional dysregulation and impulsivity, this does not mean they are dangerous. Dramatic media portrayals often contribute to the misconception that people with BPD are violent, leading to further stigma and discrimination.
TREATMENT OPTIONS AND MANAGEMENT OF BPD
With the right treatment, people with BPD can learn to manage their symptoms effectively and live fulfilling lives. Effective treatment for BPD often involves a combination of psychological therapy, medication and support, and it is essential to seek help from qualified mental health professionals who specialize in this condition. Some common treatment methods include:
1. Cognitive Behavioral Therapy (CBT): CBT helps people identify and change negative thought patterns and behaviors that contribute to emotional distress. Specifically, shape-focused therapy in CBT it addresses underlying negative core beliefs developed during childhood.
2. Dialectical Behavior Therapy (DBT): DBT is a type of cognitive behavioral therapy that focuses on teaching a person skills to manage their emotions, improve interpersonal relationships, and tolerate distress.
3. Medication: While there are no specific medications that target BPD, certain agents such as antidepressants, mood stabilizers, or antipsychotics may be prescribed to target specific symptoms such as depression, anxiety, or impulsivity.
4. Supportive Environment: Creating a supportive and validating environment is imperative for people with BPD. Family therapy can provide education and guidance to loved ones on how to effectively help someone with BPD. Support groups can also provide validation, understanding and encouragement from peers facing similar challenges.
5. Self care: Practicing self-care strategies such as mindfulness, exercise, and maintaining a healthy lifestyle can help people with BPD manage stress and regulate their emotions.
For more information about BPD, including support groups and resources for understanding and managing this condition, here are some helpful links:
Dr. Carissa Coulston-Parkinson is a Clinical Psychologist with specialist knowledge in the areas of depression, bipolar disorder, anxiety, schizophrenia, intellectual disability, personality disorders, traumatic brain injury and neurological conditions.
