Living with BPD

Borderline Personality Disorder (BPD) is as stigmatised as all other mental disorders. It is a condition that is often characterised by unstable and intense relationships, shifting self-image and difficulty with emotional regulation. There are a lot of myths, misconceptions and misunderstandings surrounding BPD. 

According to the DSM-5, there are nine symptoms associated with BPD, out of which one must have at least five to be diagnosed. These symptoms are:

1. Frantic efforts to avoid abandonment (whether the abandonment is real or imagined)

2. Unstable and intense interpersonal relationships that are characterized by alternating between extremes of idealization and devaluation

3. Difficulties with identity (for example, a quickly changing self-image or sense of self)

4. Impulsivity in at least two areas that are potentially self-damaging (such as spending, sex, substance use, reckless driving, binge eating, etc.)

5. Recurring suicidal thoughts, behaviours or self-harm

6. Emotional instability and quick-changing moods

7. Chronic feelings of emptiness

8. Extreme anger or difficulty controlling anger

9. Stress-related paranoid thoughts or severe dissociative symptoms

Living with BPD comes with a unique set of challenges. One often has to deal with being stereotyped and judged for their diagnosis. Moreover, someone with BPD may experience intense, shifting emotions. They may go from being overwhelmed by joy to raging with anger very quickly. They also find these emotions hard to control. Not only do these turbulent emotions cause personal distress, but also disrupt one’s personal and professional relationships, since how one is feeling greatly impacts how they act. 

Someone with BPD is always on high alert due to a fear of abandonment. To avoid abandonment, they may resort to extreme measures or push their loved ones away. They also tend to feel misunderstood and indulge in black-and-white thinking. Depending on the circumstances, one’s self-image may undergo dramatic changes. 

Dialectic Behaviour Therapy (DBT) among other forms of psychotherapy is extremely helpful in coping with BPD. And while there are no medications that can help manage BPD, anti-depressants, mood stabilisers and anti-psychotic medications have proven to be helpful in many cases. 

If your loved one has been diagnosed with BPD, you could support them by listening and validating their experience. Of course, it is equally important that you feel heard. To do so, you and your loved one could come up with communication strategies that would specifically work for you. To avoid speaking from a place of anger, you could ask them to write down their thoughts and double-check before expressing them. 

Emotional outlets like journaling and exercise have been found helpful in managing emotions. Moreover, finding a support group or professional help would provide them with a great channel to cope with symptoms.

NOTE: This article was originally written for The Mind Garden.