Borderline Personality Disorder (BPD) is a cluster B personality disorder marked by impulsivity, instability, mood swings, dissociation, identity and self image issues, and intense/unstable interpersonal relationships. Symptoms normally begin in the late teenage years or early adulthood. Recently, BPD has also been referred to as Emotionally Unstable Personality Disorder. Women most often suffer from this disorder, though there are also males diagnosed. In the past year, the diagnostic criteria has changed slightly and is listed below.
At least three of the following must be present, one of which must be number 2:
1. marked tendency to act impulsively and without consideration of consequences
2. marked tendency to engage in quarrelsome bahavior, especially when impulsivity is criticized
3. liability to outburts of anger or violence, with inability to control resulting behavioral explosions
4. difficulty in maintaining any course of action which offers no immediate reward
5. unstabl and capricious (impulsive, whimsical) mood
At least two of the following as well:
1. disturbances in and uncertainty about self image, aims, and internal prefrances
2. liability to become involved in intense and unstable relationships, often leading to emotional crisis
3. excessive efforts to avoid abandonment
4. recurrant acts or threats of self harm
5. chronic feelings of emptiness
6. demonstartaes impulsive bahavior (i.e. shopping, substance abuse, shoplifting, gambling, promiscuity, etc.)
Those with BPD have a much higher chance of also having comorbid (co-occuring) disorders. The most common are:
-mood disorders (including bipolar disorder)
-anxiety disorders (including panic disorder, social anxiety disorder, and post traumatic stress disorder)
-other personality disorders
-eating disorders
-attention deficit hyperactivity disorder
-somataform disorders
-dissociative disorders
Suicidal ideataion, threats, or attempts are very common among borderlines, particularly before therapy has been started. The suicide success rate of people suffereing with BPD is 10%-20%. If the borderline sets down the road to recovery, this symptom can be overcome.
Emotional dysregulation is at the core of BPD. We feel emotions much more intensely and over smaller triggers. Marsha Linehan (a specialist in BPD and DBT-a type of therapy) believes that the emotions of borderlines can be both a positive and a negative. We are overly joyful, loving, and idealistic and can make the most wonderful spouses, parents, and friends. The negative emtions are also present however; we might feel extreme depression instead of saddness, shame or humiliation istead of embarrassment, rage instead of frustration, and complete panic instead of nervousness. If a borderline feels rejected, lonely, or criticized, these negative emotions can be much more extreme or last a prolonged persiod of time. Many people suffereing with BPD cannot control or regulate their own emotions and so in a way shut them down completely, which is an extremely harmful thing to do because self injury, suicide, eating disorders, etc. typically come about in these times.
On top of the intense emotions, there is also emotion lability, or changeability. Basically this means that mood swings happening very quickly for reasons outsiders may not understand can occur quickly and seemingly without a real substantial trigger. At times these swings can be from joy to depression, but more often they go between feelings of depression, anxiety, and anger.
It's difficult for a non borderline to really comprehend the lack of control that borderlines have when it comes to their emotions. It is not as easy as "faking it" or "just focusing on the good". If it were, trust me, we'd all do it. The emotions are truly out of our control, at least until we get started on the road to revoery and learn new skills.
Feelings of emptiness and loneliness are also extremely common in those with BPD. This has a lot to do with the identity problems and confusion that borderlines suffer with. Many of us truly don't know who we are, in pretty much every way possible. Sexual identity, political opinions, religous views, morals and ethics, etc. At the core of our being many of us just feel these complete hollowness and thus many times end up sort of searching for a savior to cling on to, whether it be a relationship/person, a cause, a religion, etc.
The chameleon is what many of us call our ability to sort of morph into different versions of ourselves depending on the people or situations we are in. To some, this is seen as lying or manipulation, but this really is so far from the truth. We do not do this intentionally. It is subconcious thing that just sort of happens without us even realizing it. Most borderlines are extremely good judges of character or personality in other people, and its common for a borderline to only know someone for a few moments and then be able to change his/her opinions, mannerisms, patterns of speech, etc. in a way which would make the other person like him/her more or feel more comfortable.
Fear of abandomnet is also something that many people who suffer with BPD experience. Part of this is lack of object constancy; basically when we are not in direct contact with a loved one, our brains find it difficult or impossible to conjure up memories which make us 'feel the love'. "Normal" people can remember the feelings of being loved or cared for when they are lonely or insecure, but for a borderline, if we aren't with the person or in constant contact with the person, it's difficult to feel any real connection. This leads many of us to come off as 'clingy' or 'insecure'. With treatment, this can get better and these syptoms can go away completely.
Another huge part of BPD is splitting, which I have an entire post about already so I won't go into too many details. Basically, splitting is "black and white" or "all or nothing" patterns of thinking. It is extremely hard for us to see the big picture, a person or situation as a whole...we pretty much always are either devauling or idealizing. Meeting in the middle takes therapy and self exploration and work, but can be accomplished.
Not all, but some borderlines also experience dissociation; a seperation between self and emotions or physical experiences. Dissociation has happened to me but is not one of the most common symptoms that I struggle with. It really is the strangest thing to explain to someone who's never experienced it. From an onlooker, it may look like the person dissociating is in a sort of catatonic state, and just really "out of it". When I've been like this, I don't feel a part of the world, if that makes sense. I don't really feel the touches of people, I don't feel emotions fully, I don't think. It's actually really scary, and can create some pretty serious memory problems.
These are the most common symptoms of BPD, along with the diagnostic criteria. Everyone is different and there are many other symptoms that borderlines have to deal with. Before being diagnosed and seeking help, it may seem like there is no help for a borderline and that he/she will never be able to live a "normal" or functional life; nothing can be further from the truth. With intensive therapy, self work, counseling, and medications, BPD can be managed very well, and total recovery can occur. So don't give up on the borderline in your life, instead support him/her.
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