Understanding of Borderline Personality Disorder

Mary-Jane Amato explores how to understand and support people affected by BPD, breaking down the stigma surrounding a misunderstood issue.

Photo by Nathan Dumlao

Deemed untreatable by many until the 1970s, BPD, or Borderline Personality Disorder, is one of the most misunderstood and stigmatized personality disorders, affecting around 2% of the world's population.

It is closely interconnected to the individual’s personal relationships, causing great distress in those diagnosed and the people near them. But is it possible to better understand those who fall under the umbrella of BPD, and how can we all learn to support them properly?

What is BPD and What Are Its Causes?

According to the Diagnostic and Statistical Manual of Mental Disorders, Borderline Personality Disorder, also known as Emotional Unstable Personality Disorder ( EUPD), is characterized by "An enduring pattern of inner experience and behaviours that deviates markedly from the expectations of the individual's culture."

This pattern usually affects the individual's cognition, affectivity, interpersonal functioning, and impulse control. Such pattern is pervasive to the extent that it severely impairs those areas of life connected to one's social and occupational functioning. This specific personality disorder affects how one feels and thinks about themselves and the people around them, causing extreme anxiety and fear of abandonment, which profoundly impacts interpersonal connections, making it hard to maintain healthy relationships. This condition makes it hard to express one's feelings clearly without the fear of how one is perceived and the constant idea of being abandoned, even when there would be no reason to feel that way.

There is no known direct cause for BPD. Researchers believe that personality disorders are caused by a variety of different factors, including a stressful or traumatic life events or a genetic disposition. It is very possible that if a person is diagnosed with BPD, they might have experienced significant trauma in their early years.

Such trauma may have stemmed from various situations such as a lack of support growing up, feeling non-validated, familial instability, living in proximity of someone with an addiction, having endured sexual, physical, verbal or emotional abuse, or having lost a loved one. There is, however, a greater probability of developing certain personality disorders if someone in the family has been diagnosed with it before, which explains the genetic theory of its cause.

Heightened Feelings and an Altered Perception of Reality

People with a BPD diagnosis tend to experience everything more intensely than average. It is common within this disorder to go from extreme highs to extreme lows, and all could happen in a very brief period or last for days. No matter how intense a reaction to an event or situation may be, that response makes complete sense in that person's mind at that precise moment in time.

These extreme emotions often factor into the the typical features of the condition: impulsive actions in self-damaging areas (such as spending, substance abuse, binging, or reckless driving), unstable moods, aggressiveness towards others, or self-harming. For these very reasons, people diagnosed with BPD may shut down in fear they may seem like they are constantly overreacting or being misunderstood with how they feel about themselves. Experiencing BPD is already a rollercoaster ride to them; being stigmatized for their reactions to this experience might aggravate their state of mind.

How to Help Someone with a BPD Diagnosis

Supporting a loved one who has been diagnosed with BPD is not always simple. One of the most important things to do is not to judge how they feel about a particular situation. Keep an open mind and reassure them about their positive traits while setting healthy boundaries and clear expectations. Make sure you are aware of their triggers and try to learn about their condition; this will help them feel more secure and trusting.

It is also essential to help them seek the proper treatment. Nowadays, several effective treatments for BPD can help cope with this disorder. The most common treatment is usually a combination of psychotherapy and medication. Psychotherapy is an extended-term support and can include: Dialectical Behaviour Therapy, which consists in a form of cognitive-behavioural therapy focusing on thoughts and beliefs that can lead to behaviours; Schema Focused Therapy, which is integrative psychotherapy incorporating aspects of cognitive behavioural therapy and psychoanalytic theories; Mentalization Based Therapy which helps with recognizing mental states and Transference Focused Psychotherapy, which promotes the transferring of feelings and expectations from early relationships on to a person in the present.

Moreover, medication such as antidepressants, antipsychotics, and mood stabilizers have been proven to reduce specific symptoms when used in conjunction with psychotherapy. However, possibly the most crucial aspect in helping those with BPD is making sure that they know how to take good care of themselves. Self-care is essential in managing BPD, and finding effective coping mechanisms when anger, sadness, or anxiety strike, is extremely important.

Concluding Comments

In conclusion, it is critical to be well informed about BPD and be aware of the struggles people with this diagnosis go through to avoid worsening their already challenging situation. At the same time, it is important not to forgo your own mental health while assisting someone who struggles with this condition, and to remember that to be an ally in this battle, you must make sure you look after yourself and keep your well-being in check.

Taking care of someone with BPD can be difficult, but by understanding them and destigmatising this complicated condition, it can become more manageable and possible to live a fulfilling and prosperous life.

HelpGuide have produced a concise article to help identify and support a loved one displaying traits of BPD, and Mind have produced a variety of accessible resources about personality disorders and other topics concerning mental health.

If anyone you know might be at risk of causing harm to themselves or others, Samaritans can be contacted for free at 116 123, or by emailing jo@samaritans.org. If you have any reason to believe that a friend, neighbour or member of your family is having a difficult time, take a moment to reach out and invite them to seek the appropriate support.

Similar: Children's Mental Health Services Overwhelmed

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