Borderline Personality Disorder (BPD)

Borderline Personality Disorder is a disorder that affects mood as well as how a person interacts with others. BPD is the most commonly recognised personality disorder.

The symptoms of BPD are split into four main areas, these are:

  1. Emotional Instability
  2. Disturbed Patterns of Thinking or Perception
  3. Impulsive Behaviours
  4. Intense but Unstable Relationships with Others.

Emotional Instability:

This area of symptoms consists of experiencing a range of intense, negative emotions such as anger, sorrow, shame, panic, terror, emptiness and loneliness.

The individual may show severe mood swings over a short period of time, this can be difficult for others around them, being hard for them to understand.

It is common for people with borderline personality disorder to feel suicidal with despair and to later feel reasonably positive. Some people may find that they feel better in the morning and others may feel better in the evening, patterns can vary over time but the key sign is that their mood will swing unpredictably.

If you are experiencing suicidal thoughts, contact your GP or out of hours GP service immediately. If you have overdosed or harmed yourself in a severe way, call 999.
You can also contact The Samaritans on 116 123 – they provide 24-hour emotional support for people who are having trouble with their mental health as well as other problems.
It will also benefit you to tell a friend, family member or someone that you trust.

Disturbed Patterns in Thinking:

The individual may experience upsetting thoughts such as thinking that they are a terrible person or even feeling as though they do not exist. It can be difficult for them to be sure on these thoughts and they may seek reassurance from those around them, that they are not true.

They could also have brief episodes of strange experiences; this could include hearing voices outside of their head that are not really there, this could last for minutes at a time. These voices may be in the form of instructions, telling them to harm themselves or others. Some people may believe that these voices are real, others may not.

It is also possible that the individual will have prolonged episodes of abnormal experiences. These consist of both hallucinations and delusions. Hallucinating might be that they can hear or see things that are not really there and delusions are when the person has distressing beliefs that no one can talk them out of (such as believing that their family are planning to kill them, or that the FBI are coming after them). These types of beliefs may be psychotic, therefore it is important that the individual seeks help if they are struggling with delusions.

Impulsive Behaviours:

If an individual has borderline personality disorder, they may experience impulsive behaviour. There are two main forms of impulses which people with BPD may find hard to control:

They may have an impulse to self-harm (such as cutting or burning themselves), in severe cases, these impulses can lead to feeling suicidal and the individual may attempt or plan to take their own life.

They may have a strong impulse to engage in reckless behaviour such as spending a large amount of money, binge drinking or taking drugs, gambling or having unprotected sex with strangers.

These impulses can be dangerous and the individual should seek help if they are struggling to control themselves in such situations.

Unstable Relationships:

The individual may feel as though they are being abandoned by people close to them, or they may feel that people are getting too close to them and making them feel smothered. Fearing being abandoned could lead to feeling anxious or angry and the individual may make extreme efforts to prevent themselves being alone (such as constantly texting or ringing someone, or physically clinging to them to stop them from leaving). On the other hand, if the individual feels as though they are being smothered they may go out of their way to push the person away. This could lead to having an unstable love-hate relationship. The individual may have a very black/white view on life… meaning they either think the worst, or they think the best, there is no grey area in between.

What Causes Borderline Personality Disorder?

There is no solid cause for this disorder however various research does suggest that there are factors that could contribute to its development.

Stressful life events (especially in childhood) could have an impact on your mental health and may contribute to the development of borderline personality disorder. These events may include emotional, physical or sexual abuse, neglect, family troubles (alcoholic or drug-addicted parents/siblings, or divorce for example), or losing a loved one.

There are also studies which suggest that genetics could play a small part in the development of the disorder, meaning you are more likely to develop the condition if a parent or sibling also has it.

Treatments:

It is believed that talking therapies are one of the most helpful forms of treatment for people with borderline personality disorder although it is not necessarily the most effective.

One talking therapy that is useful for treating BPD is Dialectical Behaviour Therapy (DBT)

This therapy uses both individual and group sessions in order to help the person form coping strategies when it comes to dealing with difficult emotions.

The other form of therapy believed to be helpful for BPD is Mentalisation-Based Therapy (MBT). This therapy aims to help you recognise both yours and others mental states, helping you to examine your thoughts and create a higher level of understanding.

Other talking therapies are also available, but these two have been recommended by the National Institute for Health and Care Excellence (NICE).

Individuals with BPD are not likely to be put on psychiatric medication for prolonged symptoms as there are not any drugs that have been found effective. However, they may be placed on medication for other mental health conditions such as depression or anxiety and in a crisis situation, they may be given a sleeping pill or a minor tranquiliser to help calm them.

Misdiagnosis:

BPD often shared symptoms with other mental health conditions such as depression, bipolar and post-traumatic stress disorder. Therefore some individuals may feel as though they have been misdiagnosed. If you feel as though you have been given an incorrect diagnosis, speak to your GP or a mental health professional and tell them how you feel.

Sources:

NHS – Borderline Personality Disorder Overview

Mind Charity – BPD

Your Health in Mind

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