Understanding BPD - Borderline Personality Disorder

Borderline Personality Disorder (BPD) 

Those living with Borderline Personality Disorder 'BPD' struggle with their emotions, leading to complications with impulses, relationships and self-harm, BPD is a complex and serious mental health disorder. Those with BPD often feel constant emotional pain, with symptoms that make it more difficult to cope and develop long lasting relationships. BPD makes those with it highly sensitive to any changes in their environment often leading to intense emotions. 

What To Look For

BPD symptoms may vary because people have different traumas, and experiences, symptoms can fluctuate over time. As they gain further life experiences, and face further challenges. 

Common signs to look for:

• Intense episodes of anger, depression or anxiety, rapid onset, short-lived  
• A feeling of emptiness associated with loneliness and neediness, an urge to feel needed by others. 
• Paranoid thoughts and behaviors 
• Extreme dissociation to shut off painful thoughts and emotions
• Self-image that can change rapidly depending on situation
• Highly impulsive and harmful behaviours that can lead to major problems with substance abuse, or high-risk behaviours
• Suicidal behaviors and self-harm, typically from onset of intense emotional pain; up to 75% of those with BPD self-injure one or more times
• High rate of suicide- about 10% of people with BPD take their own lives
• Intense fear abandonment, difficulty to feel emotionally connected to someone who is not there
• Impulsive and emotionally volatile behaviours in relationships 
• Idealization and devaluation, dramatic relationships with feelings and behaviors towards others that can change from idealization (love, like, place a person on a pedestal)  to quickly devaluation (anger and hate)
• No grey area - black and white thinking. Its either good or bad. No Middle. 

What Can We Do

Previously, BPD was hard to treat and diagnose. It is still not fully understood. We are now able to diagnose and have developed treatment programs that significantly improve the lives of those living with BPD.

There is no specific medication for BPD, medication may be prescribed to help with other disorders or specific symptoms (such as, anxiety, depression, bipolar episodes and psychotic-like behaviors and thoughts). Medication can help with symptoms, it does not cure BPD and medication may not be appropriate for everyone with this diagnosis. 

Those with BPD have improved significantly with specialized treatments that may include:

• Dialectial Behaviour Therapy (DBT) 
• Cognitive-Behavioral Therapy (CBT)
• Schema Therapy (advanced) 
• Transference Focused Psychotherapy
• Mentalization-Based Therapy.

Research has shown that treatment does work.

Many people with BPD learn to cope and live happy lives with their symptoms  learning to understand and do things differently.

Due to the serious and complex nature of their symptoms associated with BPD, those affected typically require long-term treatment and care, often over several years or decades. 

Those with BPD often have complications with other disorders and challenges with their mental health that may include  

• Episodes of major depression
• Addiction & Substance abuse 
• Eating disorders & complications
• problem gambling, risky behaviors 
• posttraumatic stress disorder
• social phobia & behavior complications
• bipolar disorder 

BPD can be difficult to diagnose and treat, because the symptoms of other disorders act the same or hide BPD. Relapse and treatment in one disorder may trigger a relapse in the other disorder. It can be difficult to treat. 

Treatment is possible with professional long-term care. 

Where Does It Come From ?

The development of BPD is contributed by genetics, biology, environment, and experiences. 

Research shows that certain areas of the brain might explain impulsive risky behaviour, emotional instability and the way we perceive the world.

Studies have shown an influence from genetics, with higher rates of BPD among family members.

Environmental factors that may contribute to the development of BPD include neglect, abuse, or other traumatic childhood experiences.

Some with a nurturing and caring environment may still develop BPD, at the same time, children who experience extremely traumatic experiences do not necessarily develop BPD.

Physical and sexual abuse is high among those with BPD, many other experiences and factors can attribute to the development of BPD for those that are already emotionally vulnerable. 

Professional Resources 

Borderline Personality Disorder: An Information Guide for Families