Borderline Personality Disorder: What Is It?
You may be familiar with the term Borderline Personality Disorder (BPD). You may know someone with the diagnosis or have seen it portrayed in movies such as Girl, Interrupted, Fatal Attraction, or Prozac Nation. While Hollywood portrayals are not always accurate, they can depict behavior that is characteristic of someone with this diagnosis. BPD is a diagnosis found in the Diagnostic Statistical Manual of Mental Disorders (DSM-5). The definition of a personality disorder includes “impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits,” (DSM-5). Characteristics of BPD include emotional instability and the experience and expression of intense, negative emotions with the inability to regulate these difficult emotions. This can lead to impulsive behavior that can include sabotaging relationships, self-harm or suicide attempts.
For someone to be considered as having this diagnosis, at least five or more of the criteria listed in the DSM-5 must be present. A person can exhibit some tendencies or traits of the disorder, but that doesn’t necessarily mean they have BPD. It is important for a professional to make this determination. Other potential diagnoses such as anxiety, depression, trauma, or a mood disorder must be ruled out. The hallmark feature of BPD is the inability to manage perceived negative emotions.
Those with BPD have had their personality shaped by invalidating, and at times, abusive and/or traumatic environments. Note that not everyone with trauma backgrounds or who experienced abusive childhoods will develop BPD. People with BPD struggle in their interpersonal relationships and have difficulty maintaining appropriate boundaries. Any hint of rejection or abandonment, real or imagined, can send someone into a tailspin of unmanageable feelings. Some people suffering with BPD are very high functioning, and only those closest to them will notice dysfunctional patterns of interacting. Others with BPD have frequent suicidal ideation and are in and out of the hospital for suicide attempts.
While personality disorders cannot be “cured,” there are effective, evidence-based treatments that can involve medication and/or skill-building and therapy, as well as support groups and intensive outpatient treatment programs. In particular, Dialectical Behavior Therapy (DBT) was created specifically for the treatment of BPD. It involves learning ways to appropriately and safely handle emotions. Most importantly, there is help for you or someone you know or love to get support in treating BPD. You or your loved one do not have to suffer alone.
It’s important to remember that even if you identify with some or most of the criteria above, you cannot diagnose yourself. Only a licensed professional can assess for and give a diagnosis. If you don’t know how to find a professional, try meeting with your doctor first and discussing your concerns. Your doctor can make a referral to a psychiatrist, psychologist, or therapist for further assessment and treatment recommendations.
Make sure to check out these resources for more information, including helpful reads for family members and finding a therapist that specializes in treating BPD, as well as helpful videos to learn to use skills in the moment.
“Stop Walking On Eggshells” By Paul T. Mason, MS & Randi Kreger
“I Hate You. Don’t Leave Me.” by Jerold J. Kreisman, MD
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