Borderline personality disorder (BPD) is a common mental health disorder that can drastically impact how you see yourself and others. Because it is a personality disorder, it is different from a mood disorder. Mood disorders are seen as a more medical issue, which means that medication is a helpful intervention to medically intervene with the hormones. Personality disorders are better understood to be dysfunctions in behavior (rather than hormones) which lead to personality traits that cause issues with relationships. While having BPD can feel isolating and frustrating, it is considered a “good-news” diagnosis because it is very treatable!
Symptoms of BPD
BPD is especially known for issues/insecurities with self image, difficulty managing emotions and behavior, and having a pattern of unstable relationships.
If you struggle with BPD, you may identify with the following statements:
- I often feel “empty” or even feel like I don’t exist anymore
- My emotions shift very quickly and can even become explosive. I often experience extreme sadness, anger, and anxiety.
- I feel everything very intensely and don’t know what to do about it
- I'm constantly afraid that the people I care about will abandon me or leave me.
- I would describe most of my romantic relationships as intense, but unstable.
- The way I feel about the people in my life can dramatically change from one moment to the next—and I don't always understand why.
- I often do things that I know are dangerous or unhealthy, such as driving recklessly, having unsafe sex, binge drinking, using drugs, or going on spending sprees.
- I've attempted to hurt myself, engaged in self-harm behaviors such as cutting, or threatened suicide. My reasons for doing this are a cry for help or to help release my intense emotional pain.
- When I'm feeling insecure in a relationship, I tend to lash out or make impulsive gestures to keep the other person close.
- I feel cut off from the world
- Sometimes I dissociate and do things that I regret
- I want desperately for others to see me because I feel so empty and/or alone
My relationships feel unstable or intense. I will go from idealizing someone one moment and then suddenly believing the person doesn't care enough or is even cruel
Things that frequently co-occur with BPD:
- Past trauma - if you’ve experienced many adverse events, you can naturally become more sensitive to stress. You don’t have to have a history of trauma to be diagnosed with BPD, but it can certainly exacerbate your symptoms if you do.
- Eating disorder traits
- Substance use (drugs or alcohol)
- Anxiety or Depression
What to do about BPD
The first step is to break away from the stigma and labels that can come with BPD. People who struggle with BPD symptoms are frequently labeled as “dramatic”, “manipulative”, “crazy”, or “unstable.” This only furthers the shame and isolation that comes with the disorder. A more helpful approach is to understand that the behaviors you struggle with are due to lacking specific skills … and any skills can be learned with training and practice.
Getting treatment for BPD requires a lot of cognitive work. The treatment of choice is technically Dialectical Behavioral Therapy (DBT). DBT focuses on 4 pillars which include: Emotion Regulation, Healthy Connections, Mindfulness, and Distress Tolerance. These 4 pillars help you work through acceptance and change in your life.
While DBT is extremely helpful for working through these symptoms, Cognitive Behavioral Therapy (CBT) is also an effective tool. CBT helps you understand the relationship between your thoughts, emotions, and behaviors. This helps you build insight into each of these categories and learn how to stop any unhealthy or toxic cycles. All very learnable and doable, and it’s amazing how much relief and stability this can bring!
Medication can play a role to help you feel less emotionally sensitive, but it will not change unhealthy thoughts or behaviors that need to be addressed. Medications don’t teach skills, but they can (for some people) make skills more learnable, because they can help decrease the intensity of your overwhelming emotions. It’s important to know that medications don’t ultimately solve or treat BPD. Many people with BPD can become very frustrated with medications, feeling like nothing works or that they are untreatable. It’s not about being untreatable, it’s just about having the right treatment.
Long-term Expectations for BPD
BPD has great statistics for long term outcomes if the right interventions occur. In general, the data shows that individuals with BPD significantly improve in their behavior and ability to have healthier relationships, but that feeling emotionally sensitive is a symptom that can linger. This is because feeling emotions in a deep way is more of a personality trait, and this can be used for good as long as you are aware that it’s true for you. You can channel your emotional sensitivity to being a highly compassionate person, being easily in tune with your emotions, and being a strong relational person. Being aware of your emotional sensitivity traits also helps you know your triggers and warning signs for when you need space to cope and regulate.
Where to get treatment?
Solstice Pacific offers DBT and CBT skills through PHP and IOP. These skills are learned and practiced in group settings (which is very helpful for breaking away from stigma and learning Healthy Connections). These skills are also tailored and learned in individual case management sessions, so that you can meet specific goals. Medication management is also offered in PHP, so that you can possibly receive additional help for emotional support.
Remember, it all comes down to learning and practicing skills to find relief for BPD. The best way to learn skills is with repetition and in a safe environment. This helps you learn them more efficiently so that they become second nature or automatic. Skills aren’t learned overnight but with weekly or biweekly therapy appointments and daily practice, the changes you desire are attainable. PHP is an effective first step for you to get tools under your belt and find healing. In our program, you will:
Learn contrary action (how to respond in healthier ways),
Practice healthy routines,
Identify, refute and restructure cognitive distortions,
Build up lagging skills (such as how to connect with others in healthy ways, how to regulate emotions, etc),
Gain a wider lens to see things more flexibly and with curiosity,
Participate in habits that define healthy relationships.