Imagine living in a world in which your emotions are constantly shifting and completely out of your control. Every feeling you experience is amplified, and it seems like no one around you sees things the way you do; they just think you are “overreacting.” You constantly feel the need to pull people closer but simultaneously want to push them away. You never seem to be able to maintain friendships or relationships, you are terrified of abandonment and it seems like everyone around you abandons you. It feels like you are on a rollercoaster of emotion at all times, with your feelings, goals, relationships, opinions, and self-esteem shifting often. To cope, you turn to risky and impulsive behaviors and self-harm. Sometimes, it seems like suicide is the only option. This is the life of a person with borderline personality disorder.

What is borderline personality disorder (BPD)?

Borderline personality disorder (BPD) is a mental disorder that is characterized by a pattern of instability. People with BPD experience instability in every facet of their lives, from their moods to their behavior to their ability to function to their self-worth. As a result, they often have mercurial relationships and act impulsively. They may experience episodes of extreme anger, anxiety, or depression that vary from a few hours to a few days long. Signs of BPD often begin in adolescence or early adulthood.

Signs and symptoms

While BPD manifests differently for different people, there are nine major categories of symptoms of BPD. To be diagnosed with BPD, one must manifest symptoms from five of these categories. These symptoms also must have been present for a long period of time and affect your life in a variety of areas.

Extreme fear of abandonment

People with BPD often experience extreme fear of abandonment. They are terrified that the people who they love will leave them, and even something as small as their loved one forgetting to text them back can throw them into a state of terrible anxiety. This can lead to them desperately try to pull people closer, and they may turn to strategies such as begging, being “clingy”, tracking movements out of jealousy, and maybe even physically stopping someone from leaving. Ironically and unfortunately, these attempts tend to backfire and drive people away.

Instability in relationships

People with BPD are more likely to have intense but brief relationships. They tend to fall in love quickly, but then find themselves disappointed. They tend to either idealize or despise people, and often switch back and forth on this stance about the same person. It is difficult for friends, family, and loved ones to keep up with the unstable nature of relationships with people with BPD.

Unstable sense of self

People with BPD often experience fluctuations in their identity and their self-esteem. They may go between feeling good about themselves to hating themselves in the course of an afternoon. They do not have a stable sense of who they are and what they want to do with their lives. They may frequently switch hobbies, jobs, religions, goals, and even sexuality.

Impulsivity

People with BPD often engage in sensation-seeking, impulsive, and harmful behaviors, particularly when upset. On impulse, they may binge eat or drink, shoplift, have risky sex, drive recklessly, or do a lot of drugs. These acts can be temporarily soothing to someone with BPD, but are ultimately destructive to both the individual and the people around them.

Self-harm and suicide ideation

It is common for people with BPD to self-harm and exhibit suicidal behaviors. Suicidal behaviors include suicidal thoughts, threatening suicide, and actually attempting suicide. Self-harm is an attempt to hurt one’s self but not kill one’s self, such as cutting.

Mood swings

Often, people with BPD have extremely unstable moods and emotions. They feel happy one moment, then depressed the next. Even small actions that others may think nothing of can set them off. While these mood swings are very intense, they tend to pass quickly.

Feeling empty

People with BPD often express feeling empty inside. On the extreme end of this, they may feel like they are literally “nobody.” They often attempt to fill this hole inside them with drugs, food, or sex, but nothing ever truly works.

Angry outbursts

People with BPD often have short fuses or feel anger far more intensely than others. Once angry, they often have difficulty controlling themselves, feeling consumed by their rage. They may feel mostly angry at others or only themselves.

Paranoia and dissociation

Sometimes, people with BPD struggle with paranoid thoughts; they may be highly suspicious of the intentions of others. Under extreme stress, they may also experience the phenomenon of dissociation, during which they lose touch with reality, feel foggy, and as though they are outside their own bodies.

Causes

The cause of BPD has not been established. However, most therapists believe it to be a combination of genetics, environment, and brain characteristics.

  • Genetics: if a family member has BPD, you are five times more likely to develop it.
  • Environment: it is common for people with BPD to report having experienced trauma early in life, such as child abuse or abandonment or exposure to unstable households. However, many people with BPD do not have this history, and many people with traumatic histories never develop BPD.
  • Brain: research shows that people with BPD have differences in their brains around the areas that control impulse and emotional regulation. However, more research needs to be done to understand these differences.

Treatment and prognosis

Borderline personality disorder is most commonly treated with psychotherapy. One promising therapy that shows a lot of success for people with BPD is dialectical behavioral therapy (DBT). The foundation of DBT is focused on helping people with BPD develop behavioral skills to help them regulate and tolerate their emotions and improve interpersonal relationships. Generally, long-term therapy of any kind is used for BPD, and it can be quite helpful for some. While borderline personality disorder has a 10 percent suicide rate, making it 400 times the rate of the general population, there is actually a lot of hope for recovery. With the right therapist and support system, people with BPD can entirely recover and go on to live normal lives. It is common for symptoms of BPD to reduce on their own after the age of 40.

If you are concerned that you or a loved one has BPD, it’s important for you to seek help promptly. While the outlook for recovery is good, it is imperative to be proactive in order to help you or your loved one develop the skills necessary to live a whole life. If you need psychotherapy on Long Island, contact our therapist’s office today.