(tw: self-harm, suicide, substance abuse)
What is BPD?
Borderline Personality Disorder is an illness, often called EUPD, or Emotionally Unstable Personality Disorder. It is included in a list of “cluster-B” personality disorders, including Narcissistic Personality Disorder, Antisocial Personality Disorder and Histrionic Personality Disorder. Many people compare it to Bipolar Disorder, but the two disorders are vastly different and very much unrelated, but both are subject to the same amount of common misconceptions due to the media’s poor portrayals of both.
BPD VS Bipolar Disorder
Borderline Personality Disorder and Bipolar Disorder are often compared, due to the two illnesses sometimes co-occurring. However, they are separate disorders, with different diagnoses.
Although there are common symptoms between the two of them, which include mood swings, self destructive behaviour and suicidal ideations, the two of them differ regarding other symptoms.
Bipolar disorder is often categorised as the “mood swing” disorder, with which people diagnosed will go through stages of mania and depression, where the symptoms of the former include extremely high energy, inflated self-esteem and superiority, talking and thinking quicker than usual, and the symptoms of the latter include having less energy, feeling hopeless, self-destructive tendencies and lacking interest in typical things. Whereas, the most important symptom of BPD is not mood swings, but instead, a very dire fear of abandonment.
Common Symptoms of BPD
Please be reminded not to self-diagnose yourself - if you really believe that you have BPD, please seek a professional and gain a diagnosis.
Self-harming behaviour and/or threats of suicide
Impulsive behaviours, which may include unsafe sex, substance abuse
Changes in self image (Dissociation and/or distorted image of self)
Patterns of unstable relationships, either with friends, family, or partners
Fear of abandonment (Often will go to great lengths to please others in order to not be abandoned)
Intense mood swings
People with BPD cannot lead normal lives
This is a huge misconception. People diagnosed with BPD are no less weak than any other person, and can live perfectly normal lives. Especially with therapy and/or medication, people with BPD can live very happy and normal lives.
People with BPD are all manipulative and controlling
This is another major misconception, which mainly stems from the symptom of BPD which is a dire fear of abandonment. However, studies have shown that people with BPD often have a more idealised image of other people, believing that other people always know what’s best, instead of the other way around. And although many BPD patients will do things that seem to be only beneficial to them, this is not premeditated - but is instead due to impulsivity which BPD does cause, meaning they are not manipulative.
Men are often less diagnosed with BPD than women. In fact, the ratio between men and women with BPD is 1:3. However, like autism, this could be due to the gender biases associated with BPD; instead, men might be diagnosed with PTSD since it is seen as the more “tough” mental illness. In fact, studies have shown that 40% of people with BPD were originally misdiagnosed with another disorder.
In the US, 1.6% of people have BPD. (4 million Americans) Some famous examples include Pete Davidson - a Saturday Night Live Cast Member - Angelina Jolie, and Madison Beer.
Rates of Borderline Personality Disorder patients that are linked with substance abuse are quite high, with 50% of those diagnosed with BPD going through some sort of substance abuse.
Rates of suicide within people with BPD are also high, with about 10% of people diagnosed that have tried to commit suicide.
Causes and/or Risk Factors
Trauma (often childhood trauma is the most common risk factor)
Genes (if a direct family member has a past of BPD, it is more likely for someone to get BPD)
Brain Damage (it is not exactly clear if this is a risk factor of BPD or caused by it, but many people diagnosed with BPD have structural problems with their brain
Abuse (emotional, mental, physical)
Cognitive Behavioural Therapy
CBT is a very widely used therapy treatment, often associated with anxiety and depression. It is very much a therapist directed treatment, where the therapist will often guide you and give you advice, as well as homework to do. It is mainly used to reduce day-to-day symptoms, and most therapists would often use other methods for BPD, including DBT and Schema Therapy.
Dialectical Behavioural Therapy
DBT was created to combat BPD at first, but now has been expanded to help with many different mental illnesses, like depression and others. It focuses on four main skills - mindfulness (staying in the present moment), emotion regulation (identifying emotions and channeling them healthily), distress tolerance (accepting your current emotions and/or situation) and interpersonal effectiveness (being more assertive in a relationship while also maintaining a healthy relationship).
Research has shown that BPD is often related to basic childhood needs that were not fulfilled. These are called schemas, and one example is Social Isolation, where someone might feel like they are not accepted in the world, and therefore sabotage relationships to isolate themselves in fear of being hurt. Schema Therapy hopes to target these specific schemas to help the patient recover.