Borderline Personality Disorder (BPD) - HelpGuide.org
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Picture yourself on shifting sands—the ground beneath your feet constantly changing and throwing you off balance, leaving you scared and defensive. That’s what it’s like if you have borderline personality disorder (BPD). Almost everything in your world is unstable: your relationships, moods, thinking, behavior, and even your identity. It’s a frightening and painful way to live. But there is hope. There are effective BPD treatments and coping skills that can help you feel better and back in control of your thoughts, feelings, and actions.
What is borderline personality disorder (BPD)?
If you have borderline personality disorder (BPD), you probably feel like you’re on a rollercoaster—and not just because of your unstable emotions or relationships, but also the wavering sense of who you are. Your self-image, goals, and even your likes and dislikes may change frequently in ways that feel confusing and unclear.
People with BPD tend to be extremely sensitive. Some describe it as like having an exposed nerve ending. Small things can trigger intense reactions. And once upset, you have trouble calming down. It’s easy to understand how this emotional volatility and inability to self-soothe leads to relationship turmoil and impulsive—even reckless—behavior. When you’re in the throes of overwhelming emotions, you’re unable to think straight or stay grounded. You may say hurtful things or act out in dangerous or inappropriate ways that make you feel guilty or ashamed afterwards. It’s a painful cycle that can feel impossible to escape. But it’s not.
BPD is treatable
In the past, many mental health professionals found it difficult to treat borderline personality disorder (BPD), so they came to the conclusion that there was little to be done. But we now know that BPD is treatable. In fact, the long-term prognosis for BPD is better than those for depression and bipolar disorder. However, it requires a specialized approach. The bottom line is that most people with BPD can and do get better—and they do so fairly rapidly with the right treatments and support.
Healing is a matter of breaking the dysfunctional patterns of thinking, feeling, and behaving that are causing you distress. It’s not easy to change lifelong habits. Choosing to pause, reflect, and then act in new ways will feel unnatural and uncomfortable at first. But with time you’ll form new habits that help you maintain your emotional balance and stay in control.
Recognizing borderline personality disorder
Do you identify with the following statements?
I often feel “empty.”
My emotions shift very quickly, and I often experience extreme sadness, anger, and anxiety.
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.
When I’m feeling insecure in a relationship, I tend to lash out or make impulsive gestures to keep the other person close.
If you identify with several of the statements, you may suffer from borderline personality disorder. Of course, you need a mental health professional to make an official diagnosis, as BPD can be easily confused with other issues. But even without a diagnosis, you may find the self-help tips in this article helpful for calming your inner emotional storm and learning to control self-damaging impulses.
Signs and symptoms
Borderline personality disorder (BPD) manifests in many different ways, but for the purposes of diagnosis, mental health professionals group the symptoms into nine major categories. In order to be diagnosed with BPD, you must show signs of at least five of these symptoms. Furthermore, the symptoms must be long-standing (usually beginning in adolescence) and impact many areas of your life.
The 9 symptoms of BPD
Fear of abandonment. People with BPD are often terrified of being abandoned or left alone. Even something as innocuous as a loved one arriving home late from work or going away for the weekend may trigger intense fear. This can prompt frantic efforts to keep the other person close. You may beg, cling, start fights, track your loved one’s movements, or even physically block the person from leaving. Unfortunately, this behavior tends to have the opposite effect—driving others away.
Unstable relationships. People with BPD tend to have relationships that are intense and short-lived. You may fall in love quickly, believing that each new person is the one who will make you feel whole, only to be quickly disappointed. Your relationships either seem perfect or horrible, without any middle ground. Your lovers, friends, or family members may feel like they have emotional whiplash as a result of your rapid swings from idealization to devaluation, anger, and hate.
Unclear or shifting self-image. When you have BPD, your sense of self is typically unstable. Sometimes you may feel good about yourself, but other times you hate yourself, or even view yourself as evil. You probably don’t have a clear idea of who you are or what you want in life. As a result, you may frequently change jobs, friends, lovers, religion, values, goals, or even sexual identity.
Impulsive, self-destructive behaviors. If you have BPD, you may engage in harmful, sensation-seeking behaviors, especially when you’re upset. You may impulsively spend money you can’t afford, binge eat, drive recklessly, shoplift, engage in risky sex, or overdo it with drugs or alcohol. These risky behaviors may help you feel better in the moment, but they hurt you and those around you over the long-term.
Self-harm. Suicidal behavior and deliberate self-harm is common in people with BPD. Suicidal behavior includes thinking about suicide, making suicidal gestures or threats, or actually carrying out a suicide attempt. Self-harm encompasses all other attempts to hurt yourself without suicidal intent. Common forms of self-harm include cutting and burning.
Extreme emotional swings. Unstable emotions and moods are common with BPD. One moment, you may feel happy, and the next, despondent. Little things that other people brush off can send you into an emotional tailspin. These mood swings are intense, but they tend to pass fairly quickly (unlike the emotional swings of depression or bipolar disorder), usually lasting just a few minutes or hours.
Chronic feelings of emptiness. People with BPD often talk about feeling empty, as if there’s a hole or a void inside them. At the extreme, you may feel as if you’re “nothing” or “nobody.” This feeling is uncomfortable, so you may try to fill the void with things like drugs, food, or sex. But nothing feels truly satisfying.
Explosive anger. If you have BPD, you may struggle with intense anger and a short temper. You may also have trouble controlling yourself once the fuse is lit—yelling, throwing things, or becoming completely consumed by rage. It’s important to note that this anger isn’t always directed outwards. You may spend a lot of time feeling angry at yourself.
Feeling suspicious or out of touch with reality. People with BPD often struggle with paranoia or suspicious thoughts about others’ motives. When under stress, you may even lose touch with reality—an experience known as dissociation. You may feel foggy, spaced out, or as if you’re outside your own body.
Common co-occurring disorders
Borderline personality disorder is rarely diagnosed on its own. Common co-occurring disorders include:
depression or bipolar disorder
substance abuse
eating disorders
anxiety disorders
When BPD is successfully treated, the other disorders often get improve, too. But the reverse isn’t always true. For example, you may successfully treat symptoms of depression and still struggle with BPD.
Causes—and hope
Most mental health professionals believe that borderline personality disorder (BPD) is caused by a combination of inherited or internal biological factors and external environmental factors, such as traumatic experiences in childhood.
Brain differences
There are many complex things happening in the BPD brain, and researchers are still untangling what it all means. But in essence, if you have BPD, your brain is on high alert. Things feel more scary and stressful to you than they do to other people. Your fight-or-flight switch is easily tripped, and once it’s on, it hijacks your rational brain, triggering primitive survival instincts that aren’t always appropriate to the situation at hand.
This may make it sound as if there’s nothing you can do. After all, what can you do if your brain is different? But the truth is that you can change your brain. Every time you practice a new coping response or self-soothing technique you are creating new neural pathways. Some treatments, such as mindfulness meditation, can even grow your brain matter. And the more you practice, the stronger and more automatic these pathways will become. So don’t give up! With time and dedication, you can change the way you think, feel, and act.
Personality disorders and stigma
When psychologists talk about “personality,” they’re referring to the patterns of thinking, feeling, and behaving that make each of us unique. No one acts exactly the same all the time, but we do tend to interact and engage with the world in fairly consistent ways. This is why people are often described as “shy,” “outgoing,” “meticulous,” “fun-loving,” and so on. These are elements of personality.
Because personality is so intrinsically connected to identity, the term “personality disorder” might leave you feeling like there’s something fundamentally wrong with who you are. But a personality disorder is not a character judgment. In clinical terms, “personality disorder” means that your pattern of relating to the world is significantly different from the norm. (In other words, you don’t act in ways that most people expect). This causes consistent problems for you in many areas of your life, such as your relationships, career, and your feelings about yourself and others. But most importantly, these patterns can be changed!
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