Borderline Personality Disorder is a mental health condition that is characterized by rapidly varying moods, an uncertain sense of self, impulsiveness, and a lot of fear. With BPD, a person’s thought patterns, feelings and behaviours cause difficulty in their day-to-day life.
A personality disorder is a persistent pattern of an individual’s inner experience and behaviour that is distinguished from one’s cultural expectations. BPD disorder is denoted by a pattern of unstable moods, volatile and impulsive behaviour, issues in interpersonal relationships that are developed mostly in early adulthood and causes immense distress in an individual’s life.
What are the Traits of Borderline Personality Disorder (BPD)?
Borderline personality disorder (BPD) roughly affects 1- 3% of the general population. The personality disorder is marked by unstable relationships, volatile behaviour and emotional reactivity, impulsivity that is developed mostly in adolescence. The name borderline in the disorder denotes its symptoms mimicking a hoard of disorders; especially major mood disorders and impulse control disorders.
Individuals with BPD disorder have BPD traits that markedly show their distress while living.
- Make desperate efforts to avoid being abandoned – Individuals with BPD when sense or experience forthcoming rejection or separation or even loss of external structure, they may experience changes in their self-image, mood, thinking and behaviour. This fear of abandonment can be real or perceived. Individuals with personality disorders are extremely sensitive to the environment they live in; any changes could immediately affect their sense of self and being.
Separation or sudden changes of any kind ignites inappropriate anger and fears within them e.g., they would feel angry if their text messages from their loved ones are not replied, or if their loved one fails to be on time.
Experiencing such low tolerance for abandonment and constantly seeking people around them could lead to them taking desperate and impulsive resorts to avoid abandonment like self-mutilation or suicidal behaviours.
- Experience a pattern in their relationships that are unstable and intense – Individuals with BPD tend to highly regard and idealize their partners or loved ones. Too soon into a relationship and they would be extremely demanding of the time spent together in the relationship and need to share their most intimate details.
When the standards of idealization for their partners are not met they quickly devalue them e.g., believing their partners do not care about them. They are able to empathize and nurture their loved ones but only meeting with an expectation that their own needs and demands are met. They have the tendency to suddenly and dramatically shift their view of others when their expectations are not met.
- Disturbances in identity – It is one of the prominent borderline personality disorder traits. Individuals with BPD persistently show disturbances in their sense of self and self-image. There would be sudden and dramatic shifts in what they perceive of themselves. This is noticed in their changing goals, careers, opinions, sexual identity and values. Individuals with this personality disorder would one day seem needy and suddenly become a righteous avenger.
Mostly their self-image is based on being bad, and at times they have felt like they do not exist at all. These feelings usually occur when they lack meaningful, supportive and nurturing relationships. These individuals also have a tendency to perform badly at work or school.
- Impulsivity – Individuals with the personality disorder display impulsivity that is potentially damaging to self. They would be uninhibited and reckless in at least two areas of living; some of which are sexual intimacy, spending behaviour, substance use, eating, gambling, safety, etc.
- Suicidal behaviour – Individuals with BPD display behaviours, threats or gestures related to suicide or self-mutilating behaviour like cutting or burning. Suicide amongst these individuals occurs 8%-10% of the time.
These acts of self-destruction are predominantly carried out in order to threaten loved ones or partners when they fear rejection or separation and even in the times when they experience dissociation in order to feel alive.
- Instability in moods – Individuals with BPD display instability in their moods, i.e. they would either show intense episodic sadness, anxiety, or irritability that could last for a few hours or days. Due to their instability in mood, they often experience bouts of anger, despair or panic that is rarely subsided or relieved by satisfaction or well-being. Due to this, the individual may experience interpersonal stress.
- Feelings of emptiness – Individuals with BPD experience chronic feelings of emptiness. These feelings usually ignite tendencies for them to constantly seek something or do something.
- Issues with Anger – Individuals with BPD also experience inappropriate and intense anger. Their inability to control or manage their anger causes them to have volatile outbursts and bitterness towards their loved ones. The source of this anger is usually their perception of their loved ones showing abandonment, neglect, uncaring and withholding. Post such bouts of anger they would often feel guilt and shame.
- Paranoia and suspicion – Individuals with BPD also experience extreme stress due to their paranoia and suspicion or even due to their dissociation where they feel separated from self. These experiences occur mostly when a real or imagined abandonment takes place. These symptoms could last for a few minutes or hours.
What are the Causes of Borderline Personality Disorder?
Borderline Personality Disorder causes are difficult to define. BPD is not caused due to a single factor but is likely to be developed due to a combination of factors. They include –
The vulnerability of developing BPD increases if you have a history of the mental illness running in your family. Almost 60% of the time the cause of BPD is due to genes. Many studies carried out show examples of how genetic influences play a huge role in determining the development of personality disorder. A strong linkage is seen in chromosome 9. However, be cautious of the fact that there is no evidence of a particular gene for the development of BPD.
- Issues with brain chemicals
Individuals who suffer from BPD have malfunctions in their brain chemicals specifically serotonin. Brain chemicals are essential in controlling functions in the brain. Alterations in the levels of serotonin have links to regulation in mood, aggression, depression and issues with controlling destructive urges.
- Abnormalities in brain structure and functioning
Studies using MRI scans have helped to understand abnormalities in the brain associated with the development of BPD. The scans reveal that most individuals with BPD showed three parts of the brain that had unusual levels of activity or were either smaller than they were supposed to be. These parts of the brain were:
- The amygdala – The part of the brain associated with regulating emotions, specifically the more “negative” emotions, like aggression, fear and anxiety.
- The hippocampus – The part of the brain associated with regulating behaviour and self-control.
- The orbitofrontal cortex – The part of the brain associated with decision making and planning.
These areas of the brain contribute to symptoms of BPD. The reasoning behind this structuring is associated with environmental and social factors.
- Environmental and social factors
Environmental and social factors in childhood play a large role in the development of BPD. Most individuals who suffer from BPD have been victimized or exposed to environmental and social factors so grave that contributed to the development of personality disorder. They include:
- Being exposed to chronic distress or fears as a child
- Being victims of sexual, physical or emotional abuse.
- Being subjected to parental neglect or abandonment
- Being brought up or growing up with a family member/s who suffered from serious mental illness, like bipolar disorder, depression or substance abuse.
- Unstable family relationships.
A study published in Advances in Psychiatric Treatment indicates that 87% of the individuals diagnosed with BPD, reported childhood trauma.
The relationship a child shares with one’s parents and family determines a huge part of one’s perception and interaction with the world. Unresolved issues in childhood could later develop into distorted thinking patterns as adults.
What are the Symptoms of Borderline Personality Disorder?
The BPD symptoms manifest in different ways, they include the following. To be diagnosed with BPD, one must show at least five of the following symptoms. These symptoms could occur from early adolescence.
- Fear of being left alone – Here the individual takes desperate measures in order to avoid any kind of abandonment. The abandonment could be real or perceived.
- Instability in relationships – BPD is marked by an individual’s inability to maintain or sustain relationships. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
- Identity disturbance – Individuals in BPD show persistent instability when it comes to their self-image or sense of self.
- Impulsivity – Individuals who suffer from BPD show spontaneous and uninhibited behaviour in at least two areas of living that end up being self-damaging. Areas such as sexual intimacy, spending behaviour, substance use, eating, etc. They engage in increased reckless and risk-taking behaviours like driving recklessly.
- Suicidal behaviour – Individuals experience and engage in recurrent suicidal behaviour and gestures. They would also adopt self-harm threatening means. They have also had past experiences of self-harm.
- Unstable affect – Individuals here experience mood and emotional fluctuations that could last about from a few minutes to hours to even days. Suddenly going from happy to sad. Along with that they also experience irritability and anxiety.
- Feelings of emptiness – Individuals with BPD also experience emptiness or void within them. This feeling of emptiness drives them to engage in impulsive behaviours in order to somehow fill in their void.
- Intense anger – Individuals with BPD also experience intense and irrational anger that ends up being quite difficult to control. They would frequently display anger, engage in physical fights, etc.
- Suspicious without proper evidence – Individuals with BPD experience paranoia and suspicion of others’ motives towards themselves that could sometimes be incongruent with reality. They could also experience dissociative symptoms, where they would feel spaced out or have an out-of-body experience.
Risk Factors Related to Borderline Personality Disorder
People with BPD tend to view things in extremes, either something is too good or too bad. They find it difficult to regulate emotions. They experience major mood swings and display uncertainty about their role among others. Off late borderline personality disorder in teens is being diagnosed early helping in better patient outcomes. Some of the risk factors include –
- Poorly developed or unstable self-image
- Always being self-critical
- Dissociative feelings or disconnection from your thoughts or sense of identity
- Experiencing a persistent feeling of being ‘empty’ inside
- An unstable and constant change of goals, values, aspirations, or career plans
- Inappropriate, intense anger or problems controlling anger
- Not able to recognize the feelings and needs of others
- Lack of empathy for family and friends
- Being very unsure about yourself and not really knowing who you are or what to think about yourself
- Difficulty in intimacy
- Unstable relationships marked by conflict, mistrust, neediness
- The constant fear of rejection and being abandoned
- Feelings of isolation, boredom, and emptiness
- Impulsive, risky, self-destructive, and dangerous behaviours
- Alcohol, drug, or substance abuse
- Recurring thoughts of suicidal behaviours or threats
- Experiencing other mental health problems due to BPD
- Feeling paranoid
- Having psychotic experiences, such as seeing or hearing things that other people don’t
- Feeling numb or ‘checked out’ and not remembering things very well – a condition called dissociation.
Individuals who are diagnosed with borderline personality disorder find instability their whole lives; i.e. in their relationships, thoughts, moods, behaviour, and even in their concept of themselves. But there is hope for individuals who suffer from BPD with the help of effective treatments and coping skills individuals could manage and control their thoughts, feelings, and actions.
Can Borderline Personality Disorder Be Cured?
There has been quite a number of research on therapies that can be effective in the treatment of borderline personality disorder or BPD. BPD characterizes an individual with impulsivity, unstable relationships, high emotional impulses and feeling of abandonment. There are also other symptoms but these are primary.
The question of BPD being “cured”, that is the complete absence of symptoms, may or may not happen as it depends on various internal and external factors. However, reduction and effective management of the symptoms promoting normal and positive functioning are witnessed.
BPD is considered one of the most difficult-to-handle personality disorders. Hence quite a few studies were conducted to develop psychotherapies specifically for BPD. And Dialectical behavioural therapy is one of them. There are other therapies provided by psychologists and psychiatrists also available for the treatment of BPD.
Apart from these professional treatment options, there are a few self-help techniques you can apply that can help manage BPD symptoms. Note that these self-help techniques cannot be used as a treatment for BPD but rather they help, along with therapy, in reducing the symptoms.
- Accepting emotions can be tough but is necessary. A simple way of doing that is to simply observe these emotions without judgments. This does not mean you need to act on these emotions but rather simply observe and be aware of them.
- Reduce stress by relaxing. In BPD an individual is highly sensitive and emotional, even a small stressful incident can be triggering and overwhelming. Relaxation techniques like mindfulness or engaging in the desired activity can help.
- To deal with impulsivity it is important that you become aware of them. This is necessary as every impulse may result out of distress. Giving in to these impulses gives only temporary relief. Once you are aware of this distress you are in a better position to effectively solve the issue.
- When you feel the distress is too overwhelming, distract yourself. Any activity that you can completely pay attention to. This helps you calm down and later on you would be in a better position to think practically.
- Try to control your assumptions. When interacting with others pay attention to your assumptions. Once you identify them, sit back and reflect on them if they are valid or not and the best way is to clarify with the other person.
Cadabam’s is reputed as the best residential treatment for Borderline Personality Disorder in Bangalore. Everything that we do here is majorly focused on patient experience and clinical expertise. We understand that every individual with BPD exhibits different traits and has unique needs. We take the utmost care in tailoring the best-personalised treatment plans for everyone.
We deliver collaborative care. We work in collaboration with psychiatrists, physicians, mental health care teams and your loved ones to deliver the best possible care.
We aim at making every visit of yours to our clinic a pleasurable experience. We help you fight your condition effectively by making you feel at home.
We know how tough it is to deal with borderline personality disorders and make the right choices for well-being. Our goal is to ensure that every resident receives support and reinforcement in areas of distress tolerance, reality acceptance skills, interpersonal skills and emotional regulation skills. For help with borderline personality disorder, call us now on +919611194949.
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