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An Overview of Borderline Personality Disorder
The discussion at this week's NAMI on Campus meeting was borderline personality disorder. My only prior knowledge of the illness came from the movie Girl, Interrupted. For those of you who haven't seen it, the movie is based on the memoir of Susanna Kaysen, who was hospitalized and diagnosed with the disorder in the 1960's. In researching the topic for this week's discussion, I learned that it is much more complicated and stigmatized than the movie portrays, though it does a good job of showing how someone with the illness might think and feel.
According to the NAMI website, borderline personality disorder, or BPD, is characterized by:
Difficulty regulating emotion
Emotions felt intensely and for long periods of time
Severe mood swings
Stormy personal relationships
Impulsivity and instability
Poor self-image
It is also often misdiagnosed as PTSD or depression. The topic of discussion at every meeting is chosen beforehand by the members of the club. Borderline personality disorder was requested by a member who was misdiagnosed with the disorder a couple of years ago and was just recently told he doesn't actually have it.
BPD is very often misdiagnosed. According to an article written by Kristalyn Salters-Pedneault, PhD, gives a few reasons for why this happens to so many people. One reason is that BPD often occurs with other mental illnesses, such as depression, anxiety, bipolar disorder, substance abuse disorders, and other personality disorders, so BPD might go unnoticed. Another reason is that the symptoms might only show up in close relationships, so it takes a while for a therapist to see them. People with BPD also tend to drop out of treatment early, so the therapist never gets a chance to see the symptoms and make a proper diagnosis. The symptoms of BPD are also very similar to that of other mental illnesses, which can lead to a patient being diagnosed with a similar disorder instead of borderline personality disorder. In fact, while researching BPD for the last NAMI on Campus meeting, I found a lot of similarities with anxiety, such as intense emotions, fear of abandonment, paranoid thoughts, and a distorted or poor self-image.
The symptoms of borderline personality disorder, as listed by NAMI, are actually:
Frantic efforts to avoid being abandoned
“Splitting” personal relationships (idealizing them sometimes and devaluing them other times)
A distorted self-image, which negatively affects the afflicted's mood, values, opinions, goals, and relationships
Impulsive behaviors, such as excessive spending, unsafe sex, substance abuse, and reckless driving
Self-harming or suicidal behavior
Periods of depressed mood/irritability/anxiety, which can last from a few hours to a few days
Chronic feelings of boredom or emptiness
Inappropriate/intense/uncontrollable anger followed by shame/guilt
Dissociative feelings, stress-related paranoid thoughts, even brief psychosis
I don't personally know what it's like to live with borderline personality disorder, but The Mighty has a blog post called "20 Secrets of People Who Live With Borderline Personality Disorder" that is made up of first-hand accounts of what it feels like to be afflicted. Most of the accounts talk about the intense emotions that come with the disorder. It can be a blessing and a curse to feel emotions as deeply as those with BPD do. They know they're overreacting to things but can't help it. Any little thing can get to them, and they can't control that, no matter how much they want to. They try to keep their emotions in check, but it's like a roller coaster ride just being inside their heads.
There's also a lot of stigma that comes with the disorder. It was brought up at the meeting that people think those with borderline personality disorder are abusers, which is just stereotyping. BPD can cause rocky relationships, but that doesn't mean that a person with the disorder is purposefully trying to manipulate people or destroy relationships for the sake of drama. That's another recurring theme in The Mighty's blog post: many of the respondents say that it's hard to trust other people and that the lying, manipulative, selfish, attention-seeking persona of a person with BPD is an extreme example portrayed in the media. They really don't like being frustrating or too much for people to handle.
As tumultuous as relationships can be for people with borderline personality disorder, they actually need support from others for treatment to be successful. According to NAMI, treatment for BPD involves dialectical behavioral therapy (which is intensive training of coping skills for destructive urges and unstable emotions, as well as help with relationships), cognitive behavioral therapy (which helps them recognize negative thoughts and teaches them coping techniques), and mentalization-based therapy (which makes them more aware of their internal states and helps them develop empathy for others. Peer, family, and group support is also listed as treatment for BPD. Various medications can be used to treat the symptoms of anxiety, depression, mood swings, and psychosis. Short-term hospitalization is needed when the afflicted person displays suicidal or self-harming behavior.
NAMI also offers ways to support someone with borderline personality disorder, as well as tips on how to help yourself if you have it. To help others:
Look for warning signs, such as erratic behavior, blow-ups, shopping sprees, and sexual or substance binges. Talk to them early on about it so it can be treated quickly.
Encourage treatment. The stigma surrounding mental illness often causes people to not seek treatment, so don't promote the stigma. Your loved one is receiving treatment just like he or she would for a physical illness.
Understand treatment. Take time to learn the skills and language they are using in treatment so you can support them in it
Be honest, kind, and calm. Don't chide them if they slip up. Make specific offers and follow through with them. Listen and try to understand what they're going through.
To help yourself:
Connect with others who suffer from BPD. You can support and understand each other, and you won't feel so alone.
Avoid drugs and alcohol. They can affect your mood and mess with your medications.
Take care of your body. Maintain a well-balanced diet and exercise regularly. You might also want to try meditation, yoga, or Tai Chi.
Borderline personality disorder is a common mental illness that is often exaggerated and stigmatized in the media. People who are afflicted feel misunderstood and overwhelmed. They need the support of their peers, friends, and family in order to live a healthy life.