Mental Health

An Introduction to Borderline Personality Disorder

The hardest thing I’ve ever had to do is just to live. It doesn’t come easy for me as a person with depression, but it especially doesn’t come easy as a person with borderline personality disorder (BPD). If you don’t know much about BPD, here’s a crash course in what it is, and what living with it is like.

What is BPD?

BPD is at its most basic, a personality disorder. That means it’s a problem with how you view the world and it colors every other aspect of how you act and what you do. People with a personality disorder (at least in my experience) cannot do anything ‘normally’ unless they have been through enough therapy to cause them to no longer meet diagnostic criteria, which is very difficult.

Borderline personality disorder is called that because it used to be considered to be the ‘borderline’ between neurosis and psychosis. In the most up to date parlance, it’s called emotionally unstable personality disorder, which describes it a lot better. However, people don’t really search for EUPD as much as they search for BPD, and I still call it borderline.

To have BPD, you need to have five of nine criteria:

(1) frantic efforts to avoid real or imagined abandonment. 
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5. 
(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation 
(3) identity disturbance: markedly and persistently unstable self-image or sense of self 
(4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating). 
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5. 
(5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior 
(6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoriairritability, or anxiety usually lasting a few hours and only rarely more than a few days) 
(7) chronic feelings of emptiness 
(8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights) 
(9) transient, stress-related paranoid ideation or severe dissociative symptoms

I think with the advent of the DSM-5 these are actually no longer in use officially, but that is how I was diagnosed so I still put some weight on it. I think I have seven or eight of the symptoms, but it’s difficult to tell from within yourself. By the way, if you think you fit these symptoms, you should talk to a mental health professional! They know the questions to ask to get you diagnosed and helped.

How is BPD treated?

BPD is actually very difficult to treat. One main way it is treated is through DBT (dialectical behavioral therapy), a therapy created by a woman with BPD for other sufferers. I am currently in a DBT group that is open to people without BPD, so I find it to be a little bit ineffective since the other people in the group don’t seem to know what I am going through. I have tried to do DBT by myself as well and didn’t like it, but I don’t think you should take my opinion as a definite. It works really well for the vast majority of people with BPD who have tried it.

One other thing to know about BPD is that medication does not help it. Usually, people with BPD have a comorbid (that is, at the same time) disorder like depression or anxiety, so medication can treat those and by association make the BPD a little bit less horrible.

What is living with BPD like?

The short answer: absolutely horrible. The long answer: it’s basically like living with a mean little demon in your head that tells you everyone hates you and wants you to be unhappy. It says that no one wants to be around you and that you need to constantly give tests to people to see if they still love you. Living with BPD is like having a self-doubting voice going 100% of the time. It causes you to ‘split’ at a moments notice, suddenly forgetting every good thing a person has ever done for you and deciding they have always been mean to you – and the way it works is that you can’t remember anything good.

Some people say mental illness can be like a superpower, like something that can sometimes be considered an advantage. BPD is not one of the disorders that can be considered an advantage at any point – it’s always 100% awful. As my mother says about a variety of things, it’s full of evil.

Do any of you have BPD? What are your best coping skills for it? Do you want me to do introductions like this for other illnesses I deal with?

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