Adolescents typically experience a lot of mood changes from overactive hormones and from the pressure of learning how to deal with the world on a larger scale. Kayla, however, experienced her low mood dips more than most and suspected that her emotional experiences were much more intense and persistent than those of her peers. Hers felt over-the-top and she could not help drowning in an overwhelming tide of separation anxiety, fear of abandonment, and depression. As a consequence, she became solitary, falling behind academically and socially. In 2007, she tried to end her life to stop the persistent avalanche of negative emotions but was rescued in time by a friend. It was only by the time she turned 30 that she got her answer to her uncontrollable emotions and subsequent bad behaviour: Borderline Personality Disorder.
What BPD Is
Borderline Personality Disorder is often a marginalized or misunderstood mental illness. In fact, not many people know such a mental condition exists. BPD requires closer scrutiny as it is a dangerous mental issue with its victims turning to self harm and later, suicide, as a behavioural response to persistent heightened negative emotions. A person with BPD often feels that he cannot possibly control or manage his emotional burdens.
Borderline Personality Disorder is marked by unstable moods and behaviour. Because of the high degree of emotional instability, persons with BPD have trouble maintaining stable relationships. For decades, people with BPD were dismissively labelled as drama queens, clingers, manipulators, and attention-seekers. As there exist such personality types who are not mentally afflicted, the addition of persistent reckless, impulsive behaviours; hallucinations and delusions; and social unpredictability to these traits punctuates the diagnosis for BPD.
As Lottie, a BPD sufferer says, “It’s one of the biggest misconceptions, but we are not attention seekers. We struggle more than we ever let on. The last thing we want is to sit in A&E or in a police cell under section 136. We don’t do this for fun. We fight a battle in our heads every single day, even with a smile on our faces.”
It was only in 1980 that the BPD was recognized as a diagnosable illness in the “Diagnostic and Statistical Manual for Mental Disorders, Third Edition” (DSM-III).
The term “borderline” refers to the fact that BPD exhibits borderline symptoms of other mental disorders. One may find tinges of neurosis, bipolar, schizophrenia, and other versions of mental illness. Thus, it can co-exist with depression, anxiety, self-harm, substance abuse, eating disorders, suicidal behaviours, and other atypical behaviours. BPD is a serious condition because an estimated 60-70% of sufferers attempt suicide sometime in their lives. A few succeed.
Statistics show that women are unfortunately more susceptible to BPD than men. Female patients are more likely to exhibit anxiety disorders, major depression, or eating disorders. Male sufferers typically indulge in substance abuse and antisocial behaviour.
Symptoms of BPD
According to the 4th edition of the DSM, a diagnosis for Borderline Personality Disorder may be made if the patient exhibits a chronic pattern of at least five of these behaviours or symptoms:
• Extreme anxiety, fury, depression, panic, and other negative reactions to abandonment, whether the abandonment is real or simply perceived.
• Intense, bipolar-like mood swings that last from a few hours to a few days. A person with BPD may feel light and glowy in the morning and feel utterly dejected by afternoon.
• Unstable and unpredictable relationship patterns with family and friends marked by intense closeness and love (idealization) for some time and suddenly deviating to severe dislike (devaluation) for another, and back again. In this case, BPD patients cannot form much less maintain strong, stable personal and work relationships.
• Problematic anger management issues
• Weak sense of identity which changes depending on whom the BPD patient is with. The patient often changes plans, goals, values, and opinions and is therefore very prone to manipulative intentions of other people.
• Impulsive behaviours which may cause the sufferer harm. Behaviours may range from quitting jobs, going on spending sprees to indulging in unsafe sex and dangerous thrill-seeking activities without much regard for safety.
• Recurring thoughts and actions concerning suicide
• Self harming behaviours such as cutting, burning, banging head on wall, etc.
• Constant feelings of emptiness, loneliness, and boredom.
• Psychotic experiences; hallucinations, delusions, or hearing things other people do not
• Severe dissociative signs such as feeling numb, observing one’s self like a third person, and losing touch with reality.
What Causes BPD?
BPD is still not very well understood; but scientists agree that both heredity and environment play a role in its inception. Studies have shown that people can inherit temperament particularly impulsiveness and aggression. Traumatic events in childhood such as parental neglect and emotional abuse can instigate BPD development.
BPD is not easy to diagnose simply because it usually is accompanied by symptoms from other mental conditions. Eighty five percent of the time, BPD meets the diagnostic criteria for other mental disorders. As such, one may be misdiagnosed with bipolar syndrome when a broader Borderline Personality Disorder is the true case.
Psychotherapy is a common approach to treating BPD. It is important for a mental health professional to achieve a relationship of trust with his patient as the very nature of BPD makes it very difficult for patients to maintain a bond with their therapist. Psychotherapy can help patients reframe the way they perceive themselves; control intense feelings and destructive behaviours, and improve relationships in the patient’s milieu. This may be conducted as a one-to-one session or in a group setting.
The family of the BPD patient may also stand to benefit from therapy. Oftentimes, the stress of living with a BPD patient takes its toll and may provoke actions, knowingly or unknowingly, detrimental to the BPD sufferer.
It is interesting to note that Omega-3 fatty acid supplementation has helped people with BPD reduce their aggressive and depressive symptoms. In a study done on 30 women, Omega-3 supplements helped stabilize mood in BPD patients and with fewer side effects.
Although difficult to treat, Borderline Personality Disorder does have a silver lining and people with this affliction may improve their mental health over time. It is important to recognize that people with BPD be given appropriate emotional support so that they may have the patience to weather the time it takes for healing to take place.