Borderline Personality Disorder

Borderline Personality Disorder

Also known as BPD or EUPD (emotionally unstable personality disorder)

This particular mental health condition is difficult to diagnose and treat. It has been negatively stereotyped in the media and there is still a lot of stigma surrounding the condition. There are thought to be 5 general types of borderline personality disorder, but this is not applicable for every patient with BPD. They can shift between categories. 

Five types of Borderline Personality

Affective

The first type of BPD is characterised primarily by emotional dysregulation. In simpler terms, this means feeling like you can’t control your emotions.

Impulsive

Dr. Oldham said that similar to the affective type of BPD, the impulsive type of BPD involves a loss of control. Instead of losing control of your emotions, it’s losing control of your behaviour.

Aggressive

The third type of BPD is connected to the uncontrollable symptom of BPD. This anger seems inappropriate due to the scale of the anger being disproportionate to the circumstances.

Dependant

People with this type of BPD often weren’t encouraged to become independent and autonomous growing up, leaving them with overly dependent behaviors in adulthood.

Empty

Like the dependent type, people with the fifth “empty” type of BPD often struggle with identity issues and with trusting others or may feel directionless in terms of setting personal goals.

This blog post will cover…

Causes & Symptoms

Recognise BPD

Coping Tips

Treatments

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You might not know…

  1. BPD sufferers have unusal brain activity … in many people with BPD, 3 parts of the brain were either smaller than expected or had unusual levels of activity.

  2.  Not all sufferers experience the same symptoms, to be diagnosed with BPD you must present with five or more of the criteria symptoms.

  3. Dialectical behaviour therapy is the most effective, highly recommended treatment for people with BPD.

Causes

There are studies supporting a hereditary correlation amongst BPD sufferers, but no confirmation that it is a genetic disorder. Most mental health professionals believe that borderline personality disorder is caused by a combination of inherited or internal biological factors and external environmental factors, such as traumatic experiences in childhood.

Invalidating Environments

Emotional, sexual or physical abuse, exposure to long-term stress or fear as a child, neglected by 1 or both parents, growing up with another relative with a serious mental health condition, or insensitivity toward children's emotions. For example, assuming a child is being oversensitive. Children cannot communicate or work through emotions properly unless an adult can show them how to do so first. These environments can be hidden or disguised.

Brain Chemicals

It's thought that people with BPD have damaged neurotransmitters or receivers in their brain, particularly for serotonin. Neurotransmitters are messenger chemicals used by the brain to transmit signals between cells. Altered levels of serotonin are linked to depression, aggression and difficulty controlling destructive urges. The fight or flight urges would over produce cortisol in the brain (stress chemical) leading to chronic damage from long term stress and anxiety.

Brain Abnormalities

Researchers have used MRI to study the brains of people with BPD. MRI scans use strong magnetic fields and radio waves to produce a detailed image of the inside of the body. The scans revealed that in many people with BPD, 3 parts of the brain were either smaller than expected or had unusual levels of activity. There are medical debates as to whether BPD is a neurological disease as opposed to a mental health personality disorder.

Symptoms

There are 9 main symptoms, of which 5 need to be present in order for a healthcare professional to diagnose BPD.


In addition to this there are changes to the amygdala, the hippocampus and the orbitofrontal cortex, which control emotional regaulation, behaviour and decision making. It is unclear whether this is the cause or a consequence of the condition. 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.

**Important Information** Some people with BPD will contain their emotions internally, on the exterior seeming calmly collected, whereas others might have explosive episodes of emotional outbursts. Don’t give up! With time and dedication, you can change the way you think, feel, and act.

Fear of Abandonment

Unstable Relationships

Lack of Self Image

Impulsive Behaviour

People with BPD are often terrified of being abandoned or left alone. Even small things like a loved one arriving late or going away for the weekend may trigger intense fear. This can prompt 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. This behaviour tends to have the opposite effect—driving others away.

People with BPD tend to have relationships that are intense and short-lived. You may fall in love quickly, believing each new person is the one who will make you feel whole, only to be disappointed. Your relationships seem perfect or horrible, without middle ground. Your lovers, friends, or family members may feel like they have emotional whiplash as a result of your rapid swings from idealisation to devaluation, anger, and hate.

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.

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 behaviours may help you feel better in the moment, but they hurt you and those around you over the long-term

Self-harm

Mood Swings

Emptiness

Explosive Anger

Paranoia

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.

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.

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.

Recognising 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 behaviours 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.

Coping with Borderline Personality Disorder - Top Tips

Tip 1: Calm the Storm
Tip 2: Ground the Senses

As someone with BPD, we spend a lot of time fighting impulses and emotions. Acceptance can be a tough to wrap your head around. Accepting your emotions doesn’t mean approving of them or resigning yourself to suffering. It means you stop trying to fight, avoid, suppress, or deny what you’re feeling. Giving yourself permission to have these feelings can take away their power.

Try to simply experience your feelings without judgment or criticism. Let go of the past and the future and focus exclusively on the present moment. Mindfulness techniques can be very effective in this regard.

Start by observing your emotions, as if from the outside.
Watch as they come and go (it may help to think of them as waves).
Focus in on the physical sensations that accompany your emotions.
Tell yourself that you accept what you’re feeling right now.
Remind yourself that just because you’re feeling something doesn’t mean it’s reality.

Engaging sense is one of the quickest and easiest ways to self-soothe as distress tolerance. 

You will need to experiment to find out which sensory-based stimulation works best. 

You’ll need different strategies for different moods. What may help when you’re angry or agitated is different from what may help when you’re numb or depressed.

You can try identifying all the things you can sense in moments of distress or use a sensory feeling to help.

Touch. If you’re not feeling enough, try running cold or hot water over your hands; hold a piece of ice; or grip an object or the edge of a piece of furniture as tightly as you can. 

Taste. If you’re feeling empty and numb, try sucking on strong-flavoured mints or candies, or slowly eat something with an intense flavor, such as salt-and-vinegar chips. 

Smell. Light a candle, smell the flowers, try aromatherapy, spritz your perfume, or whip up something in the kitchen that smells good. You may find that you respond to strong smells, like citrus.

Sight. Focus on an image. This can be something in your immediate environment (a great view, a beautiful flower arrangement, a favourite painting or photo) or in your imagination.

Sound. Try listening to music, a buzzer, or blowing a whistle when you need a jolt. To calm down, turn on soothing music or listen to the sounds of nature, such as wind, birds, or the ocean. 

Tip 3: Reduce Emotional Vulnerability
Tip 4: Reduce Emotional Vulnerability

You’re more likely to experience negative emotions when you’re run down and under stress. That’s why it’s very important to take care of your physical and mental well-being.

Take care of yourself by:

  • Avoid mood-altering drugs
  • Eating a balanced, nutritious diet
  • Getting plenty of quality sleep
  • Exercising regularly
  • Practicing mindfulness & meditation
  • Minimising stress
  • Practicing relaxation techniques
  • Visiting your GP if you feel unwell

Learning to implement new coping strategies to replace detrimental behaviours is essential to shifting your mindset and creating successful change. It will seem difficult at first, but after a lot of practice, you will feel the positive change as your perspective moves.

There are self-help resources on how to get start at DBT SELF HELP’s website. They provide radical acceptance, distress tolerance and impulsivity information to help take back control of your life.

You must practice the DBT skills at every opportunity, even for small emotions that you think won’t have an impact, to get used to accessing the tools to make it automated behavoiur to replace the unhealthy coping strategies currently being engaged. 

Tip 5: Interpersonal Skills
Tip 6: Take Responsibility

BPD leads to difficulty in maintaining stable, satisfying relationships with lovers, co-workers, and friends. This is because you have trouble stepping back and seeing things from other people’s perspective. You tend to misread the thoughts and feelings of others, misunderstand how others see you, and overlook how they’re affected by your behavior. Sometimes it’s just plain assumptions!
It’s not that you don’t care, but when it comes to other people, you have a big blind spot. Recognizing your interpersonal blind spot is the first step. When you stop blaming others, you can start taking steps to improve your relationships and your social skills.

Stop to consider the different possibilities. Maybe the person is under pressure at work, having a stressful day, hasn’t had a coffee yet. There are many alternative explanations for behavior.
Ask the person to clarify their intentions. One of the simplest ways to check your assumptions is to ask the other person what they’re thinking or feeling. Double check what they meant by their words or actions. Instead of asking in an accusatory manner, try a softer approach: “I could be wrong, but it feels like…” or “Maybe I’m being overly sensitive, but I get the sense that…“

To fight projection, you’ll need to apply the brakes—like you did to curb impulsive behaviors. Tune into emotions and the physical sensations in your body. Take note of signs of stress, such as rapid heart rate, muscle tension, sweating, nausea, or light-headedness. When you’re feeling this way, you’re likely to go on the attack and say something you’ll regret later. Pause and take a few slow deep breaths. Then ask yourself the following three questions:

  • Am I upset with myself?
  • Am I feeling ashamed or afraid?
  • Am I worried about being abandoned?

    If the answer is yes, take a conversation break. Tell the other person that you’re feeling emotional and would like some time to think before discussing things further

Finally, it’s important to take responsibility for the role you play in your relationships, behaviours and outcomes. Ask yourself how your actions might contribute to problems. How do your words and behaviors make your loved ones feel? Are you falling into the trap of seeing other people as either all good or all bad? As you make an effort to put yourself in other people’s shoes, give them the benefit of the doubt, and reduce your defensiveness, you’ll start to notice a difference in the quality of your relationships.

Try our page on self-help, mindfulness, or check out the other services if you need further support. Alternatively, contact us.

This Post Has 2 Comments

  1. Heidi

    As someone waiting for a formal diagnosis, this is most helpful. Thank you.

    1. LighterMinds

      We’re happy it’s helped. If there are any specific questions relating to this post feel free to get in touch.

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