Written by: Daniella Marchese
Edited by: Taina Stuart
Borderline Personality Disorder (BPD) is a type of personality disorder that is often misrepresented and misunderstood. Some common misconceptions include that it is untreatable, avoidable, attention-seeking behavior, unharmful, and people with borderline personality disorder cannot live on their own (Mattocks 2019). This article will debunk these common myths, clarify what borderline personality disorder is, and discuss treatment options.
According to the DSM V, which is the authoritative guide for diagnosing mental disorders, to be diagnosed with borderline personality disorder, one must experience “impaired personality functioning,” such as within the self (identity and self-direction or goals), and with other people (issues with empathy and intimacy) (American Psychological Association 2011). There must also be “pathological personality traits” in areas such as affect, disinhibition, and antagonism (American Psychological Association 2011). Affect refers to their emotional experience, specifically relating to anxiety, fears of separation, depression, and mood instability. Disinhibition refers to risky behaviors and impulsions. Antagonism refers to frequent anger or outbursts. These observable personality dysfunctions must be consistent over time and not normal with respect to their socio-cultural surroundings. These symptoms must also not be related to substance use or a medical condition. Suicidal risk should always be taken into consideration for people with borderline personality disorder due to their negative affect, risky and impulsive decision making, and short temper. People diagnosed with borderline personality disorder often have comorbidities with other psychiatric disorders, such as mood disorders, anxiety disorders, eating disorders, and substance use disorders (Pascual et al., 2023).
People often misconstrue borderline personality disorder as being untreatable. This is not the case. Some evidence-based treatment options include dialectical behavioral therapy (DBT), “mentalization-based treatment (MBT), schema-focused therapy (SFT), transference-focused psychotherapy (TFP), and systems training for emotional predictability and problem solving (STEPPS)” (Choi-Kain et al., 2017, p. 21). The most common and widely known treatment option is DBT. DBT is a form of talk therapy which aims to recognize one's thoughts, understand how that way of thinking may be unhealthy, and try to change that way of thinking into more positive, productive thoughts (Choi-Kain et al., 2017). This form of treatment can help with antagonistic tendencies and short tempered outbursts. It can also help people with borderline personality disorder to understand the consequences of their actions, regarding their risk-taking and impulsive tendencies. DBT can help people become more mindful and patient with those around them and encourage them to think before acting. Another form of treatment for borderline personality disorder is through psychiatric medications, yet these are not studied as extensively as talk therapy forms of treatment (Choi-Kain et al., 2017). Due to the lack of consensus surrounding psychiatric medications for borderline personality disorder, many people may have tried multiple medications or taken them simultaneously. Some classes of medications include mood stabilizers, antipsychotics, antidepressants, and benzodiazepines (Pascual et al., 2023, p. 490). While there is extensive research on borderline personality disorder, more research needs to be done to create more agreement and confidence in treatment options. With proper treatment, people can live productive lives.
References:
Choi-Kain, L. W., Finch, E. F., Masland, S. R., Jenkins, J. A., & Unruh, B. T. (2017). What
Works in the Treatment of Borderline Personality Disorder. Current Behavioral
Neuroscience Reports, 4(1), 21–30. https://doi.org/10.1007/s40473-017-0103-z
Liu, Y., Chen, C., Zhou, Y., Zhang, N., & Liu, S. (2024). Twenty years of research on borderline
personality disorder: A scientometric analysis of hotspots, bursts, and research trends.
Frontiers in Psychiatry, 15, 1361535. https://doi.org/10.3389/fpsyt.2024.1361535
Mattocks, N. (2024, February 7). Borderline Personality Disorder Myths and Facts. NAMI.
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Pascual, J. C., Arias, L., & Soler, J. (2023). Pharmacological Management of Borderline
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