Written by: Samaira Tohin
Edited by: Eastlyn Zhou
Imagine living in a building with an unstable foundation. The ground doesn’t feel completely solid, and the walls seem to sway even with the slightest breeze. It seems as if one small misstep can lead to the whole structure collapsing. This is how people with Borderline Personality Disorder feel when navigating their emotions.
What is Borderline Personality Disorder?:
Borderline Personality Disorder (BPD) is a mental health condition in which a person has a persistent pattern of emotional instability. This leads to instability in interpersonal relationships, increased impulsivity, and unhealthy self-image views. The condition also comes with a strong fear of abandonment, which leads to impulsive behaviors like self-injury that can push people away from them.
Other symptoms of the disease can include persistent feelings of emptiness, episodes of stress-related paranoia and disconnection with reality, threats of suicide or self-injury, often triggered by concerns of abandonment or rejection, and unwarranted displays of strong anger (DSM-5-TR 2022). Not everybody with BPD necessarily experiences these symptoms but they do persist.
How does it start?:
The origin of BPD is multifaceted, arising from a combination of genetic, social and environmental factors. Individuals with a family history of the disorder may have a higher likelihood of developing it themselves. Adverse childhood experiences such as abuse, abandonment or hardship can also be a very strong factor in the development of the disorder. It usually emerges during early adulthood and symptoms are most severe during this time period. While problems like mood swings, anger and impulsiveness can eventually improve as one ages, issues relating to self-image, relationship stability and fear of abandonment can stubbornly persist (U.S. Department of Health and Human Services).
Treatments:
A licensed mental health professional (a psychiatrist, psychologist or clinical social worker) can diagnose one with BPD. They do this through lengthy psychological and medical evaluations. BPD is usually diagnosed in late adolescence or early adulthood. Psychotherapy is the main treatment for the disorder. Several approaches have been deemed effective in treating BPD which includes: Dialectical Behavior Therapy (DBT), Cognitive Behavior Therapy (CBT), and various other methods. Medications aren’t typically used to treat the condition, but they may be prescribed by psychiatrists to treat certain symptoms such as depression or mood swings ((U.S. Department of Health and Human Services).
Stigma Surrounding BPD:
Not only does BPD challenge people who live with it but also people who seek to understand it. All mental disorders have some sort of stigma surrounding it. However in the case of BPD, it is more prevalent because of how complex the disorder is and how many misconceptions surround it.
One common misconception is that people living with BPD are manipulative and attention-seeking. However, this does not signify deliberation on their part. People with the condition resort to these unhealthy coping skills usually because they cannot seek the relief they need. Their behaviors stem more from difficulties in regulating their own emotions rather than the desire to deliberately manipulate others. Another harmful misconception surrounding the condition is that people with BPD are dangerous. While people with the condition are more prone to emotional volatility, it doesn’t mean they are a threat to others. In fact, they are more likely to hurt themselves than hurt others on account of their high self-harm and suicide rates (The Recovery Village, 2023).
Unfortunately, there is also negative bias surrounding BPD in health practice. Because of this, people with BPD can be undiagnosed or misdiagnosed. “In past research, clinicians have reported feeling less optimism, less empathy and more hostility in relation to patients with BPD, compared with patients with other disorders. These negative attitudes and ideas may result in less effective care and lead some clinicians to avoid working with patients who have BPD” (Masland & Peeples, 2023). Promoting empathy and understanding can help to create a more supportive environment for BPD patients so that they can receive the care they deserve.
Returning to the unstable building analogy, people with BPD feel a similar way due to the precarious nature of their emotions, relationships, and self-perception. They feel as if these fundamental life aspects have been built on a shaky ground, susceptible to collapse at any moment. This uncertainty leaves people with BPD feeling vulnerable and unsettled. However, just like a homeowner must reinforce and fortify the structure of their house, those with BPD must do the same with their wellbeing and work towards strengthening their emotional resilience and maintaining their own stable foundation.
References:
Diagnostic and statistical manual of mental disorders fifth edition text revision: DSM-5-TR. (2022). . American Psychiatric Association Publishing.
Klein, P., Fairweather, A. K., & Lawn, S. (2022). Structural stigma and its impact on healthcare for borderline personality disorder: A scoping review. International Journal of Mental Health Systems, 16(1). https://doi.org/10.1186/s13033-022-00558-3
Masland, S. R., & Peeples, H. E. A. (2023, March 7). People with bpd need compassion yet even clinicians stigmatise them: Psyche ideas. Psyche. https://psyche.co/ideas/people-with-bpd-need-compassion-yet-even-clinicians-stigmatise-them
The Recovery Village. (2023, August 11). Myths (and facts) about borderline personality disorder (BPD). The Recovery Village Drug and Alcohol Rehab. https://www.therecoveryvillage.com/mental-health/borderline-personality-disorder/bpd-myths/
U.S. Department of Health and Human Services. (n.d.). Borderline personality disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/borderline-personality-disorder#:~:text=What%20is%20borderline%20personality%20disorder,impact%20their%20relationships%20with%20others
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