The name itself is feared, whispered behind the backs of people straddled with a weight I wouldn’t expect anyone to bear. Why is this disorder so stigmatized? What is this disorder? Who suffers from it? The answers may be different from what you expect. I myself, suffer from BPD and have suffered through it for years.
Borderline Personality Disorder (BPD for short) is characterized by 9 distinct traits. To be considered for diagnosis, you must show at least 5 of these traits. In this blog post, I will go over those traits, and explain what they mean. This is not meant to be a way of diagnosing yourself, and if you resonate with these traits, please seek out a licensed psychiatrist to help you through diagnosis.
The first trait we see with people with BPD is an intense fear of abandonment (real or, even perceived abandonment). This trait cuts through every single reported case of BPD. What this means is that every single person with BPD, shows an EXTREME fear of people leaving, or neglecting them. This often stems from some sort of neglect or abandonment in childhood. People with this disorder will do everything in their power to prevent this abandonment from happening, and in turn, they usually create this self fulfilling prophecy. Lashing out, pushing people away, suicidal behavior. Its all a defense mechanism for someone who is desperately trying to avoid the pain from being abandoned. This fear can even run so deep, that the person chooses to leave their life, before anyone else has the chance to abandon them.
The second trait we see is a series of unstable interpersonal relationships. These can be romantic relationships, friendships, coworkers, even family. Its always chaotic. Most of this is due to the first trait, fear of abandonment. Constantly being afraid that people will hurt you, or leave you, is exhausting for everyone involved. The other reason we see so many unstable relationships with people with BPD, is because of the instability of their moods, and the intensity of their emotions. People with this disorder are QUICK to anger. We can go from happy, to sad, to angry, all in the period of ten minutes. This can be a roller coaster ride for the people in our lives. They never know which version of us they are going to get, and that causes people to walk on eggshells around us, always worried about the next big explosion. What people don’t realize, and its not an excuse for the behavior, is how exhausting it is for the person with BPD as well. I never know how someone’s response is going to affect me. I never know if I’m going to walk into a trigger. And while this is confusing, and exhausting, its still my responsibility to control my reactions and reduce damage as much as possible. Part of living with this disorder, is learning to recognize when you’re about to go too far, and removing yourself from the situation before things are said or done that you can’t take back.
The third trait that is commonly found in people with BPD is an unstable sense of self. People with this disorder often report not knowing who they really are. While many people can feel this way, it seems to run deeper with people who struggle with BPD. Someone with BPD can go from seeing themselves as the best thing on this earth, to instantly despising themselves. We can shift from thinking we’re incredibly smart and able, to thinking we are worthless. This can happen in a matter of seconds. What this also means is that we do not really know what we want to be, or what we want to do. Our lives are constantly shifting. Jumping from one job to the next, searching for that something that feels….like us. Going from relationship to relationship, always looking for someone to fill that emptiness inside of us. We may change our appearance on a regular basis, some people with BPD even change their name. We are all just looking for ourselves, but sometimes we never find it.
Number four can be debilitating. Poor Self control/Impulsive or destructive behavior. This is often seen in forms of reckless spending, over/under eating, reckless driving, substance abuse, or even risky sexual encounters. The main reason behind this is the release of dopamine you get whenever you do something risky. Its like the equivalent to an adrenaline junkie. What makes us feel better in the moment, often plays a big part in our demise. It is not uncommon for someone with BPD to end up homeless, addicted to drugs, or dead. Our brains are just wired differently, we need that constant sensation to feel alive, and that ends up killing us faster.
The fifth trait is something that is stereotypical borderline. Self-harm and suicidal behavior. A lot of this plays on the impulsiveness that people with BPD have. For me, self harm was always a way for me to show people how much I was hurting. I couldn’t ever express it in a way that people understood, but when I started expressing it in a physical manner, people started to pay attention. Another BIG reason I used to (and still struggle with) self harm, is because of control. I couldn’t control the things I was feeling. The emotions of someone with BPD are intensified tenfold. We experience things MUCH more strongly than others. Sadness feels like sorrow, Happiness feels like euphoria, anger feels like rage. There are no mild emotions for someone with BPD. When I felt I couldn’t control my emotional pain, I knew I could control my physical pain. It became the only form of control I had over my life at all. This behavior is dangerous though. Although someone with BPD typically does not self harm as a form of attempted suicide, they may go too far, cut too deep, and then its too late. Suicidal gestures are also seen with BPD, people with this disorder have a high rate of suicide attempts, which mostly stems from a desperation in times where they are feeling abandoned. They feel like the only way to keep someone in their life, is to threaten to end theirs. Its a manipulative tactic, but in the moment, there’s nothing malicious about it. In order to be maliciously manipulative, you have to know what you’re doing is manipulative. You have to be actively trying to manipulate someone. With BPD, there is no conscious effort to manipulate, there’s only the panic of feeling abandoned. Does that make this behavior okay? Absolutely not. Manipulation is still manipulation and its still abusive. What I’m saying, is that there is a slight difference between actively trying to be abusive, and being abusive out of panic. Neither are good, but one is more understandable than the other.
Number six is something we talked about a bit above. Extremely unstable moods. Now you might say, well this sounds a lot like Bipolar Disorder. And I’d agree. The main difference between someone with Borderline Personality Disorder and someone with Bipolar Disorder, is the duration of the mood swings. Someone with Bipolar Disorder will experience mood swings that last for weeks or even months. Someone with BPD, will experience their mood swings over the period of a day, or even an hour. The intensity of our mood changes can be extremely crippling to us, and the people around us. The smallest things seem to set us off, when in reality, its not about the small thing, its about something much bigger, usually related to a trauma we have experienced. Our brains go into protection mode if we feel slighted, hurt, abandoned. We will lash out, or sometimes lash “in” at ourselves. This rapid change in emotion can be extremely confusing to those around us, and can be the cause for a lot of unstable relationships we may endure.
Trait number seven is characterized by a chronic feeling of emptiness. People with BPD often describe themselves as a shell or a mold. They look normal on the outside, but inside there’s nothing. Which, isn’t true because inside the person with BPD is EVERYTHING. I think that’s why we feel chronically empty. We are so used to feeling every little thing, that it gets overwhelming and there’s nothing left for us to feel about ourselves. I think this trait also stems from the unstable sense of self. If you don’t know who you are, its hard to feel like you’re anything. Most days it feels like I am just going through the motions, doing what I have to do to survive. But I don’t feel much pleasure in things. I don’t feel fulfilled or whole. Maybe I never will. But I do know that I have an amazing support system who makes me feel important, even if I don’t feel whole.
The eighth trait is explosive anger. Remember when I said that anger feels like rage? We don’t know what simple anger feels like. Any amount of anger feels like rage to us. The burning chest, the wind knocked out of you, seeing red, etc. That’s what we get when we get angry. This can lead to all sorts of inappropriate shows of anger and extreme outbursts. This type of behavior is never okay, and shouldn’t ever be written off as “part of the disorder”. Is it part of the disorder? Absolutely. But it should be the FIRST thing the person with BPD works on controlling if they are looking to heal from their disorder. Typically the person with BPD will make a big show out of their anger. Throwing things, breaking things, even hitting people. This is always a reflection of the pain they are feeling and never a reflection of the person they are lashing out on. The person with BPD needs to do some inner work to figure out why their reactions to certain triggers are so severe, and try to heal the wounds that are below the surface.
The last trait is not as widely seen, but still a big part of BPD. Paranoia and/or dissociation. Dissociation is described as losing touch with reality. A lot of people who experience dissociation will express feelings of emptiness, and they experience life as if they are watching a movie, or reading a book. Dissociation is the brains natural defense mechanism to stress. When the body experiences extreme stress, the brain just checks out. Your body is there, but mentally you are not. This can feel a lot like a “dream” state and the person experiencing it can seem distant, aloof, or even completely unresponsive. A lot of people who experience BPD have also experienced extreme or repeated trauma. Dissociation is their brains way of keeping them safe from more trauma. When our bodies experience extreme stress, it sends us spiraling into that state, as a way of keeping us out of the situation.
Borderline Personality Disorder is an extremely stigmatized disorder, even within the mental health community. I have been turned down by several therapists, who refuse to treat people with BPD because we are seen as “untreatable” but that’s just not the case. Over the last twenty years, more and more information is being released about the disorder, and we’re starting to understand more of why things are the way they are among the people suffering with BPD. My hope is to one day remove the stigma from the name, and to really help shed light on this disorder.
1.4% of the U.S. population suffer from Borderline Personality Disorder, 75% of those diagnosed are women. So why does this disorder seem to disproportionately affect women? Well the answer may not be what you think. Women are far more likely to seek help for mental health disorders than men are, due to the extreme stigma around masculinity and mental health. Within the men that DO seek help, it has been noted that men exhibiting symptoms of BPD are often shrugged off as “typical male behavior” (angry outbursts, mood swings, etc.) which leads to less men being diagnosed with the disorder due to the assumption that anger is a “natural” male behavior. Clinicians are actually famous for misdiagnosing men due to bias standards on behavior. We are increasingly failing our male population by refusing to see past the patriarchal ways of thinking and what we “expect” from men.
The truth is, Borderline Personality Disorder affects a fairly large portion of our population, and until we end the stigma around the disorder, we will continue seeing the damage its doing to the young men and women it affects.