Borderline Personality Disorder: What it is, Causes and Treatment
Between 1.6% and 5.9% of the population has borderline personality disorder. Symptoms develop early in adulthood but can be observed as children through emotional instability and impulsive behavior. This disorder is very popular, people like Amy Winehouse, Angelina Jolie, Jim Carrey or Winona Ryder have been known to suffer from it. Do you want to know more about borderline personality disorder? Keep reading.
Borderline Personality Disorder Reviewing: Personality Disorders
We are humans, cohabiting with other humans and, unconsciously, writing our own history. Immersed in a social context, we have generated persistent patterns in the way we perceive, think and relate to the environment and ourselves, which is called personality traits.
The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines personality disorder as “an enduring and inflexible pattern of long duration that leads to significant distress or impairment and is not due to use of substances or another medical condition. At least two of the following areas are affected: cognition, affectivity, interpersonal functioning or impulse control. This pattern, moreover, is inflexible and extends to a wide range of social situations, causing discomfort that is clinically significant and work and social deterioration. “
To study better personality disorders, they grouped them according to similar characteristics.
- Group A: includes personality disorders where people who have them often appear to be rare or eccentric.
- Group B: consists of individuals characterized as being overly dramatic, emotional or erratic. It is in this group where we find borderline personality disorder.
- Group C: includes personality disorders for which people are often anxious or fearful.
What is Borderline Personality Disorder (BPD)?
To place ourselves within the classification of personality disorders, borderline personality disorder is found in group B (which also includes histrionic personality disorder, narcissistic personality disorder, and antisocial personality disorder).
Borderline personality disorder implies an inflexible and permanent pattern of personality traits that include relationship instability, poor self-image, and emotional lability. Impulsive behaviors are also a common trait in this disorder.
Marsha M. Linehan describes people with this disorder as “people with emotional irregularities that come from a crippling environment.” She is the author of one of the most famous therapies for people with borderline personality disorder.
In the following video, you can understand a bit more about borderline personality disorder.
Characteristics of Borderline Personality Disorder
What traits do people with borderline personality disorder have? A summary of the main borderline symptoms is given below:
- People who suffer from borderline personality disorder respond with very intense emotional reactions. However, they don’t have the necessary skills to identify and express these emotions, which impacts on their quality of life.
- Another important characteristic of borderline people is that they have a very unstable mood. For example, they can go from a deeply depressed state to a state of agitation, anger or anguish in a matter of hours or days. There is a lack of self-control, having bad temper, inappropriate and intense anger.
- Usually, borderline people have feelings of emptiness or uncontrollable fear of abandonment, which lead them to take desperate actions to avoid these fears from coming true.
- People with borderline personality disorder have a great deal impulsive behaviors that are harmful to themselves. For example, the impulsiveness is shown through different behaviors related to sex, spending, binge eating, reckless driving, or the use or abuse of substances such as cocaine, alcohol and other drugs.
- Another characteristic of borderline people is that they often see their identity altered. That is, the image and the sense they have of themselves is unstable and changes easily.
- Borderline people, in stressful situations, have paranoid ideation, that is, a false belief of being treated unjustly or being tormented. Severe dissociative symptoms such as the feeling that your body doesn’t belong to you or that the environment around you is unreal are very common.
- Therefore, people with borderline personality disorder have relationships that are unstable and intense, characterized by alternating from idealization to devaluation of the other person. They switch from loving the person to hating the person in a short span of time, making it difficult for them to relate or have a long lasting relationship.
Causes of Borderline Personality Disorder
Instead of focusing on the causes, it’s important to focus on the risk factors. Research has found that genetic factors and family factors may be related to borderline personality disorder.
As for genetic factors, it has been found that borderline personality disorder has a higher prevalence. This means it happens five times more frequently in first-degree relatives with the disorder than in the rest of the population. They also have a higher family risk of addiction, depression, bipolar disorder or antisocial disorder.
In addition, borderline personality disorder is more commonly diagnosed in women (75%) than in men.
Another factor closely related to borderline personality disorder, supported by various studies, is the relationship between the person who develops a borderline personality with their primary caregivers, particularly their mother.
The characteristics of borderline personality disorder have been explained as a consequence of a dysfunctional, poorly adapted and poorly integrated pattern of relationships in the family during childhood and the style or type of attachment that is generated.
Treatment for Borderline Personality Disorder
Does it have a cure? Within personality disorders, this disorder is known to have the most probably effective psychological treatments.
Currently, the best-studied and most evidence-based treatment that is effective is the cognitive-behavioral dialectic therapy of M. M. Linehan. This is a treatment specifically designed for borderline personality disorder. It focuses on the problematic features we have described above, such as suicidal behavior, self-harm or emotional instability.
It consists of a set of techniques aimed at teaching different skills, including emotional regulation, acceptance, mindfulness, improving social skills and interpersonal relationships, and working through their frustration.
People who receive therapeutic treatment sometimes show improvement during the first year. Although the tendency to show intense emotions, impulsiveness and instability are long-lasting.
Therefore, more than cure, these patients learn to assimilate certain skills that improve their quality of life and help them understand better borderline personality disorder.
How to help a person with Borderline Personality Disorder (BPD)?
Living with a borderline person creates a lot of confusion and stupor in family and friends. In many cases, this disorder, characterized by emotional instability and impulsiveness, can be confused with an eccentric, unpredictable, egocentric, and chaotic behavior. Sudden changes of mood can generate great conflicts with loved ones, making it difficult to relate to them.
These tips can help you coexist with a person diagnosed with borderline personality disorder. Find out how you can help them.
- Borderline people are extremist and impulsive. They move between “white or black”. Therefore, it may be convenient for family or friends not to promote this polarization between “all or nothing”. When the BPD person says, “I can’t stand it,” “I can’t do it,” “I can’t”, parents, siblings or friends shouldn’t go to the other extreme or say “you will overcome it”, “you can “,” if you try you will be able”. In this situation, it may be more useful to express yourself like this “it is very complicated, but we believe in you, we will help you to achieve it”. This way, we prevent the borderline person from leaving the extremes of “good or bad, all or nothing, etc.”
- Find information and help them get diagnosed. If you want to help a borderline person it is important that you look for information and understand the disorder well. If your family member or friend hasn’t yet received a diagnosis or treatment, it is appropriate to help them in this process. Look for a professional that can give them appropriate treatment or therapy if he or she does not already have one. Offer emotional support, try to be patient and compassionate. You might even benefit from going to therapy with them to get a better understanding of the disorder and get advice on how to deal with situations outside of therapy. That way you can grow and improve together. Keep in mind that although sometimes you find it difficult to understand their actions, who suffers the most is the person with borderline personality disorder. Being emotionally unstable can become very overwhelming and deep down all borderline people want to get better so they can stop suffering. Try to convey to your family member that you are by their side to help him improve and raise his willpower to work through the different issues.
- It would be interesting to go to family therapy so that the whole family can establish healthier bonds with the patient. Having access to information is important in trying to understand the borderline patient’s situation. This does not mean that we accept their actions and behavior. For example, if you injure yourself, or have an anger attack, we have to try to interpret the deeper meaning of this behavior (disgust, anger, request for help, etc.). We can even help them express their feelings with words, release their tensions hitting a pillow, doing sports, etc. Different techniques that might help them feel better.
- There are exercises and techniques aimed at reducing impulsiveness. These strategies can help the person with BPD make fewer impulsive decisions, and avoid acting rashly. Impulsiveness and the inability to withstand frustration can lead our family members to make more emotional than rational decisions that lead to self-harm, endangerment, drug addictions, etc.
- Do not tolerate blackmail or lies, or abusive treatment from the BPD person. It is recommended that family or friends speak how the person’s actions make them feel. For example, expressing grief, anguish or sadness is conveying the real concern that we have against a certain behavior, for example, when the borderline person harms themselves or uses drugs. When you are in a crisis situation don’t take things personally, think that your family or friend doesn’t act this way because he has decided to do it, most of the times can’t help or avoid it. You should never feel guilty about your actions.
You can give us some other advice on how to deal with family or friends with borderline personality disorder. Don’t hesitate to leave your suggestions, questions, and comments below.
This article is originally in Spanish written by Rosa Calderón Vicente, translated by Alejandra Salazar..
Alejandra is a clinical and health psychologist. She is a child specialist with a diploma in evaluation and intervention in autism. She has worked in different schools with young children and private practice for over 6 years. She is interested in early childhood intervention, emotional intelligence, and attachment styles. As a brain and human behavior enthusiast, she is more than happy to answer your questions and share her experience.