Borderline Personality Disorder (BPD) is an intense and complex mental illness that disturbs a persons’ thoughts, emotions and behaviours.
Sometimes known as Emotionally Unstable Personality Disorder (EUPD) or Emotional Regulation Disorder, BPD is one of the ten personality disorders recognised by the Diagnostic and Statistical Manual of Mental Disorders (DSM) and is often misunderstood.
The symptoms of BPD are vast, varying and can manifests in countless combinations. A diagnosis should only be made during a thorough assessment by an experienced Psychiatrist.
A person with BPD exhibits at least 5 of the following 9 symptoms:
1. Frantic efforts to avoid real or imagined abandonment.
2. A pattern of unstable and intense interpersonal relationships characterised by alternation between extremes of idealization and devaluation.
3. Identity disturbance – markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging, e.g. spending, sex, substance abuse, reckless driving or binge-eating
5. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour.
6. Affective instability due to a marked reactivity of mood, e.g. intense episodic dysphoria, irritability or anxiety, which usually lasts for between a few hours and several days.
7. Chronic feelings of emptiness
8. Inappropriate, intense anger, or difficulty controlling anger, e.g. frequent displays of temper, constant anger or recurrent physical fights.
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.
Applicable traits must be long-standing and there must be no better explanation for them, e.g. physical illness, a different mental illness or substance misuse.
Given the number of possible combinations of these symptoms, people with BPD will not always act in the same way as one another. For example – a patient with BPD may present with symptoms 3, 4, 7, 8 & 9, while another patient may experience symptoms 1, 2, 5, 6 & 9. These people can experience the disorder in largely different ways, however they are both able to be diagnosed with the same illness.
When Borderline Personality Disorder was originally named in 1938, it was applied to those who were considered to be on the ‘borderline’ between neurosis and psychosis. There became a tendency to issue this diagnosis to people who were thought to be too complex, unruly or impossible to treat. Over time – due to misinformation, confusion and misdiagnosis – BPD became heavily stigmatised by the general public who began branding BPD sufferers as manipulative, hostile and out of control.
In recent years the understanding of this illness has evolved and the symptoms of BPD clarified, leading to a better understanding of the BPD experience. Better understanding has helped to explain that the basis of this disorder is one of emotional pain, invalidation, instability and emptiness, rather that of outer edge neurosis or psychosis.
Though in the past many have held the opinion that BPD was not treatable, a variety of treatments have emerged that have proven to aid in the stabilisation and even recovery of some patients with BPD. Treatment options include Dialectical Behaviour Therapy, Cognitive Behaviour Therapy, medications and Self Care.
Though these treatments are not absolute and may take time and customisation to be effective, an increasing trend of recovery in those with Borderline Personality Disorder gives hope that an improved quality of life is possible.
More On BPD Treatments: National Education Alliance – Borderline Personality Disorder