Borderline personality disorder

Borderline personality disorder (BPD), also known as an emotionally unstable personality disorder (EUPD), is a mental illness that profoundly impacts how a person thinks, feels, and relates to others.

It is the most common personality disorder. In the UK, it has been reported to affect up to 1 in 50 people in one’s lifetime.  

You may be experiencing strong emotions, mood swings and feelings that you find difficult to deal with. This can make you anxious and worried, leading to problems with your identity and self-image and affecting relationships with others. 

If you live with BPD, you may find your way of coping with emotions is different from others around you and that these emotions are hard to control. You may find your feelings confusing, tiring, and isolating. This can lead to other mental health problems, such as anxiety and depression. 

Myths about Borderline Personality Disorder

Symptoms of BPD

Living with borderline personality disorder (BPD) is a highly individual experience. According to the DSM-V, diagnosis typically requires the presence of at least five (5) of the following symptoms: 

• Persistent feelings of emptiness and abandonment 
• Difficulty managing emotions and anger 
• Frequent and intense mood swings 
• Occasional paranoid thoughts 
• Intense reactions to perceived abandonment 
• Unstable relationships 
• Conflicted self-identity and emotions 
• Impulsive behaviours with potential harm, such as excessive spending, substance abuse, or reckless driving. 
• Engagement in self-harm, harbouring suicidal thoughts, or engaging in self-destructive behaviours 

Every person’s journey with BPD is unique, and understanding these symptoms can help individuals seek appropriate support and treatment. For instance, those with BPD often experience money worries because of their symptoms. Managing money can become challenging, as individuals with BPD may encounter impulsive spending, turn to alcohol or drugs, and neglect to check their bank accounts.

Causes of BPD

There is no single reason why someone develops BPD. BPD can be caused by stressful and traumatic experiences, genetic factors like having a family member with BPD, or a combination of both. It is suggested that some cases of BPD can be caused by problems with certain neurotransmitters such as serotonin or with brain development.

Stressful and traumatic life events might include:

• Having experienced physical or sexual abuse or neglect during childhood.
• Experience the loss of a parent or guardian at a young age.
• Family difficulties or instability, such as living with a parent or carer who experienced an addiction.
• Enduring prolonged periods of fear, upset, or invalidation.
• Growing up in a household where someone had mental health problems such as bipolar disorder.

Treatment 

The most common treatment for borderline personality disorder (BPD) is talking therapy. Talk therapy can feel intimidating, but research has shown that it can be effective in helping BPD symptoms.

Among the therapies used is dialectical behaviour therapy (DBT), which teaches alternative methods for coping with grief rather than harmful practices like substance abuse or self-injury. Another therapy often used when treating BPD is Mentalisation-based therapy (MBT). MBT aims to help you recognise and understand mental states and examine thoughts about yourself and others.

There is no medication to treat borderline personality disorder (BPD). However, your doctor can prescribe medication if you have another mental illness besides BPD, such as anxiety and depression. 

On top of therapy, there are also things you can do to help your symptoms:

• Establish a routine: form a daily routine for structure and purpose, with consistent wake-up and mealtimes.
• Practice breathing exercises: incorporate calming breathing exercises into your daily routine to regain control over your emotions.
• Join a supportive community: connect with like-minded individuals by joining a supportive community or group to share your emotions.
• Pause and reflect: take a moment before responding to things, and consider your response patterns.
• Reach out to a loved one: confide in a trusted loved one, sharing your feelings and knowing they care about your well-being.