Borderline personality disorder (BPD) is a condition featuring persistent and ongoing patterns of varying behaviours, moods and a distorted self-image.
BPD can lead to a series of relationship problems as the symptoms of the condition often result in impulsive actions and drastic mood changes.
It is not uncommon for those with a borderline personality disorder to have intense episodes of anxiety, anger and depression that may last from a few hours to days.
Sign and Symptoms
Those with a borderline personality disorder often experience intense shifts in mood and have an overall sense of uncertainty about how they see themselves and the role they play in the world.
Since having the ability to deal with uncertainty is an element of psychological well being, those with borderline personality disorder tend to suffer in extremes.
For BPD sufferers, everything (and everyone) is either good or bad. There is no middle ground.
Those with BPD often experience drastic and sudden mood changes, which can shape their relationships in negative ways.
BPD sufferers often change their perceptions of friends, lovers and family members quite frequently, leading them to either over love (idealize) or discard people according to their fluctuating moods and perceptions.
Some of the symptoms associated with borderline personality disorder include:
- Impulsive behaviours such as substance abuse, unprotected sex and dangerous driving
- Suicidal thoughts and recurring thoughts of suicidal behaviours or threats
- Intense and highly fluctuating moods ranging from a few hours to a few days
- Dissociation – this means feeling cut off from oneself, or a person feeling as though they are outside of their own body, and feelings of unreality
- Self- harming, such as cutting oneself or harming oneself in any way
- Intense feelings of anger and an inability to regulate or control the anger
Other symptoms may include:
- Issues with trusting others
- Distorted perception of oneself including self-image
- Unstable relationship patterns with relatives or loved ones which can swing from extreme like (idealization) to extreme dislike (devaluation)
- Cutting people off to avoid future abandonment
- Loss of interest in hobbies and activities that once were pleasurable
It is also important to mention that not every person will display each of the symptoms of borderline personality disorder. Some people may only experience a few.
Those suffering from BPD are easily triggered, events such as a temporary separation from a loved one or an event that might leave them with feelings of uncertainty can cause a trigger response.
The duration of an episode in BPD varies from person to person as does the frequency.
The link between childhood trauma and borderline personality disorder
Numerous studies have shown that childhood trauma leads to brain damage and can create altered brain wave patterns affecting the way a person sleeps.
One particular study conducted in 2012 found a correlation between altered brainwave patterns during sleep and adults with a borderline personality disorder.
The study illustrated that those with altered brain waves tended to suffer from insomnia more than a person without BPD.
It also showed that patients suffering from BPD took less time to enter into REM (a state of deep sleep where people dream).
BPD patients also had long periods of REM sleep at the beginning of the night, compared to normal sleep function where people enter REM at the end of the night.
The study hypothesized that BPD is likely caused by functional changes in the brain, through the balance of neurotransmitters or structural alteration of synaptic pathways.
When it comes to a person’s Childhood, there are several risk factors for those with BPD:
- Damaging parenting styles: This involves being exposed to a disorganized or dysfunctional household such as witnessing conflict and disharmony, even if the conflict between family members was subtle, children are very good at picking up on cues
- Childhood trauma and child abuse: Adverse childhood experiences (ACES) are known to cause BPD – this is especially true if the abuse was from a close relative or trusted family friend. Although, not all children who experienced child abuse will develop BPD as other factors such as genetic resilience often play a role
- Loss and separation: Since a person’s developmental bonding process was likely to be disrupted by either the death of one or both parents or separation of some kind, they are more likely to develop anxious attachment styles as adults. All this can manifest as a person being dependent, clingy, or, fearful later on
- Invalidating emotions: If a child is told off for crying, or made to feel guilty about being anxious or upset, they may resort to extreme measures to get the emotional validation they crave. This scolding might manifest as episodes of explosive anger and an inability to trust their feelings and perceptions as adults. All this is to gain the recognition they failed to receive
According to the University of Manchester, research shows that those with borderline personality disorder are 13 times more likely to report child abuse compared to those without mental health problems.
The report shows that 71.1% out of the 5,000 people that were studied, were diagnosed with BPD and reported at least one traumatic childhood experience with the most common form of adverse experience being physical neglect (found in 48.9% of cases).
Genetic factors also play a big part in the development of BPD as studies of families (particularly in twins) have proven that there is a strong link between genetics and borderline personality disorder.
A borderline personality disorder is a common condition with over 20,000 cases a year in the UK alone. The condition can be lifelong or last for several years depending on whether a person has received treatment.
There are a wide range of treatment options available for people suffering from borderline personality disorder. These include:
There are many different forms of psychotherapy, but most involve the patient coming to an understanding about themselves, their behaviour, and any patterns they might want to address.
Psychotherapy aims to seek a deeper understanding of the self and, ultimately, seek long-term resolution.
Essentially, the therapy enables those with BPD to develop a sense of control over their thoughts and behaviours.
Psychotherapy is usually delivered by a psychiatrist, psychologist or other mental health professional.
The duration of psychotherapy can last a year or longer, depending on a person’s requirements.
Dialectical behaviour therapy
Dialectical behaviour therapy (DBT) is a form of therapy designed to treat BPD.
DBT operates on the principle that the following two factors may have contributed to the development of BPD:
- The person’s emotions were dismissed in Childhood, and they were likely told that they were “silly” for crying or for feeling vulnerable in certain situations
- The person tends to be emotionally vulnerable and therefore low levels of stress tend to make them anxious
These factors can create a vicious cycle as an individual may experience intense and upsetting emotions and subsequently feel guilty and worthless for having them.
The cycle then comes full circle since the person was brought up to believe that having emotions is bad or shameful.
Self-fulfilling beliefs can become destructive as someone develops the sense that they must be a bad person for feeling the way they do.
DBT aims to challenge any unhelpful thoughts and beliefs that were created during the developmental phase in two ways:
1. Through validation: Accepting that emotions are acceptable, valid and real.
2. With dialectics: By banishing ‘black and white’ thinking styles, a person will eventually learn that not everything is as cut and dry as they were taught to believe.
This method teaches people to be more receptive and open to new ideas, thoughts and ways of behaving.
Dialectical behaviour therapy is proven to be very effective in treating those with BPD and those with a history of suicidal behaviour and self-harm.
Group therapy and counselling might also be alternative options for those seeking treatment for BPD.
Certain types of prescribed medications can help treat BPD, such as:
- Certain antidepressants
- Antipsychotic drugs
- Mood stabilizers/anticonvulsants
- Anxiolytics (anti-anxiety drugs)
If you think you might be experiencing any of the symptoms associated with a borderline personality disorder, then perhaps it’s time to reach out and speak to a professional.
The team at Tikvah Lake Recovery are trained specialists who are always on hand to support you and discuss your treatment options. Contact the team today to find out how we can help.