Q & A: What is Borderline Personality Disorder?

So-Mai Brown

What is Borderline? Is it when someone almost has a mental disorder?

The word “borderline” can be confusing, but the disorder stands alone and is not tied to another diagnosis. Borderline Personality Disorder (BPD) is under the umbrella of personality disorders in the Diagnostic and Statistical Manual IV (DSM-IV-TR), the text used by mental health professionals to diagnose patients. Personality disorders develop in early adulthood, affect most areas of a person’s life, are long standing and are part of their personality. This is different from someone with a phobia, one episode of major depression (not permanent) or post-traumatic stress disorder (not inherently part of their personality).

BPD is characterized by unstable and volatile relationships. People with BPD are constantly scared of and will react strongly to the thought of abandonment. They are confused about who they are and feel empty inside. They can be emotionally erratic, are impulsive in ways that may be self-destructive (e.g. overspending, substance abuse, unprotected sex), and have increased suicidal behavior. Most people have had some of these traits at one time or another, but by distinction they do not cause significant issues in one’s life.  This disorder is thought to affect 2% of the population, 75% of whom are female. Treatment for those suffering from BPD is imperative because the successful suicide rate is estimated to be 8%-10% compared to 0.011% in the general population.

It is often the case that most people affected with personality disorders don’t seek treatment for the personality disorder itself, but for another disorder like depression or anxiety. Research shows Dialectical Behavioral Therapy (DBT), a form of talk therapy, is the most effective way to treat BPD.  DBT was created by Marsha Linehan and explores thoughts and behaviors that are problematic. Mindfulness, focusing on the present moment with non-judgment and compassion, is integrated for times when discomfort is inevitable. Medication, specifically selective serotonin reuptake inhibitors, or SSRIs, are used to treat the emotional swings and impulsivity in BPD, but do not treat the disorder completely. The good news is that research indicates personality disorders resolve themselves over time. In one study, those diagnosed with BPD were reassessed 10 years later and most no longer qualified for the diagnosis.

This disorder is very painful for those who suffer with it and is difficult for those around them. If you, or your loved one is struggling with BPD, the best thing to do is to find a therapist.

Best,

So-Mai Brown Marriage and Family Therapist Intern

5 Comments

  • I have a co-worker with this disorder and find her very difficult to deal with, at times exasperating. Thank you for your thoughtful article that gives me some comfort and understanding that time might be the tincture as she seeks professional help through this difficult time.

  • My son was diagnosed with this but trying to find treatment for him is difficult. He does take antidepressants which seem to help. He has dabbled with drugs which affect his behaviour-mainly making him aggressive and has spent quite a few years in prison because of his aggression. It is encouraging to read that he may grow out of this.

  • I am a survivor. After over 100 parasuicide attempts, several that were nearly successful, feeling day in and out that no one in the world saw the world like I did, DID to boot, and spending a few years as a poster child for the condition that wasn’t really understood back in the seventies to early eighties, I can say without a doubt, we are difficult to deal with. However, it does burn out during your thirties and with the proper care, you CAN and WILL fully recover. I was fortunate enough to have a doctor that was on the forefront of studying it, before most doctors knew what it was. After two years of three visits a week and minimal medication I went into remission. I am still married to the same man who walked as blindly into dealing with this condition as I did 30 years ago. I’m now a peer advisor and Advocate for the mentally ill. Recovery is not only a theory, it’s a reality. The secret is not in the medicine cabinet but in the determination of the patient.

  • My ex-wife had this condition, and it progressively destroyed our marriage. The mood swings, violent emotional, verbal and physical abuse all became too much. The sad thing is when we met, we were 20, and she only had a glimmer of these symptoms; she progressively got worse over the next 12 years, until we hit a breaking point. I begged her to go to a doctor and seek treatment; she took meds maybe for a week, but gave up, and the behavioral therapy itself did little to no good. Ultimately I left the marriage because of her condition and her refusal to seek and stick with treatment.

  • Sadly my mother has bipolar and bpd. Imagine being an only child isolated by a parent with these two disordercompunded by drug and alcohol addiction. Yeah… life was impossible! it’s a miracle I’m alive!

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