What is Borderline Personality Disorder?
What is borderline personality disorder? Many ask this question. The word borderline may make you think of having borders or lines but in fact these borders do not exist and lines are very easily crossed. Borderline in this context really means on the borderline of psychosis.
Borderline personality disorder occurs more frequently in women and to those who are victims of childhood abuse or other traumas such as the death of a parent. The Diagnostic and Statistical Manual of Mental Disorders IV defines borderline personality disorder as existing if a person suffers from 5 or more of the following symptoms:
- Intense fear of abandonment
- A pattern of unstable relationships
- Unstable self-image or sense of identity
- Impulsive or self-destructive behaviors
- Suicidal behaviors or self injury
- Wide mood swings
- Chronic feelings of emptiness
- Anger-related problems such as temper outbursts that often lead to fights
- Periods of paranoia and loss of contact with reality
As with all diagnosis in the DSM IV, these symptoms must persist without another medical problem being better able to explain the symptoms. It should also not be drug induced and must cause significant difficulties for the individual.
Borderline in Relationships
Borderline personality disorder is a mental illness that is accentuated by a major disturbance in self-image or sense of identity that results in a major disruption of interpersonal relationships. In other words, a BPD person's sense of who they are and how they relate to others make it very difficult for anyone suffering from the disorder to maintain close relationships or to maintain employment.
They have an intense fear of abandonment which can result in extreme behaviors including aggression if they suspect they might be abandoned by someone close to them – even when there are actually no real grounds for the suspicion. They may perceive everyday occurrences such as going on a vacation, being sick and cancelling a date, and someone else's bad mood as abandonment. This is because their perceptions are distorted and they often see the world in black or white and are unable to comprehend shades of gray. They often feel insecure, worthless and flawed. Due to this weak sense of self, they are easily hurt and misinterpret the behaviors of others in very negative ways.
People with BPD tend to have extreme and often short shifts in mood and display strong emotions that are out of control. These moods swings are often associated with episodes of aggression, self-injury, suicidal ideation, risk taking behaviors including sexually acting out, binge eating, excessive spending and drug and alcohol abuse.
Self-injury is very common among those afflicted with this disorder and self-injurious actions can include cutting or burning. Their goals, values, sexual identity, career paths, jobs, friendships, and hobbies are often changing due to this ever evolving and unstable sense of self. For example, one minute the person may seem completely motivated and determined to be successful and pick a career with elaborate plans and enthusiasm. You may feel excited for that person believing they will go all the way. Then the next time you see them, they have forgotten all about that career path and are just as enthusiastic about another.
In spite of occasional aggressive episodes, someone who suffers from borderline personality disorder can make you feel as if you walked on water. They tend to vacillate between idealizing and devaluing a person of interest. Basically, they have strong love/hate relationships. When they idealize you, they can lavish such intense praise and adoration that you glow. They may likely tell you that you are the only person who understands them and that you are the only one they can trust. They tend to have major issues with trust.
When you think you are the best thing since sliced bread, the slightest incident can happen that you don’t even comprehend and all of a sudden you are the Devil incarnate. It is like a roller coaster and you never know what to expect.
BPD people are difficult in treatment due to this constant flux in their view of self in relation to others. They are also known to make accusations of improper conduct that are not true but they may in fact actually believe them to be true due to this distortion in their perceptions or cognitions. For example, they can interpret innocent caring behavior as sexual overtures. In extreme moments of stress, they can experience paranoia and loss of contact with reality.
Borderline personality disorder is difficult to manage for all those involved including the individual suffering from this mental illness. However, improvement can be made in relationships and the person's life with treatment.
Borderline Personality Disorder, Mayo Clinic Staff
Borderline Personality Disorder, Topic Overview, WebMD
Borderline Personality Disorder, National Institute of Mental Health, NIMH
Diagnostic and Statistical Manual of Mental Disorders IV