Borderline personality disorder is a condition in which you have varying moods that can feel intensely painful and overwhelming. You will also have a strongly negative self-image and be unsure of who you are as a person.
- Borderline personality disorder (BPD) is a mental health condition in which you have an ongoing pattern of varying moods that can feel intensely painful and overwhelming, as well as an unstable sense of self and a strongly negative self-image.
- You attempt to cope with this through behaviours that aim to reduce your stress or punish yourself for things you think you have done wrong. The behaviours may include self-harm.
- Key symptoms include a fear of abandonment, unstable and intense relationships, intense and varied moods and being impulsive (acting without thinking about the consequences).
- BPD often appears in teens or early adulthood. It can affect your relationships, work and wellbeing. Sometimes people with BPD face stigma, but if you have these symptoms you are not bad, mad or attention seeking.
- If you have BPD, there is support for you and treatments that have helped many people. With support and treatment, most people can learn to manage these symptoms and live full and purposeful lives.
What are the symptoms of BPD?
Because each person experiences a different combination of symptoms, each person with BPD deals with different difficulties. You may experience some or all of the following symptoms (five are needed for a formal diagnosis):
- fear of abandonment (real or perceived) and trying to avoid it
- unstable and very intense relationships
- quick changes of mood, eg, feeling very happy then very sad in the same day
- inappropriate and intense anger
- doing things on impulse (not planning to do them or thinking about the consequences)
- identity disturbance (not knowing who you are)
- often having suicidal thoughts or behaviours
- feeling empty most of the time.
If your condition is more severe, you may have thoughts of self-harm or suicide. If you do, get help urgently from your doctor or one of the helplines listed on this page. There are people who can help you get through.
(MedCircle, US, 2018)
What causes BPD?
The exact cause of BPD is unknown but many factors may play a role. For many people with BPD, their difficulties appear to be related to some of the following:
- abandonment or neglect
- poor attachment to your parents or parents who are not available to you
- sexual, physical or emotional abuse
- traumatic experiences such as bullying
- living in an unhappy family
- having a family member with BPD.
For others, however, the cause is less clear.
Borderline personality disorder in a minute
(One Minute Diagnosis, 2017)
How is BPD diagnosed?
If you have some of the symptoms mentioned above, it’s a good idea to see your doctor. They will ask you questions about your thoughts, feelings and behaviour, including sleeping and eating patterns, as well as how long you have been feeling this way. They will also ask if you have experienced these symptoms before and may ask about what is happening in your life at the moment. They may also do a physical examination and blood tests to rule out other causes for your symptoms.
Sometimes, it can be difficult to diagnose BPD because people with BPD may have symptoms that are similar to other mental health conditions or may have other mental health conditions at the same time. Your GP or local doctor may refer you to a qualified mental health professional, who can do a more detailed assessment.
How is BPD treated?
Treatment of BPD can involve a combination of psychological therapy, lifestyle changes and medication, if required. Psychological therapies are usually the treatment of choice for BPD. They may include individual, couple, family or group therapy. Examples of psychological therapies for BPD include:
- dialectical behaviour therapy (DBT)
- cognitive behavioural therapy (CBT)
- mentalisation-based treatment
- counselling or psychotherapy.
Medication for BPD may include:
- antidepressants to reduce depressive symptoms
- mood stabilisers to help reduce extremes of mood
- anti-psychotics if under times of extreme stress you become paranoid.
For some people, alternative approaches have been useful, such as mindfulness meditation, yoga and online courses.
Self-care – what can I do?
Small steps are the key to change – choose what feels manageable and build from there. This can include:
- building your self-care skills – this builds your resilience so you can cope better with the challenges of life
- keeping physically active – this helps your mental wellbeing
- finding healthy ways to reduce and manage stress
- getting help when you need it – remember this is a sign of strength, not weakness
- staying connected to family, whānau and friends
- finding a purpose, which increases your sense of meaning and belonging.
If you would like to talk to someone, see your doctor or try one of the following free helplines:
- 1737 phone or text 24/7 to reach a trained counsellor
- Lifeline (0800 543 354)
- Samaritans (0800 726 666)
- Youthline (0800 376 633).
Borderline personality disorder Mental Health Foundation, NZ
Borderline personality disorder The Royal Australian and New Zealand College of Psychiatrists, 2017
Borderline personality disorder symptoms Psych Central
Borderline personality disorder in a minute One Minute Diagnosis, US, 2017
Borderline personality disorder National Institute of Mental Health, US, 2017
Borderline personality disorder NHS Choices, UK, 2016
How borderline personality disorder affects your life Patient Info, UK
1. Borderline personality disorder Mental Health Foundation, NZ
Information for healthcare providers
Emotionally unstable personality disorder PatientInfo Professional, UK, 2016
Look at the human being in front of you who’s hurting Mental Health Foundation, NZ
Treatment of borderline personality disorder RANZCP, 2017
Choi-Kain LW, Finch EF, Masland SR, Jenkins JA, Unruh BT. What works in the treatment of Borderline Personality Disorder Curr Behav Neurosci Rep. 2017; 4(1): 21–30.
|Emma Sutich is a clinical psychologist with 25 years of clinical experience. She has worked with people in a range of settings, including ACC sensitive claims, prisons, community mental health, an eating disorder service and private practice. Her clients have had a wide range of backgrounds and difficulties.|