What is Borderline Personality Disorder?
Borderline Personality Disorder (BPD) is a serious mental illness that makes it hard for a person to feel comfortable in themselves. People with BDP have difficulty managing emotions, impulses and relating to others. They have high levels of distress and anger and can easily take offence at things other people do or say. This can cause distress in their work life, family and social life. For most people this pattern begins during their teenage years or as a young adult but the distress can improve in later adulthood.
BPD is treatable and people can live full and productive lives.
Signs and symptoms of BPD
A diagnosis of BPD is made following a psychiatric assessment, which can take time. There is no test for BDP. Not everyone who is diagnosed with BPD will experience the same symptoms or present the same and BDP can seem very different from one another.
A person with BPD will have several of these signs or features.
- A history of unusually intense and unstable relationships (e.g. Idealising someone then intensely disliking them)
- Fear that other people might leave or abandon them, including extreme emotional reactions to real or perceived abandonment
- Becoming suspicious of others and feeling detached from themselves or their surroundings when stressed
- Being very unsure of themselves, not knowing who they really are or what they really think
- Acting impulsively and taking risks that are self-damaging including risky sexual behaviour, uncontrolled spending, driving recklessly or dangerous drug and alcohol use.
- Self–harm and/or suicidal threats gestures and behaviour
- Short lived but intense emotional lows, anxiety or irritability.
- Persistent feelings of being “empty” inside
- Showing anger that is out of proportion to the trigger
Borderline personality disorder symptoms vary from person to person and women are more likely to have this disorder than men.
The term “borderline” refers to that fact that people with this condition tend to “border” on being diagnosed with additional mental health conditions in their lifetime, including psychosis.
What causes borderline personality disorder?
BDP is a psychological condition that is often misunderstood. People with BPD experience very intense and distressing symptoms that can be challenging to others. It is not deliberate and BPD it is not a fault with the persons ‘personality’ and they did not cause it.
The exact cause is not known but it is probably caused by genes as well as environmental experiences – not just one or the other. Current theories suggest that some people may have a higher genetic vulnerability and when combined with adverse childhood experiences such as loss, neglect, abuse and trauma the risk is increased. However, some people with no history of abuse can develop BPD. It is not possible to predict who will develop BDP.
It is important to seek help as BPD is a serious mental illness that can cause much distress to the person as well as their friends and family. BPD carries a risk of suicide. It is important to get an accurate diagnosis for targeted treatment.
With the appropriate treatment most people see improvement in one year and over time 80% of people will reduce their symptoms.
Seek help in the first instance via a GP. A GP can make referrals to a mental health professional, such as a psychologist or psychiatrist. Your GP is the best person to start with when looking for effective treatment for BPD.
Different kinds of therapy work for different people. Individual therapy involves seeing a skilled mental health clinician for an agreed amount of time. Therapy may be structured or unstructured or a combination of both. Clinicians may help identify problems, develop goals, ask the person to talk about whatever comes to mind or even ask them to try some things outside the session.
Group therapy involves attending sessions with others who are having similar experiences. Groups usually consist of two clinicians and up to 10 group members who all work together to support one another. Groups often help people feel connected to others who are having similar experiences and provide a space to share experiences, learn new skills, deal with problems, and have fun.
A short hospital stay can help manage a crisis or difficult time and get the person back on track. Ideally, hospital stays will be planned and talked through with the doctor or clinician.
Psychoeducation helps people with BPD and family and friends understand the illness. It can explain symptoms, treatment options and recovery. It can be done individually or in groups and may include written information, videos, websites meetings or discussions with your doctor. This can be done in conjunction with psychological treatment.
Self-Care is of equal importance. It is important to look after your body and your mind.
Medications do not usually treat personality disorders, but they may help with other difficulties such as anxiety and/or depression that are happening at the same time. As with any medications, it is always best to take it as prescribed, and avoid suddenly stopping or changing the dose without talking to the doctor first.
How friends and family can help?
- Encourage the person to seek professional treatment
- Educate yourself about the condition
- Maintain routines
- Remain calm and have a plan for potential crisis
- Acknowledge the fears the person is experiencing and that change is difficult
- Be realistic with expectations – support problem solving by breaking things into small steps
- Seek support for yourself.
The following program is available through Borderline Personality Disorder Australia
Family Connections® is a free, 12-week course that meets weekly for two hours to provide education, skills training, and support for people who are in a relationship with someone who has BPD. Focusing on issues that are specific to BPD, it is hosted in a community setting and led by trained group leaders who are either clinicians or family members of relatives with BPD. Contact Australian BDP Foundation for more information.