I know, World Mental Health Day was on the 10th, but can we really leave this important discussion to only a month or day of awareness? I don’t think so. It needs to be an ongoing discussion in my opinion.
What’s great is all of the posts I see in support of those with anxiety and depression. People really seem to be beginning to understand these things a little bit more. What’s not great is the stigma that still surrounds many mental illnesses that aren’t anxiety or depression, especially personality disorders.
Personality disorders are characterized by distorted thinking, problematic emotional reactions, over or under regulated impulse control, and interpersonal difficulties. In order to be diagnosed with a personality disorder, you must be struggling with at least two of these four symptoms.
Personality disorders are grouped into three categories: clusters A, B, and C. Cluster A includes Paranoid, Schizoid, and Schizotypal; Cluster B includes Borderline, Narcissistic, Histrionic, and Antisocial; and Cluster C includes Avoidant, Dependent, and Obsessive-Compulsive.
Today, though, I’m going to focus in on Cluster B – specifically Borderline Personality Disorder. I’m not claiming to be an expert on the subject, I’m just speaking from my firsthand experience with the disorder.
I was nineteen years old when I was diagnosed with BPD. I had just attempted to commit suicide, which resulted in being seen by a psychiatrist. She evaluated me, asked me lots of questions about my identity, my relationships with others, and whether I considered myself “promiscuous” or “impulsive.” I was confused. I mean, I just thought I was depressed.
She asked me to go home and watch a documentary called “Back from the Edge.” It featured people living with BPD and their stories. Watching this documentary changed everything for me; I had never related to anything more in my life, honestly.
In order to be officially diagnosed with BPD, you must display 5 of the 9 following symptoms:
Frantic efforts to avoid real or imagined abandonment.
A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
Identity disturbance: markedly and persistently unstable self-image or sense of self.
Impulsivity in at least 2 areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
Recurrent suicidal behavior, gestures or threats, or self-mutilating behavior.
Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days).
Chronic feelings of emptiness.
Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
Transient, stress-related paranoid ideation or severe dissociative symptoms.
At that time in my life, I was demonstrating all nine symptoms. I was in college, majoring in art, attempting to get into a program that only accepts 15 students per year. I was in an extremely toxic relationship. I was using drugs and alcohol to make things seem better than they were. I could not keep a job to save my life. Being diagnosed with BPD was like the icing on the cake. On one hand, I was relieved that I could put a name to my condition. On the other hand, I didn’t want to accept that I had just been diagnosed with a disorder with such a bad reputation.
After a few quick google searches, I quickly learned that the stigma surrounding Borderline Personality Disorder was extremely negative, even among medical professionals. Some doctors and therapists place a limit on how many BPD patients they will treat, while others refuse to see us altogether. We are labeled as “treatment resistant” and often dropped as patients.
A study observed that patients seeking treatment for a personality disorder faced more stigma than patients who sought treatment for other mental illnesses. Out of those patients seeking treatment for personality disorders, those with BPD faced the most stigma.
It is estimated that 1-3% of the population suffers from Borderline Personality Disorder, yet so little is widely known or understood about it. 70-80% of us will attempt suicide, while 10% will die by suicide. This is why it’s so important for resources to be available to those suffering.
We are often seen as manipulative, abusive, over-dramatic, violent, and attention-seeking. The stigma surrounding BPD makes it difficult for those suffering from it to get the help and support they need in order to get better; it can often be as debilitating as the illness itself. It’s important that mental health professionals and loved ones of those with BPD take the time to understand the illness. So here’s ten things I wish everyone knew about Borderline Personality Disorder:
- We usually think you hate us. If you are a friend, family member, or significant other of someone with BPD, know that they sometimes need your love and support spelled out for them. Try not to be annoyed by being asked “do you still like me?” a thousand times.
- Our intense emotions are not only negative. We also sometimes feel happiness and love in great proportions. This can mean we become very devoted, fiercely loyal, and passionate when we find things and people of interest to us.
- We can be extremely empathetic. Us being the sensitive souls that we are, we often pick up on others’ emotions. In turn, this makes us very understanding and compassionate human beings.
- We have a distorted sense of time. Months can feel like days and seconds can feel like hours, all depending upon where our mood is at the time.
- We are resilient. Each and every day is a battle with BPD. We fight our mental illnesses, as well as the stigma that goes along with them on a daily basis. Though we may be emotionally unstable, we are strong because we keep going even when our brain tells us not to.
- We’re really creative. Many of us are artists, writers, actors, and musicians. I think having a creative outlet is important when it comes to recovery.
- Sometimes we dissociate. Dissociation is described as a mental departure from reality. Some examples are remembering events that did not happen, not remembering events that did happen, splitting, mirroring, and projection. These episodes can be brought on stressful situations.
- Our moods can change rapidly. One minute we could be perfectly content, and the next we are contemplating suicide. It actually happens that quickly, and sometimes without a real reason.
- We lack the gray areas. We see things in very black-or-white, all-or-nothing terms. Things are considered “all good” or “all bad,” there is no in-between. This makes it easy to misinterpret the actions and motivations of others.
- BPD is treatable. Research shows that, despite opinions on the subject, psychotherapy is a helpful treatment. Medication does not directly treat BPD, however it can help stabilize mood and treat co-morbid disorders. Long-term, intensive therapy is necessary in making progress with treatment.
This list could honestly go on and on with facts and statistics and my opinions on Borderline Personality Disorder, but I think this is a good, general overview that points out a few things you may not have known about us borderlines.
- DSM-IV and DSM-5 Criteria for the Personality Disorders
- Diagnosing Borderline Personality Disorder
- Out of the Fog
Resources for BPD patients:
Reading material I have found helpful:
- Buddha and the Borderline
- Mindfulness for Borderline Personality Disorder