10 Things I Wish You Knew About BPD

OCTOBER 10TH IS WORLD MENTAL HEALTH DAY!

Because all of my previous mental health posts were deleted by a hacker, I wanted to create a new, updated version of one of my most popular posts. In honor of World Mental Health Day I wanted to share a little about my experience with Borderline Personality Disorder, as the key to ending the negative stigma surrounding the illness is being open and willing to educate and discuss.

TRIGGER WARNING: mention of suicide, substance abuse, sex

For those of you who do not know much about it, “borderline personality disorder (BPD) is a mental illness marked by an ongoing pattern of varying moods, self-image and behavior” according to the National Institute of Mental Health. Symptoms often result in rocky relationships, impulsive behavior, and intense episodes of rage, depression, and anxiety.

There are nine diagnostic criteria for BPD; in order to be diagnosed you must meet at least 5 of the 9 below criteria.

  • 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.

Now that we know the main symptoms of BPD, we can jump into the list.

10 Things I Wish You Knew About Borderline Personality Disorder

  1. We feel too much. I believe this quote from Dr. Marsha Linehan, the founder of Dialectical Behavior Therapy (a common treatment for BPD), sums it up perfectly: “People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement.
  2. It’s not just BPD we’re dealing with. It’s more common than not that a person with Borderline Personality Disorder is suffering from more than just BPD. We are often also diagnosed with anxiety disorders, depression, eating disorders, PTSD, Bipolar, substance abuse, etc.
  3. We probably think you hate us. Usually due to the fact that we do not feel like we are “enough,” or that we are unlovable, we often think you will abandon us at any moment. This can cause us to act out, either in hopes of making you stay, or pushing you away before you get the chance to leave. In all honesty, if I ever marry, I feel like I will be standing at the altar asking, “Are you 100% sure you actually like me???”
  4. We’re often thought of in a negative light. There’s a lot of negative stigma surrounding the BPD diagnosis. We are often described as manipulative, untreatable, selfish, too sensitive, or attention-seeking. I have even heard of medical professionals refusing to see borderline patients due to these harmful beliefs.
  5. Research shows several differences in healthy brains and those with BPD. These differences include a smaller amygdala, an overactive hippocampus, an inefficient prefrontal cortex, and abnormal cortisol production. The smaller the amygdala, the more overactive it is, making emotions much more intense than normal. The hippocampus, being in a constant state of hyperarousal, interprets otherwise safe situations as threatening and relays faulty messages back to the amygdala. The prefrontal cortex is responsible for rationality, reason, and decision-making. Because it is underactive, it is believed to be the reason for the impulsivity that comes along with BPD. Cortisol is a natural chemical released during times of stress; Those with BPD have abnormal levels of cortisol in their bloodstream, causing any stressor to seem incredibly overwhelming.
  6. 90% of everyone diagnosed with BPD will attempt suicide. Recurrent suicidal thoughts and actions play a major role in the lives’ of those with BPD. 10% of those diagnosed with Borderline Personality Disorder will successfully commit suicide. The rate of suicide among those with BPD is 50 times greater than that of the general population, according to an analysis of BPD research by the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2014. In fact, BPD is the only mental illness that includes suicidal behavior in its diagnostic criteria.
  7. BPD is not Bipolar Disorder. Sure, both illnesses cause extreme shifts in mood, but they’re not the same disorder. Bipolar Disorder involves shifts in behavior between depressive and manic or hypo-manic episodes, and does not involve a fear of abandonment. In some cases, such as mine, you can be diagnosed with both BPD and Bipolar, making for an interesting combination of symptoms.
  8. We understand others’ feelings to a greater degree. I’m usually pretty good at sensing a change in someones’ mood as soon as it happens. Picking up on the emotions of others is quite taxing though; if I am around someone who’s in a bad mood all day, it can take some time to recover. A study from the Department of Psychiatry at Columbia University suggested that individuals with BPD may have a greater ability in a particular form of emotion recognition called “mental state discrimination,” particularly when it comes to the eye region of the face. According to the study “an enhanced sensitivity to the mental states of others may be a basis for the social impairments in BPD.”
  9. Not everyone with BPD has the same symptoms or experiences. As I mentioned above, there are 9 different criteria that medical professionals go by in order to diagnose BPD. Because you must have at least 5 of those 9 symptoms, there are 256 total possible combinations of symptoms by which you could be diagnosed with Borderline Personality Disorder.
  10. We can recover. Previously it was believed that Borderline Personality Disorder was an untreatable illness. A study of BPD patients published in 2011 found that 85% of them were in remission within 10 years of treatment (remission being defined as having 2 or fewer of the 9 diagnostic criteria). With therapy, medication to treat comorbid disorders, and a lot of hard work, BPD is actually very treatable and the outlook a lot brighter than originally believed.

If you’ve made it this far, I just want to thank you for reading this post! I could probably make a list of 100 things I wish everyone knew about Borderline Personality Disorder, but ain’t nobody got time for that! So I hope you find this list informative and helpful.

Lastly, in honor of World Mental Health Day, I ask you to share your experiences with mental health with others; whether it be in the comments of this post, on your own social media, or just with a friend or family member. Be open and honest. Let others know they’re not alone! Reach out to your friend who may be struggling. Let them know they can talk to you and be supportive of those who are having a hard time. And I hope you all have a lovely World Mental Health Day!

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