BPD Symptoms make this personality disorder particularly difficult and painful for their environment, loved ones, family and friends, as well to a large degree themselves. BPD is a complex condition, often challenging (but not impossible) to treat. It is characterised by lack of emotional self-regulation, poor/violated boundaries, and a “roller coaster” cycle of paradoxes (imploring someone / pushing them away for ex.)
BPD Symptoms
“Borderline” as it is often used in short hand, is a paradoxical condition, alternating mood swings, love-bombing with love withdrawal. It is a disorder also hard to spot for the general public as BPD have a heightened sense of their public image, and tend to behaviour structurally more charmingly in public. Being paradoxical in nature, that disorder means that BPD symptoms can only be identified as part of proper context. BPD symptoms are part of a spectrum:ย DSM-IV defines BPD in the real world in a patient, if they meet 5 (or more) of 9 criteria for diagnostic. Most commonly BPD individuals show the following symptoms (summarised):
- Emotional instability – Frequent, intense changes of mood, sometimes several times per day
- Unstable personal relationships – BPD individuals often alternate wilder phases in their romance: They can start at excessive idealisation outright, followed by intense rejection and devaluation of the partner. Recurrent conflict, shorter relations, of lower quality on average.
- Fear of abandonment – Intense anxiety at the prospect of being abandoned. This triggers extreme, excessive, and ultimately counter productive efforts in the BPD to avoid abandon (excessive jealousy, excessive manipulation etc.)
- Impulsivity: BPD are known to engage in impulsive, sometimes dangerous behaviours (drugs, unprotected sex, dangerous driving, financial profligacy etc.)
- Low sense of self and identity: BPD individuals often feel depressed, and lacking internal “anchor”. Their sense of self-worth is often disturbed or confused. They are unsure of their image or place in the world and consciously try to manage it, outwardly.
- Self-harm: Self-mutilation, threats, aggressive provocations, suicidal thoughts or behaviours.
- Feelings of emptiness: Recurrent internal experiences of void, emptiness.
- Inappropriate anger: One of the most deleterious aspects of BPD is their propension for flashes of anger or rage, wildly out of proportion to the harm or offence. BPD struggle to manage their anger, and can leap into intense bouts of white hot rage, during which they harm their environment and burn bridges for themselves.
Prevalence of BPD
Borderline Personality Disorder, and specifically its prevalence in the population is a hotly disputed topic in psychology. Most estimates range between 1.5% and 6% prevalence. Another area of recurrent debate regarding BPD is its prevalence in females, often estimated to around x4 more common than in males. There is no consensus to share here. One school of thought is that this over-diagnostic is actually mirroring natural prevalence. The other asserts that males are just as likely to have BPD, or at least more than the current estimate, but are misdiagnosed through comorbidity with similar disorders (ASPD, NPD) or cultural bias.
Impact of BPD on themselves and partners
BPD symptoms tend to create a profound impact on their partners, often disrupting daily basic processes, work performance, and social connection. Their impulsiveness, lack of respect for boundaries, roller-coaster mood swings and dangerous behaviours create all manners of trouble and issues in the real world. The often result in financial, physical or legal harm, leading for the BPD themselves to further depression and anxiety, drug abuse and occasionally food misuse. BPD symptoms are numerous, frequent, hurtful, undermining and their collective impact is huge on a partners who suffer directly, more than anyone else, from the behaviour of the Borderline. Unable to connect safely, to plan, to agree boundaries or principles, partners gradually learn to “walk on eggshells”, accrue trauma from the violence and mood swings. More generally, partners are profoundly confused by the BPD behaviour, their excuses and inability to self-regulate, their lack of self-reliance. BPD individuals can also engage in trauma-bonding, or love-bomb their partners regularly, leading partners to feel more confusion and guilt yet.
Treatment of Borderline Personality Disorder
BPD is known to be a “sticky” disorder, complex and challenging but possible to treat. BPD treatment also involves treating symptoms, how to spot them earlier, how to develop better coping strategies at the ready. The typical tools used to treat BPD individuals are often the same as those used to treat their partners.
- Dialectical Behaviour Therapy (DBT): A therapeutic protocol unique to BPD, DBT combines mindfulness and meditation with behavioural therapy techniques. It aims at strengthening emotional management, how to manage intense emotions, improve personal relations and self-harm.
- Psychodynamic therapy: Freudian type psychoanalytical therapies can help unlock profound early trauma often found in BPD individuals. How these and their related emotional-behaviours create risk, disconnection and harm in the real world.
- Cognitive Behavioural Therapy (CBT): CBT can be helpful to explore, loosen up and practice new mental maps and schemas, build contrast and awareness around destructive behaviours.
- Group therapy: Providing a safe space for BPD patients or survivors helps all learning more about the condition, identify common triggers or coping mechanisms. BPD is essentially relational and experiencing, practicing, in real life, with a safe group is very helpful.