Individuals with Borderline Personality Disorder (BPD) are often misdiagnosed with Bipolar Disorder, because the symptoms of these two disorders can overlap. For instance, Borderline individuals have patterns of unstable moods, fear of abandonment, identity confusion, erratic behaviors, and chaotic relationships, which may appear as Bipolar symptoms but which are causally distinct in that they result from stressful and painful life events, not from a genetic biochemical imbalance. While Bipolar Disorder often requires medication, Borderline Personality Disorder does not. Rather, this personality disorder is developed over time from experiencing a dysfunctional family environment, loss, and/or trauma during one’s childhood, adolescent, and young adult years. If you think that you may have Borderline Personality Disorder, you may benefit from an antidepressant medication but will also need to do the hard work of increasing awareness and understanding of the life experiences which created this disorder.
Borderline Personality Disorder (BPD) is characterized by many faulty thought processes and mood swings which can have extremely detrimental effects upon one’s personal life leading to unstable relationships, work performance, and overall self-esteem. The most severe effects of BPD include persistent fear of failure, ruminating thoughts about one’s inadequacy, shame, depressive episodes, and perceived negative evaluations or rejection from others. BPD can also cause conflictual interpersonal and unstable relationships, due to one’s irrational sensitivity to criticism, persistent difficulty with handling daily pressures, poor ability to complete both small and large tasks, and “black-and-white thinking” related to present and future experiences. Furthermore, obstacles in one’s work or academic environments may result from catastrophizing problems or projects, procrastinating due to an overwhelming fear of failure, and poor time management skills due to unstable moods.
A Description of Your Life with Borderline Personality Disorder
BPD can wreak total havoc on your daily coping skills in general! You may experience a “stuckness” from ruminating thoughts which are firmly rooted in the past or future, and you are often debilitated by shame, regret, guilt, and insecurity. Innocuous events can be severe triggers which lead to disproportionate emotional reactions and unstable relationships. You may be prone to anger outbursts and irritability, due to chronic feelings of fear and sadness. You may also engage in self-destructive behaviors, such drug and alcohol usage, risky sexual experiences, and overall poor self-care. You may start to consider therapy after you have lost several jobs, have dropped or received poor grades in academic classes, and have had a pattern of failed and dysfunctional romantic relationships dominated by your extreme fear of abandonment and your continual testing of your partner’s loyalty.
In sum, your repetitive chaotic and impulsive behaviors are very difficult to overcome, because they are deeply rooted in early life experiences of trauma, loss, and/or abuse. BPD symptoms are often perpetuated by your perceptions of traumatic experiences as part of who you are versus what happened to you. BPD can be a huge liability in your friendships and romantic relationships, because you have a continual fear of abandonment and rejection leading to unstable relationships. You may have frequent emotional instability, and you may engage in “idealization versus devaluation” of others, which is a common BPD symptom. Other dysfunctional thought patterns may include disappointment and labelling others as “bad” when they do not give you enough reinforcement and using “should” and “should have” self-statements which ultimately create your own emotional and mental prison sentence.
Why is Borderline Personality Disorder so Difficult to Treat?
Borderline Personality Disorder (BPD) often coexists with Post-Traumatic Stress Disorder (PTSD) and fear of abandonment, due to your personal history of multiple traumatic events. Trauma creates permanent biological brain changes. After a traumatic experience, your brain has learned to exist in a constant state of the “fight or flight” response. You may feel as if you are continually in crisis mode, and this state of being can easily develop into depression and anxiety. Borderline symptoms have been classified into four main types, but it is common for an individual with BPD to have two or more coexisting types.
The BPD Discouraged Type can include passive-aggressive behaviors, a pattern of emotionally abusive and codependent intimate relationships, fear of abandonment, depressive thoughts, ongoing self-doubt and self-persecution, and frequent thoughts about hopelessness and helplessness.
The BPD Impulsive Type can include attention-seeking behaviors, self-destructive behaviors, a very fragmented and weak sense of self, unstable moods, dramatic intimate and familial relationships, persistent boredom and emptiness, and a constant search for validation and acceptance.
The BPD Petulant Type can include an inability to express one’s true feelings, paranoid ideation, an irrational need for control in relationships and daily life tasks, frequent dissatisfaction with others and life in general, extreme fear of rejection and abandonment, and a pattern of testing others’ love and/or loyalty.
The BPD Self-Destructive Type can include intense self-loathing thoughts, lack of self-care, unstable moods, extreme mistrust and anger in one’s familial and intimate relationships, and patterns of self-harm through substances, abusive relationships, excessive video gaming as an escape, and other addictions.
How is Borderline Personality Disorder Best Treated?
Although Borderline Personality Disorder is not curable, it is manageable. Learning and applying the strategies for managing Borderline Personality Disorder symptoms is as challenging as preparing for a marathon. It is very important to stay focused on the strengths developed through the internal process of recovery and empowerment and not on the perceived weaknesses which were imposed upon you by your external traumatic circumstances. Three particular therapeutic approaches have shown positive results in treating BPD symptoms.
The first technique is Narrative Exposure Therapy (NET), which can help you to gain awareness of and to work through the long sequence of repeated exposures to traumatic events and to childhood stressors within your family, peer, and other social environments. Narrative Exposure Therapy focuses on your separation from external circumstances, so that they can be diffused from your internal sense of self.
The second technique is Mindfulness-Based Cognitive Therapy (MBCT), which can increase your moment-to-moment awareness of thoughts and emotions. Through mindfulness, you can gradually learn self-compassion toward accepting your disturbing thoughts and perceiving them as less threatening and as catalysts for personal growth.
The third technique is Dialectical Behavior Therapy (DBT), which was originally developed to treat chronically suicidal individuals diagnosed with BPD and has become a preferred therapeutic technique for this disorder. DBT has four main goals: (1) mindfulness, or the practice of being fully aware and present in each thought or emotion, (2) distress tolerance, or how to tolerate, not attempt to change, the pain in difficult situations, (3) interpersonal effectiveness, or using productive coping strategies and communication skills in your significant relationships, and (4) emotional regulation, or how to decrease your vulnerability to painful emotions through conscious cognitive strategies.
Borderline Personality Disorder can have the “gift” of tapping into your resilient traits, which you naturally developed by having to deal with trauma, fear of abandonment abuse, and/or loss. You must also know that malleability is even more important along the BPD path. Malleability is a valuable trait which is represented by confronting all life experiences with wisdom, humility, and self-respect. While traumatic memories will never completely go away, they can be managed with conscious efforts and an unbending commitment to empowerment by engaging in treatment and by educating oneself about the causes and effects of this disorder. If you have Borderline Personality Disorder or are in a close relationship with a BPD individual, you already know about the frustrating and, at times, terrifying roller coaster of emotions, self-confidence, and motivation. One day you or your loved one may be optimistic, focused, confident, and loving, while the very next day, you or your loved one may feel rejected, hopeless, and fearful. This roller coaster may not stop, but the ride can be transformed into a MUCH more manageable and productive path. You or your loved one must be willing to put in the hard work toward creating specific coping strategies for your stress and insecurity triggers and toward embracing greater acceptance of your painful life events as a strong and wise survivor.
Written by New Age Psychiatry’s Compassionate Therapist: Rebecca Wang-Harris PhD
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