Borderline personality disorder is used to describe a unique list of symptoms that are associated with significant suffering for the individual. Below is a list of symptoms associated with BPD. Please note that individuals may strongly identify with a number of BPD symptoms, but still not meet the criteria for a BPD diagnosis.
Symptoms
- Chronic feelings of emptiness
- Unstable or inconsistent self-image
- Significant mood shifts in reaction to day to day events (eg. Moving from intense anger to intense sadness)
- Frantic efforts to avoid real or imagined abandonment
- Tendency towards intense and unstable relationships - often characterised by idealisation (seeing the other as all good) and devaluation (seeing the other as all bad)
- Stress related paranoia or severe dissociation
- Impulsivity in at least two areas of life, for example, binge eating or drinking, drug use, spending, risky or impulsive sex, dangerous driving etc.
- Recurrent suicidal gestures, threats, or attempts
- Self-harm
BPD and Stigma
Unfortunately, BPD has a significant amount of stigma associated. This is due to a focus on the behavioural manifestations of the illness and a general misunderstanding of the significant suffering and desperation behind the behavioural aspects. While the behavioural aspects of BPD requires intervention, it needs to be accompanied by compassion and understanding. From a Dialectical Behaviour Therapy (see DBT) perspective, even the most dysfunctional of behaviours are functional in some way i.e. done in an attempt to cope or survive.
BPD vs cPTSD
There is significant overlap between BPD and cPTSD (see cPTSD) in that many individuals with cPTSD significantly identify with the BPD symptoms. While BPD symptoms can be viewed as a form of trauma response, there is controversy around whether all individuals with BPD have experienced trauma. Due to the stigma associated with BPD, some professional are very reluctant to to diagnose individuals with BPD, instead opting for cPTSD if the individual has experienced trauma. In spite of this, some individuals find BPD a useful term separate to cPTSD to describe their symptoms.
Treatment
Undercontrolled Presentation.
Most individuals with BPD will tend to have an undercontrolled presentation characterised by high impulsivity and high emotional expression. DBT is considered the gold standard treatment for BPD, but individuals with BPD may also benefit from a number of interventions such as trauma therapy or Schema therapy (see schema therapy).
Overcontrolled Presentation.
Some individuals with BPD have an overcontrolled presentation. These individuals, while experiencing emotional turmoil on the inside, put a lot of effort into masking this distress and hiding difficulty from others. They may engage in behaviours such as restrictive eating, compulsive exercise, and planned, secretive self-harm. Individuals with BPD with an overcontrolled presentation are likely to benefit most from a combination of DBT and Radically Open DBT (see RO-DBT). That said, everyone situation is unique and some people find more success from alternative interventions such as Compassion Focused Therapy (see CFT) or Schema Therapy. It is important to find a psychologist that will work with you to find the best fit for you.-
For me, having BPD can feel like you have two people inside you. At baseline you have your genuine, loving and kind self. This person is quiet, intellectual and self aware. However, occasionally when triggered by an unpleasant memory the other part that is a by-product of your trauma erupts. When this side is triggered you can act in an unpleasant primitive way as your body tries to get you through the trigger. However this can sometimes outwardly be expressed through impulsive, highly emotional and volatile ways. Unfortunately, this small part of you can be what society chooses to remember you like and it becomes this continual cycle of trying to prove your worth to the small minority that see you as "non-compliant", "attention seeking" and "manipulative". It can be a soul destroying process but when you have a team that are BPD/trauma informed you can begin to heal from your past
- T, Brisbane
