Living with Borderline Personality Disorder

BPD is a type of personality disorder, like avoidant personality disorder or antisocial personality disorder. These belong to a group of mental disorders that cause unhealthy and rigid patterns of thought and behaviors that impact relationships, activities, work, academics, and many other aspects of life. Living with an untreated personality disorder can be hugely disruptive to normal life.

BPD is just one type of these disorders and can severely impact your ability to manage stable relationships with other people, to choose and follow a career, to have a good relationship with family, and to enjoy life without mood swings, anger, fear, and anxiety. If you are living with BPD you need to remember that this is an illness, but it is a treatable and manageable one. It is crucial to seek a diagnosis, to accept and engage in treatment, and to seek support from family, friends, and other people going through similar experiences.

The first challenge of living with borderline personality disorder is that you may struggle to realize that there is anything wrong with the way you think or behave. Personality disorders often cause a person to assume that their own patterns are normal and that it is other people who are to blame for their difficulties. It is important to find out what the recognized symptoms of BPD are, but also to hear from others what it feels like to live with this condition. With this kind of information you may begin to recognize that something is not right and that you may need to get help. The possible symptoms of BPD include:

• Fear of abandonment
• Unstable, often intense relationships
• Impulsive behaviors that often lead to risk taking
• A chronic empty feeling
• Intense mood swings, sometimes lasting just a few hours
• Excessive anger directed inward or at others
• A distorted self-image or difficulty determining a sense of self
• Self-harm or suicidal behaviors
• Paranoid or delusional thoughts
• Dissociation, like feeling outside of the body

These are the kinds of symptoms that mental health professionals use to diagnose BPD, and they may sound familiar, but it may also be more helpful to consider how it really feels to experience these symptoms:

• Your feelings about other people change rapidly—from passion to disgust—and you don’t understand why.
• Your romantic relationships tend to be very intense, but short-lived.
• You often feel empty inside, or as if you don’t know who you are.
• You feel a constant fear that people in your life will leave you.
• Because of that fear of abandonment, you do desperate things or lash out to try to stop them from abandoning you.
• You have intense emotions, and other people think you overreact to small things.
• Your intense feelings are difficult to control; you have a hard time calming down after extreme fear, anxiety, or anger.
• Your emotional extremes change quickly, and it can feel like being on a roller coaster.
• Small things feel like the end of the world.
• You feel the urge to do things that may be risky.
• You sometimes feel a crazy level of anger that you can’t control, and it is often anger directed at yourself.
• You feel paranoid, like someone is out to get you.

Whether you suspect you have borderline personality disorder or you are just sure that something isn’t right, it is important to ask for help. No one can beat a personality disorder or any other psychological disorders alone. Treatment from mental health professionals and support from those who care about you is essential in being able to manage this illness. It isn’t easy to ask for help, but it is important to do so. Turn to someone you trust to help you decide what to do next. This could be a close friend, a family member, your doctor, a caring nurse in your doctor’s office, or someone you know who is a therapist or mental health professional.

Once you have decided to ask for help, your next step is to get an official diagnosis. Only then can you get a treatment plan that will work for you. There is no borderline personality disorder test, but there are diagnostic criteria that are used to make the diagnosis. You may start with your general doctor or a nurse, but your diagnosis should be made or confirmed by a psychiatrist. To be diagnosed you will undergo a psychiatric evaluation during which a mental health professional will ask you questions, listen to your answers, and observe your behaviors and the way you think and react.

With a diagnosis, you can participate in a treatment plan that will help you manage symptoms. BPD is a troubling diagnosis, but it is important to remember that this is a treatable condition. You will see improvements if you work with your therapist and others involved in treatment. There are no borderline personality disorder medications, although some drugs like antidepressants may help with some symptoms or complications, like depression or anxiety.

More important to treatment is dialectical behavior therapy (DBT), a type of therapy that was developed specifically for BPD and that is based on cognitive behavioral therapy. DBT teaches you to be mindful and aware of your moods, emotions, behaviors, and thoughts and to recognize those that are negative or destructive. Being aware enables you to better control and change these feelings and thoughts. A DBT therapist will teach you specific skills and strategies for accepting your negative thoughts, controlling intense emotions, limiting self-destructive behaviors, and improving relationships with others.

With borderline personality disorder, relationships are extremely challenging, but evidence from research suggests that when family is educated about BPD and involved and supportive, patients do better. Family psychoeducation is a strategy that involves teaching family members more about the condition and how to create an environment that is conducive to recovery. Working with a mental health professional, family members learn specific strategies for communicating with a loved one with BPD, strengthening the relationship, and coping with the stress of the situation. If you are diagnosed with BPD, family could be one of your strongest tools for getting well, so get them involved.

In addition to engaging with therapy and other treatments, and accepting support from others, there are steps you can take to help manage your symptoms, thoughts, and emotions:

• Find and join a support group. It could be a BPD support group or a group for any personality disorder, but getting involved with people who have similar experiences is a great way to heal, to learn strategies for coping, and just to be able to talk to someone who understands.
• Learn and use calming strategies. Your therapist will help you learn how to calm extreme emotions. Find what works for you and use those strategies when you feel out of control. It may be mindfulness practice, meditation, or engaging your physical senses to stay grounded.
• Try distractions. If you find you still can’t calm down, try to distract yourself with television, a busy activity, something creative, a walk or run, or a phone call to a friend.
• Actively work on relationships. This is one of the hardest parts of living with BPD, but you need the people who care about you in your life. Work with your therapist to develop tools for strengthening relationships. Actively working on it can help you learn not to assume the worst, that you will be abandoned, and will guide you to be better able to communicate with others.
• Take charge of your health. Eat well, get exercise and plenty of sleep, avoid drugs and alcohol, and generally manage your overall health and you will be better able to manage your emotions.
• Manage any co-occurring disorders or complications. Mood disorders, anxiety disorders, eating disorders, substance abuse, suicidality, and other issues can commonly co-occur with or result as a complication of BPD. It is important to talk to your doctor or therapist about these issues so you can manage them along with your BPD symptoms.

When living with BPD, help from others, support, therapy, and a commitment to self-care and management are all crucial to success. This is a challenging mental illness, and there will be days when it feels impossible to overcome the hurdles. Remember that BPD can be managed. If you take all the right steps, you will start to feel better and will gain more control over your life.