MH Diagnosis

What Is Borderline Personality Disorder?

“He is strong, but not in the way people think. He loves more than he will ever get back and he knows it. And yet, he loves anyway”

I was diagnosed with borderline personality disorder back in 2005. Its not something that is particularly easy to live with without professional help and support, but it is possible. A great deal of understanding is also required from those directly involved in your life, like your family and friends. But unfortunately, as with any other mental health problem, there is a stigma attached to it. Some people like myself believe that those of us with BPD receive some of the worst stigma, this is in part thanks to false information in mainstream media. But its slowing changing and turning around thanks to the many people who chose to take a stand and educate people on the true facts.

A quick overview of BPD

Borderline Personality Disorder (BPD) aka Emotionally Unstable Personality Disorder (EUPD), is a mood disorder and effects how a person interacts with others. In general, someone with BPD will be different from an average person in terms of how he/she thinks, feels, perceives, or relates to other people.

After years of research, which is still ongoing in all fields of mental health, the causes of BPD remain unclear. However, as with other mental health conditions, it appears to be a result of genetic and environmental factors. Events, such as childhood trauma (neglect, physical, sexual, or emotional abuse), is associated with developing BPD.

The symptoms of BPD are broad and can be grouped into the following groups.

Emotional Instability

You experience a range of often intense and overwhelming negative emotions like:

  • Emptiness and loneliness
  • Rage
  • Terror
  • Shame
  • Sorrow
  • Panic
  • Despair
  • Suicidal

You may experience some of these over a long period of time, or they be short but rapidly switch from one to another, known as severe mood swings. It is very common for people with BPD to feel suicidal at times, and then a few hours later be feeling positive. Some people feel worse in the evenings and some people feel worse in the mornings. The pattern varies a lot, but the key sign is that your moods are swinging in unpredictable ways.

Disturbed patterns of thinking

There are different types of thoughts that can affect people with BPD which include:

  • Upsetting thoughts such as thinking that you are a terrible, horrible person or feeling like you don’t even exist. You may seek reassurance from other people because you’re unsure.
  • Episodes of strange and abnormal experiences such as hearing voices (hallucinations). These could often feel like instructions to harm yourself or others. You may or may not be certain whether these are real. You may also have distressing beliefs that no one can talk you out of, such as believing someone is trying to kill you.

These beliefs may be psychotic and a sign you are becoming more unwell.

Impulsive behaviour

With BPD there are two types of impulsive behaviour you may find difficult to control.

  • Impulse to self-harm these impulses can manifest in a variety of ways including, cutting, burning, biting, skin picking, small overdoses. These types of impulses can lead to suicidal behaviour and attempts in extreme cases.
  • Reckless and irresponsible impulse these impulses could include binge drinking, drug abuse, spending sprees, unprotected sex (strangers included), dangerous driving.

Unstable relationships

Having BPD can bring on very strong feelings of abandonment. These feelings can lead to intense anxiety and anger. You may make some frantic efforts to prevent being left alone like;

  • Constantly texting and phoning a person you fear is leaving
  • Making threats to harm and kill yourself if they don’t stay
  • Calling a person suddenly in the middle of the night

You could also feel that people are smothering, crowding or controlling you which can create intense feelings of fear and anger. This could make you react in such a way to make them go away, such as emotionally withdrawing or using verbal abuse. These feelings can cause the “love-hate” relationship with certain people.

A lot of people with BPD have a very rigid “black and white” view of a relationship. One minute they think that person is so wonderful and perfect and the next minute they think the person is horrible and the relationship is doomed. For a lot of people with BPD, any kind of relationship, including with professional carer’s, include “go away/please don’t go” states of mind. This is very confusing for all concerned, and often leads to relationship breakdowns.

What are the possible causes of BPD?

Through years of research and science, its been determined that there is no single cause of BPD, and it is likely that there is in fact a combination of factors that can cause it. Some of the factors that are likely to contribute include:

Genetics

It is quite possible that genes inherited from your parents can make you more vulnerable to developing BPD. I did read one study a while back that found that if one identical twin had BPD, there was a two in three chance that the other twin would also have BPD. These results, however, must be treated with caution as there is no evidence recorded anywhere for a gene with BPD.

Brain chemicals

It is widely thought that many of those who have BPD have a problem with the serotonin neurotransmitters in their brain. As you may already know, neurotransmitters are messenger chemicals used by your brain to transmits signals between brain cells. Insufficient levels of serotonin have been linked to depression, aggression, and difficulty controlling self-destructive urges.

Brain development problems

Magnetic resonance imaging (MRI) scans have been used by researchers to study the brains of people with BPD. Researchers found that many people with BPD had three areas of the brain that were affected. These parts of the brain where either smaller than expected or had unusual levels of activity. These three parts where:

  • The hippocampus which helps to regulate self-control and behaviour.
  • The amygdala which helps to regulate emotions, especially negative emotions, such as aggression, fear and anxiety.
  • The orbitofrontal cortex which is for planning and decision making.

These parts of the brain are also involved in mood regulation, which may account for some of the problems people face when it comes to relationships. Early upbringing also effects these parts of the brain. And any problems may well contribute to symptoms of BPD.

Environmental factors

People with BPD tend to have some common and widespread environmental factors which may contribute to the development of BPD. Some of these include:

  • Being neglected by parents, one or both
  • Exposure to chronic fear or distress in childhood
  • Being a victim of physical, emotional or sexual abuse
  • Growing up around others with serious mental health, drink, or drug misuse problems

A person’s relationship with their parents and family has a strong influence on how they see the world and what they believe about other people. Unresolved issues from childhood can develop a variety of distorted thinking patterns as an adult.

Getting a diagnosis of BPD

If you think you may have borderline personality disorder, or someone you know, please do not diagnose yourself. Its important to go and see your GP at the earliest opportunity. Your GP will ask a series of questions about your symptoms and how it is affecting your quality of life. Your GP will want to rule out any immediate risk to your health and wellbeing and rule out other mental health problems such as depression. If your GP thinks its possible you have BPD, then he/she will likely refer you to the community mental health team where you will receive a more detailed assessment with a psychiatrist.

Please involve your family

I can not recommend enough that you tell your close family/friends if you receive a diagnosis of BPD. Many symptoms effect your relationships, so by involving them it may help them to understand as well as helping you in your treatment. Family and friends can also be alert for any behaviour that may indicate you are in a crisis. Family and friends may also benefit from some of the support groups set up to help carers of those with BPD. However, the decision is entirely individual to your circumstances, and is entirely your choice.

Thank you so much for reading, I really appreciate it. For my next post i am planning on talking about the various treatment options available for BPD.

Until then, stay safe, and take care.

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