Personality Disorders: Introduction to BPD

Borderline Personality Disorder (BPD) has been the focus of intense interest among clinical researchers due to the chaotic effects it has on the individuals suffering from it, as well as their families and therapists. There may be an occurrence rate of 3 to 5 percent among the general population, and around two-thirds of those diagnosed are women.

Black and White Vision

Individuals suffering from Borderline Personality Disorder see the world as black and white, with no grey areas around. They tend to change the way they feel about a person from one moment to the next, making a person they once adored and respected someone they distrust and despise. Their views and values tend to change rapidly.

Before 1980, the term Borderline was referred to an intermediate level of disturbance between psychotic and neurotic symptoms. However, at present, BPD refers to a collection of symptoms characterised primarily due to serious instability in emotion, behaviour, identity, and interpersonal relationships.

Borderline individuals tend to have intense and unstable interpersonal relationships. They also experience chronic feelings of extreme anger, loneliness, emptiness, distrust (due to the irrational fear of not knowing a person’s intentions); as well as fear of abandonment and momentary loss of personal identity, such as feeling cut-off from oneself or seeing oneself out of their body. They tend to engage in impulsive behaviours, such as going on shopping sprees, running away, promiscuity, binge-eating, as well as drug and alcohol abuse. Their lives are often marked by repetitive self-destructive behaviours such as reckless driving, self- mutilation, and suicide attempts, calling forth saving responses from the people in their lives.

The following is an example of the complex nature of Borderline Personality Disorder:

A 27-year-old married woman with two small children, had undergone a stormy adolescence. She had been forced into sexual relations with a brother six years her senior; whom, at first, she idolised; and later, feared. Their relationship had continued until just before she left home for college, at which time she confessed to her parents about it. In the ensuing emotional turmoil, she made a gesture of suicide (overdose of aspirin) but was hospitalised. 

Outwardly flirtatious, although inwardly shy and ill at ease, she felt intensely lonely, causing her to go through a period of mild alcohol abuse and brief sexual affairs in order to cope with feelings of anxiety and a sense of inner emptiness, which was halted at the age of 19 when she married a classmate and dropped out of school.

For the first few years of marriage, she was fairly at ease. But with the birth of her second child, she became anxious, bored and got into fits of sadness and fearfulness. Her mood started fluctuating from hour to hour and day to day, but the negative feelings were greatly intensified on the 3 or 4 days before her period. As the family expanded, the husband had become less attentive towards her.

As a response, she became increasingly irritable, provocative, and even abusive at times (hurling insults and breaking plates). This resulted in her husband beginning an extramarital relationship, which she eventually discovered. This caused her to get seriously depressed, which caused her a loss of appetite and sleep. She then began abusing alcohol and sedatives and also made several gestures of suicide, including an instance where she cut her wrists. On two occasions, she hid for several nights in motels without informing anyone of her whereabouts (Stone).

Association with Other Disorders

BPD is highly associated with a number of other disorders, which include mood disorders, PTSD, and substance abuse disorders. In one study, BPD's symptoms of impulsivity and emotional instability had predicted recurrent problems in academic achievements and social relationships two years later (Bagge). In one intensive study of 57 individuals diagnosed with BPD, a total number of 42 suicide threats, 40 drug overdoses, 38 episodes of drug abuse, 36 instances of self-mutilation, 36 instances of promiscuity with near strangers, as well as 14 accidents mainly caused by reckless driving, were revealed.

The chaos that marks the lives of BPD patients extends to their relationships with their psychotherapists. These individuals are considered to be among the most difficult patients to treat, owing to their clinging dependency, irrational anger, and tendency to engage in manipulative suicidal gestures and threats as an effort of controlling the therapist (Linehan).

Every individual with Borderline Personality Disorder does not experience all these symptoms. Some may experience a few symptoms, while others experience the whole array of them. Symptoms can be triggered by ordinarily simple events; for example, individuals with BPD may feel angry and distressed due to minor separations from the people they are close to, even if it’s just a business trip. The severity and frequency of symptoms, as well as the lengths of the periods, may vary depending on the individual and their illness.

These behaviours and symptoms occur primarily during a period of elevated mood and energy. Therefore, If you know anyone like this, you may need to consider that they may not be suffering from Borderline Personality Disorder; instead, they may be signs of a mood disorder.

Borderline Personality Disorder, though historically viewed as a difficult disorder to treat; with new evidence-based treatment, many individuals with this disorder suffer fewer or less severe symptoms—and an improved quality of life.