NB: Information presented here is only for educational purposes. While the information is accurate and up to date, it should NOT be used for self-diagnosis; only a trained psychiatrist is able to offer a mental illness diagnosis.

What is Borderline Personality Disorder?

Borderline personality disorder (BPD), also referred to as emotionally unstable personality disorder (EUPD), is a mental health disorder often manifested through a long-term pattern of unstable relationships, a distorted sense of self and intense emotional reactions. Individuals affected by BPD often struggle with fear of abandonment, suffer detachment from reality and experience feelings of emptiness. Women are diagnosed with BPD about 3 times as often as men. It appears to become less prevalent among older people; up-to half of the individuals diagnosed with BPD improve over a 10-year period.

Symptoms of Borderline Personality Disorder:

Below are some of the symptoms that one may experience for a BPD diagnosis to be made:

1. An intense fear of abandonment and feelings of emptiness
2. A pattern of unstable intense relationships, such as idolizing someone one moment and then suddenly believing the person doesn't care enough
3. Rapid changes in self-identity and self-image that include shifting goals and values, and seeing yourself as bad or as if you don't exist at all
4. Impulsive and risky behavior, such as gambling, reckless driving, unsafe sex, spending sprees, binge eating or drug abuse, or sabotaging success by suddenly ending a positive relationship or quitting a job you enjoyed
5. Suicidal threats or behavior or self-injury, often in response to fear of separation or rejection
6. Wide mood swings lasting from a few hours to a few days, which can include intense happiness, irritability, shame or anxiety
7. Inappropriate, intense anger, such as frequently losing your temper, being sarcastic or bitter, or having physical fights

Causes & Diagnosis:

Like other mental illnesses, BPD is a complex disease whose main cause is not well known. However, the factors below might contribute to the chances of BPD:

1. Genetics Some studies of twins and family members suggest that personality disorders may be inherited or strongly associated with other mental health disorders in the family.
2. Brain abnormalities. Research has shown changes in certain areas of the brain involved in emotion regulation, impulsivity and aggression. Certain chemicals in the brain that help to regulate mood such as serotonin, may not function properly.
3. Hereditary predisposition. BPD occurs 5 times more often in an individual who has an affected close relative.
4. Childhood Abuse: Many people with BPD report to having been sexually/ physically/emotionally abused or neglected during their childhood

Treatments:

Psychotherapy is the primary treatment for borderline personality disorder. Treatment should be based on an individual’s needs, rather than upon the general diagnosis of BPD. Medications are useful for treating comorbid disorders (those existing simultaneously with and usually independently of another medical condition- in this case BPD), such as BPD and anxiety. Short-term hospitalization hasn’t been found to be more effective than community care for improving outcomes/ long-term prevention of suicidal behavior in those with BPD.

1. Psychotherapy (Psychological counselling or talk therapy): The therapeutic approach mostly used is Cognitive Behavioral Therapy (CBT) which as opposed to dwelling on the causes of the BPD, it focuses on what one can do to help change the way they are feeling. Apart from CBT, other approaches such as Dialectical Behavioral Therapy adds mindfulness approaches like meditation that can help those suffering from BPD.
2. Medications- depending on the symptoms, medications are usually prescribed by a psychiatrist, often mood stabilisers and antipsychotics.

Misdiagnosis:

People with borderline personality disorder may be misdiagnosed especially because BPD has symptoms that co-exist (comorbidity) with other disorders such as BPD, bipolar disorder and Post Traumatic Stress Disorder.  

How can I help someone I know with BPD?

Supporting a loved one with BPD can sometimes be a challenging task. You can be under great pressure not knowing what to do or say for your loved one since anything you say, do not say, anything you do and do not do can be taken personally and negatively by your loved one. There is no instruction manual on what to do and say to make it better for them, but always remember being there and offering your help can be everything they need.

Below are a few ways you can help your loved one:

1. Learn all you can about BPD. This will help you help your loved one better.
2. Do not judge and criticize but be understanding. Instead of trivializing the illness by saying mean things like “Why can’t you just be normal like other people?” you can say, “You seem to have a challenging time, anything I can do to make it easier for you?”
3. Be present. Just being there for your loved one even without saying a word makes them feel much better. Loneliness and BPD makes it harder for someone suffering BPD to recover.
4. Validate the person and the difficult phase they are going through. Statements like “I might not know what you are exactly going through but things will get better and I will be here for you” are very helpful. Acknowledging what they are going through is so important and goes a long way to help one feel loved and cared for.
5. Remind them they are not a bother and that they make your life special by being in it.
6. Help your loved seek professional attention. Let them know the hospital is a safe and viable option especially when a loved one is feeling suicidal.
7. Even if you are not physically present for your loved one, keep in close touch. Send several text messages every so often and give them a call. Send them memes and stuff that makes them happy. Do they love cooking for example? Send them a new recipe to try out. Do they love a certain kind of music? Send them a link of that so that they can listen to it.
8. Do things they enjoy together with them. When they seem isolated, offer to take them out on a movie they have been looking forward to watch. Is there a music concert they would enjoy? Buy tickets and go together with them. Do they love reading? Buy them a novel. Do they love baking? Buy ingredients and go bake with them. It really doesn’t have to be much. It really is the little things.
9. Instead of always talking about what your loved one is going through, have general conversations as well. Talking about the weather, what is trending on the internet, politics and anything else your loved enjoys really helps their minds wander. And this is helpful to make them feel better.
10. Remember that you cannot fix your loved one so do not feel helpless when you do something and they do not seem better or they push you away. Just be there and remember actions speak louder than words.

 

Love and light,

Wangari Murage