Have you wondered what it’s like to have a relationship with someone diagnosed with borderline? Maybe you’re already acquainted as a therapist, family member, friend, co-worker, or through some other role. Perhaps you’re even questioning if you have borderline. In honor of Borderline Awareness Month, let’s take a look at signs, symptoms, myths, and facts so that you can make informed decisions on what possible
steps to take next.
-SIGNS and SYMPTOMS-
According to The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013), BPD can be detected through the existence of 5 or more of the prevalent symptoms listed below:
1. Frantic efforts to avoid real or imagined abandonment.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two potentially self-damaging areas (e.g., spending, sex, substance abuse, reckless driving, binge eating).
5. Recurrent suicidal behavior, gestures or threats, or self-mutilating behavior.
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and rarely more than a few days).
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.
-MYTHS AND FACTS-
Q. I related to some of these, does this mean I have BPD?
- No. Relationships are hard and we ALL have them. Therefore, many individuals may struggle with BPD ‘tendencies’. A formal diagnosis is given when a licensed professional assesses the long-term pattern and current presence of behaviors, emotions, thoughts/beliefs, and additional symptoms related to BPD.
Q. If my loved one has BPD, does this mean I was a bad parent/support person; that could’ve done more to prevent this?
- No. The diagnosis of BPD is multi-faceted and takes careful consideration of genetic predisposition, biological, environmental, and social factors that also play a role in symptomology. In other words, if a parent was inconsistent with their child, a licensed
professional will look at the additional context of that person’s life. Treatment of BPD does NOT include “Who’s at Fault”. Instead, it is geared towards emotional regulation, interpersonal effectiveness, radical acceptance, and distress tolerance skills.
Q. If I have BPD, does this mean I’m going to suffer forever?
- No. Although individuals living with BPD do have a reduced life expectancy and lower quality of life than the general population, increased awareness, and the recruitment of trained professionals is becoming more accessible.
Q. I heard that there is a stigma about BPD. Should I try to seek help if I think a clinician doesn’t even want to see me?
- Yes. First, notice how you are feeling about the therapeutic relationship before you even start. How might your belief impact your attendance or commitment? Know that your therapist is NOT going to chase after you or try to “fix you”. Please know that they understand the courage it took you to even reach out for help in the first place, and that they area neutral soundboard for your growth.
Q. I see my loved one struggling with BPD. They constantly tell me I’m ‘nagging them’ when I try to help, but even when I suggest therapy, they’re offended by that too! Are we stuck in this pattern forever?
- No. It is common for those with BPD to be sensitive to suggestions and criticisms due their perceived fear of rejection or abandonment. Learning to reflect your loved one’s emotions and encourage them to seek their own solutions can help alleviate symptoms of this vicious cycle.
Q. Should I consider individual therapy or family therapy if a loved one or myself has been diagnosed or suspected of having BPD?
- Yes. Individual therapy can be helpful, especially when the treatment modalities include DBT (Dialectical Behavioral Therapy) and/or EMDR (Eye-Movement Desensitization and Reprocessing) Therapy. In general, a clinician who focuses on
relationships, emotional regulation strategies, and belief systems. Family therapy can also be helpful, in that it doesn’t single out or treat the person with BPD, but instead focuses on addressing the family dynamic as a catalyst for positive treatment outcomes.
If you are looking for a therapist to work on BPD, relationships, or emotional regulation, consider reaching out for a free consultation today!
For MORE about BPD:
NAMI- National Alliance on Mental Illness
NEA-BPD- National Education Alliance for BPD
Kreisman, J. J., & Straus, H. (2021). I Hate You--Don’t Leave
Me: Third Edition: Understanding the Borderline Personality.
Penguin.
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