BPD
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Borderline personality disorder (BPD) is a serious mental illness marked by unstable moods, behavior, and relationships.
Symptoms:
Extreme reactions—including panic, depression, rage, or frantic actions—to abandonment, whether real or perceived
A pattern of intense and stormy relationships with family, friends, and loved ones, often veering from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)
Distorted and unstable self-image or sense of self, which can result in sudden changes in feelings, opinions, values, or plans and goals for the future (such as school or career choices)
Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating
Recurring suicidal behaviors or threats or self-harming behavior, such as cutting
Intense and highly changeable moods, with each episode lasting from a few hours to a few days
Chronic feelings of emptiness and/or boredom
Inappropriate, intense anger or problems controlling anger
Having stress-related paranoid thoughts or severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality.
Symptoms:
Extreme reactions—including panic, depression, rage, or frantic actions—to abandonment, whether real or perceived
A pattern of intense and stormy relationships with family, friends, and loved ones, often veering from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)
Distorted and unstable self-image or sense of self, which can result in sudden changes in feelings, opinions, values, or plans and goals for the future (such as school or career choices)
Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating
Recurring suicidal behaviors or threats or self-harming behavior, such as cutting
Intense and highly changeable moods, with each episode lasting from a few hours to a few days
Chronic feelings of emptiness and/or boredom
Inappropriate, intense anger or problems controlling anger
Having stress-related paranoid thoughts or severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality.
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Borderline personality disorder is quite different from bipolar I disorder. The mood swings seen in borderline personality disorder seldom last more than one day. Mood swings in bipolar I disorder last much longer. Borderline personality disorder doesn't exhibit the prolonged episodes of decreased need for sleep, hyperactivity, pressured speech, reckless over-involvement, and grandiosity that are ...characteristic of bipolar I disorder.
Borderline Coping Styles
◦Feels misunderstood, mistreated, or victimized.
◦Blames her own failures or shortcomings on other people or circumstances; attributes her difficulties to external factors rather than accepting responsibility for her own conduct or choices.
◦Gets into power struggles.
◦When upset, has trouble perceiving both positive and negative qualities in the same person at the same time (e.g. may see others in black or white terms, shift suddenly from seeing someone as an angel to seeing her as a devil).
◦Becomes irrational when strong emotions are stirred up; may show a significant decline from customary level of functioning.
◦Has little psychological insight into her own motives, behavior, etc.
◦Is unable to soothe or comfort herself without the help of another person (i.e. has difficulty regulating her own emotions).
◦Tends to “catastrophize”; is prone to see her problems as disastrous, unsolvable, etc.
◦Tends to hold grudges; may dwell on insults or slights for long periods.
◦When distressed, tends to revert to earlier, less mature ways of coping (e.g. clinging, whining, having tantrums).
◦Relationships tend to be unstable, chaotic, and rapidly changing.
Borderline Coping Styles
◦Feels misunderstood, mistreated, or victimized.
◦Blames her own failures or shortcomings on other people or circumstances; attributes her difficulties to external factors rather than accepting responsibility for her own conduct or choices.
◦Gets into power struggles.
◦When upset, has trouble perceiving both positive and negative qualities in the same person at the same time (e.g. may see others in black or white terms, shift suddenly from seeing someone as an angel to seeing her as a devil).
◦Becomes irrational when strong emotions are stirred up; may show a significant decline from customary level of functioning.
◦Has little psychological insight into her own motives, behavior, etc.
◦Is unable to soothe or comfort herself without the help of another person (i.e. has difficulty regulating her own emotions).
◦Tends to “catastrophize”; is prone to see her problems as disastrous, unsolvable, etc.
◦Tends to hold grudges; may dwell on insults or slights for long periods.
◦When distressed, tends to revert to earlier, less mature ways of coping (e.g. clinging, whining, having tantrums).
◦Relationships tend to be unstable, chaotic, and rapidly changing.
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Tips for Friends and Family of Someone with Borderline Personality Disorder
It can be difficult to deal with a friend or loved one who has borderline personality disorder (BPD). Use these tips to handle tough times and help maintain a safe environment:
•Read as much as you can about BPD — knowing about the disorder helps you deal with it.
•If you live with someone who has BPD, join a support group or consider therapy for yourself to help you deal with the issues you face.
•Understand that BPD behaviors aren’t about you. Try to depersonalize what’s happening.
•Even if you understand BPD behaviors, you need to know your own limits and stick by them — don’t ever allow yourself to be abused.
•Understand your loved one’s hot buttons and try not to push them — yet know that you won’t always succeed.
•Realize that sometimes the only thing you can do is leave the relationship when your loved one repeatedly runs over your limits or when your loved one refuses treatment.
It can be difficult to deal with a friend or loved one who has borderline personality disorder (BPD). Use these tips to handle tough times and help maintain a safe environment:
•Read as much as you can about BPD — knowing about the disorder helps you deal with it.
•If you live with someone who has BPD, join a support group or consider therapy for yourself to help you deal with the issues you face.
•Understand that BPD behaviors aren’t about you. Try to depersonalize what’s happening.
•Even if you understand BPD behaviors, you need to know your own limits and stick by them — don’t ever allow yourself to be abused.
•Understand your loved one’s hot buttons and try not to push them — yet know that you won’t always succeed.
•Realize that sometimes the only thing you can do is leave the relationship when your loved one repeatedly runs over your limits or when your loved one refuses treatment.
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As with other mental disorders, the causes of borderline personality disorder aren't fully understood. Experts agree, though, that the disorder results from a combination of factors. Factors that seem likely to play a role include:
•Genetics. Some studies of twins and families suggest that personality disorders may be inherited or strongly associated with other mental disorders among family members.
•Environmental factors. Many people with borderline personality disorder have a history of childhood abuse, neglect and separation from caregivers or loved ones.
•Brain abnormalities. Some research has shown changes in certain areas of the brain involved in emotion regulation, impulsivity and aggression. In addition, certain brain chemicals that help regulate mood, such as serotonin, may not function properly.
•Genetics. Some studies of twins and families suggest that personality disorders may be inherited or strongly associated with other mental disorders among family members.
•Environmental factors. Many people with borderline personality disorder have a history of childhood abuse, neglect and separation from caregivers or loved ones.
•Brain abnormalities. Some research has shown changes in certain areas of the brain involved in emotion regulation, impulsivity and aggression. In addition, certain brain chemicals that help regulate mood, such as serotonin, may not function properly.
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TIPS FOR COMMUNICATING WITH AN INDIVIDUAL WITH BORDERLINE PERSONALITY DISORDER
(Some of these are more for when a person may be agitated. You don't have to treat us like there is something wrong all the time.)
1. Be realistic.
You will not eliminate another person's borderline behavior, no matter how well you communicate. Only that person can do that.
2. Leave if necessary.
You do not have to tolerate physical threats or emotional or verbal abuse.
3. Simplify.
When speaking with a BP, especially about sensitive issues, remember emotion is likely to be so strong that neither of you can do high-level thinking. Make each sentence short, simple, and direct. Leave no room for misinterpretation.
4. Separate the person from the behavior.
Make it clear to the BP that when you dislike behavior, you do not dislike the person.
5. Address feelings before facts.
In ordinary conversation, we put facts before feelings. We assess facts and react with our feelings to them. But people with BPD often reverse this process.
6. Keep focusing on your message.
Ignore the BP's attacks or threats or attempts to change the subject. Stay calm and reiterate your point.
7. Ask questions.
Turn the problem over to the other person. Ask for alternative solutions.
8. Remember the importance of timing.
There are good times and bad times to bring up certain subjects.
9. In the midst of an intense conversation that is escalating and unproductive, practice
Delay, Distract, Depersonalize, and Detach.
(Some of these are more for when a person may be agitated. You don't have to treat us like there is something wrong all the time.)
1. Be realistic.
You will not eliminate another person's borderline behavior, no matter how well you communicate. Only that person can do that.
2. Leave if necessary.
You do not have to tolerate physical threats or emotional or verbal abuse.
3. Simplify.
When speaking with a BP, especially about sensitive issues, remember emotion is likely to be so strong that neither of you can do high-level thinking. Make each sentence short, simple, and direct. Leave no room for misinterpretation.
4. Separate the person from the behavior.
Make it clear to the BP that when you dislike behavior, you do not dislike the person.
5. Address feelings before facts.
In ordinary conversation, we put facts before feelings. We assess facts and react with our feelings to them. But people with BPD often reverse this process.
6. Keep focusing on your message.
Ignore the BP's attacks or threats or attempts to change the subject. Stay calm and reiterate your point.
7. Ask questions.
Turn the problem over to the other person. Ask for alternative solutions.
8. Remember the importance of timing.
There are good times and bad times to bring up certain subjects.
9. In the midst of an intense conversation that is escalating and unproductive, practice
Delay, Distract, Depersonalize, and Detach.
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BORDERLINE PERSONALITY DISORDER
TIPS FOR LOVED ONES
Delay, Distract, Depersonalize, and Detach.
Delay.
Tell the other person, "Why don't we think about things and talk about this later?" or "Give me some time to think about what you're saying." Speak calmly and in a way that affirms the other person as well as yourself.
Distract.
Suggest, for instance, that the two of you run an errand together.
Depersonalize.
Throughout, you will do better if you remind yourself frequently that the BP's harsh criticism of you is not real, but still feels very real to that person. Don't take the other person's comments personally, however cutting or cruel they may feel to you. This is the nature of the disorder.
Detach.
Remove yourself emotionally from getting caught up in the emotional whirlwind. Resolve to yourself, "I'm not going to get so involved in this."
TIPS FOR LOVED ONES
Delay, Distract, Depersonalize, and Detach.
Delay.
Tell the other person, "Why don't we think about things and talk about this later?" or "Give me some time to think about what you're saying." Speak calmly and in a way that affirms the other person as well as yourself.
Distract.
Suggest, for instance, that the two of you run an errand together.
Depersonalize.
Throughout, you will do better if you remind yourself frequently that the BP's harsh criticism of you is not real, but still feels very real to that person. Don't take the other person's comments personally, however cutting or cruel they may feel to you. This is the nature of the disorder.
Detach.
Remove yourself emotionally from getting caught up in the emotional whirlwind. Resolve to yourself, "I'm not going to get so involved in this."
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Borderline Personality Disorder Coping Skills:
•Reduce the intensity of the emotional distress you feel
•Reduce the likelihood that you will do something harmful (e.g., engage in self- harming behaviors) to attempt to escape from the emotional distress
•Reduce the likelihood that you will engage in behaviors that destroy relationships (e.g., physical aggression) when you are upset
•Improve y...our ability to be able to continue to function well even when in stressful circumstances
•Build confidence in your ability to handle difficult situations
•Ultimately reduce your overall experience of emotion dysregulation
•Social Support. Talk to others who may understand what you are going through.
• Behavioral Activation. Engage in an activity that might take your mind off the stressful situation for a little while.
Relaxation Exercises. Practice a relaxation exercise, such as deep breathing or progressive muscle relaxation.
• Grounding. Practice grounding exercises that are designed to keep you "grounded" in the present moment, rather than caught up in replaying events in your head, worrying about the future or zoning out.
•Mindfulness Meditation. Practice mindfulness meditation, which helps you to observe and describe your experiences without judging or rejecting them.
•Active Problem-Solving. Consider the problem at hand: Is there a way to solve the problem directly?
Many psychological treatments for BPD, including cognitive behavioral treatments such as Dialectical Behavior Therapy (DBT), focus on teaching healthier coping skills to manage strong emotions.
“Mindfulness-Based Stress Reduction”), who defines mindfulness as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.”
•Reduce the intensity of the emotional distress you feel
•Reduce the likelihood that you will do something harmful (e.g., engage in self- harming behaviors) to attempt to escape from the emotional distress
•Reduce the likelihood that you will engage in behaviors that destroy relationships (e.g., physical aggression) when you are upset
•Improve y...our ability to be able to continue to function well even when in stressful circumstances
•Build confidence in your ability to handle difficult situations
•Ultimately reduce your overall experience of emotion dysregulation
•Social Support. Talk to others who may understand what you are going through.
• Behavioral Activation. Engage in an activity that might take your mind off the stressful situation for a little while.
Relaxation Exercises. Practice a relaxation exercise, such as deep breathing or progressive muscle relaxation.
• Grounding. Practice grounding exercises that are designed to keep you "grounded" in the present moment, rather than caught up in replaying events in your head, worrying about the future or zoning out.
•Mindfulness Meditation. Practice mindfulness meditation, which helps you to observe and describe your experiences without judging or rejecting them.
•Active Problem-Solving. Consider the problem at hand: Is there a way to solve the problem directly?
Many psychological treatments for BPD, including cognitive behavioral treatments such as Dialectical Behavior Therapy (DBT), focus on teaching healthier coping skills to manage strong emotions.
“Mindfulness-Based Stress Reduction”), who defines mindfulness as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.”
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