Borderline Personality Disorder is the medical and technical name for personal terror, torture and hell. Ok, not really. However, it has certainly felt this way over the years. Borderline Personality Disorder, commonly referred to as BPD, is a major mental health illness. It is said that there are as many as 3 million US cases per year. According to data from a subsample of participants in a national survey on mental disorders, about 1.6 percent of adults in the United States have BPD in a given year. BPD usually begins during adolescence or early adulthood. Some studies suggest that early symptoms of the illness may occur during childhood.
According to the DSM, Fourth Edition, Text Revision (DSM-IV-TR), to be diagnosed with borderline personality disorder, a person must show an enduring pattern of behavior that includes at least five of the following 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.
I recently read a statement regarding diagnosis of BPD:
No single test can diagnose BPD. Scientists funded by NIMH are looking for ways to improve diagnosis of this disorder. One study found that adults with BPD showed excessive emotional reactions when looking at words with unpleasant meanings, compared with healthy people. People with more severe BPD showed a more intense emotional response than people who had less severe BPD.
I’m not ashamed or embarrassed to share that I have/exhibit all nine of the criteria. My “official” diagnosis came at the age of 19. I believe I showed symptoms of BPD much earlier in my life. However, it wasn’t until 1980, that the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed BPD as a diagnosable illness for the first time.
Opportunities for treatment for me were inaccessible for many different reasons before the age of 19. After years of being misunderstood, mistreated and ignored, I was “lucky” to finally fall under the care of a psychiatrist who understood BPD and thus made the correct diagnoses. Finally, it wasn’t just “in my head,” something made up, or I wasn’t “making a mountain out of a molehill.” My feelings and struggles were real and regarded and treated as such. After all of those years being told it was me. Finally, my feelings were validated.
The cause of BPD is unclear but is believed to involve both genetic and environmental factors. Twin studies suggest that the illness is partly inherited from one’s parents. Traits such as impulsiveness and aggression can be attributed to temperament. It is also believed that social or cultural factors may increase the risk for BPD. For example, being part of a community or culture in which unstable family relationships are common may increase a person’s risk for the disorder.
Over the years, much research and new discoveries have been made regarding those who suffer from BPD. For example, people with this disorder also have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides.
One of the most unsettling misconceptions regarding BPD concerns suicide attempts and self-harming behavior. As many as 80 percent of people with BPD have suicidal behaviors, and about 4 to 9 percent commit suicide. Even though the percentage rate for those who commit suicide may seem high to some, it really isn’t.
I firmly believe that most attempted and successful suicide attempts aren’t actually intentional. Such has been the case with myself. Living through the sheer hell of BPD certainly has brought me to the edge of not wanting to live anymore and it may again in the future. However, the near misses I have experienced have come about accidentally, not intentionally. Unfortunately, we can’t ask the victims of suicide whether this was the case for them. I can only assume based on my own experiences.
Unlike suicide attempts, self-harming behaviors do not stem from a desire to die. However, some self-harming behaviors may be life threatening. Self-harming behaviors linked with BPD include cutting, burning, hitting, head banging, hair pulling, and other harmful acts. People with BPD may self-harm to help regulate their emotions, to punish themselves, or to express their pain. They do not always see these behaviors as harmful.
I have an extensive and long history of self-harming behaviors. I have many different types of scars all over my body. At the moment I am engaged in self-harm, I never think about what it is going to look like, how painful it might be later, what others might think, where it is located on my body. The only thought I have is hurting myself…creating physical pain. In fact, the more intense the pain, the better. The more distracting it becomes for me to not have to deal with emotional pain. I can handle physical pain…too much, in fact. Emotional pain, distraught, suffering…well, that is another story.
And now, I have to mention again those co-occurring behaviors mentioned above. For me personally, I have also been diagnosed with Major Depressive Disorder, PTSD (Post Traumatic Stress Disorder), and Anxiety Disorder. If one understands the definitions of each of these disorders, then it is easy to understand why at the beginning I stated BPD is terror, torture, and hell.
So, you may be asking, “What is the treatment and/or cure for BPD?” I wish it were that easy. My simple answer, there isn’t one! There is no such thing as a cure for BPD. It isn’t something you can get rid of like a cold or heal like a broken bone. BPD is chronic. It can last for years or be lifelong (such as myself). However, you can receive treatment in different forms to learn how to live with BPD. There are still many in the medical profession who are of the opinion and firmly believe that all people with BPD are just manipulative and looking for attention. Well, don’t even get me started on this extremely sore subject because I will most likely explode with my experiences and knowledge and because I do suffer from BPD…well, it would be expressed as intense anger. Just sayin’.
There are so many good resources available now. I’m not going to list all of the ones I have personally found and still find beneficial. However, I am willing and eager to share with those who have been diagnosed or family members and friends of those who have been diagnosed with BPD. I use the word “diagnosed” because it is extremely important to see a psychiatrist, psychologist, therapist, social worker or some other MENTAL health provider to receive a proper diagnosis. Even then, it is still easy to be misdiagnosed. Unfortunately, as discussed above, there isn’t a simple blood test to indicate such a diagnosis. If only it were that simple. I want to be clear that I’m not saying general practitioners, family doctors, etc. are not qualified. However, mental health is not their speciality. Please go see a mental health specialist.
My story and struggle with BPD used to be very private. It is still to some degree. However, I am now entering my 30th year with an official diagnosis of BPD. I have “been around the block” as some would say. I have an incredible amount of experience, a vast amount of education, and even more personal opinions and stories to share. My hope is that my blog will prove to be a stepping stone, a resource, a sense of familiarity for many like myself. I hope I can, in my lifetime, help at least one person.
I’m not an expert in the field and I’m not professing to be such. I am, however, someone who continues to deal with BPD on a daily basis and hopefully, continues to make progress each day. As the “semicolon project” states:
Resources quoted above:
Roger E. Jacobson, MD – Mayo Clinic, MN – Retired