Understanding Borderline Personality Disorder (BPD)
Have you ever been taken aback by someone’s sudden emotional changes, or found yourself walking on eggshells around a loved one because you couldn’t predict their mood from one moment to the next? These experiences may be familiar to those living with or around a loved one (parent/sibling.co-worker/friend/boss/partner/ with Borderline Personality Disorder (BPD).
As a family therapist, I’ve observed the challenges faced by individuals displaying signs of BPD, though it’s crucial to note that I am not in a position to diagnose this complex psychiatric condition. My role allows me to recognize symptoms and support families in navigating their complexities, always with the goal of guiding those affected towards seeking expert evaluation from psychologists and psychiatrists.
People with BPD often experience intense mood swings and feel uncertainty about how they see themselves and their relationships. Their feelings for others can quickly swing from extreme closeness to extreme dislike, contributing to unstable relationships and significant emotional pain. They may live in constant fear of instability and abandonment, making everyday interactions fraught with potential for misunderstanding and distress. From their perspective, the world is a series of black and white encounters, with little room for the grays that define much of human interaction. This can lead to feelings of emptiness, severe distress, and a profound fear of being alone—emotions that are as real and overwhelming as any physical pain.
For partners and family members, living with someone who has BPD can be like being on a continuous emotional roller coaster. Their wild mood swings, angry outbursts, and impulsive behaviors can leave loved ones feeling helpless, emotionally exhausted, and perpetually off balance. Loved ones often describe their lives as being overshadowed by constant upheaval and uncertainty, which can be incredibly isolating and frightening. They may struggle with feelings of guilt, frustration, and helplessness, not knowing how to provide support or when the next emotional storm will hit.
If you or someone you know may be exhibiting signs of BPD, it is critical to refer them to a psychologist for a formal diagnosis and a psychiatrist for medication management assessment. Only a psychiatrist can prescribe medications that might help manage some of the symptoms of BPD.
Let’s explore what BPD is and how it affects not just the individuals diagnosed with it, but their families and close relationships as well. Our hope is to shed light on these struggles, offering understanding and pathways to support for those who find these experiences all too familiar.
Understanding BPD in Layman’s Terms
Let’s explore what Borderline Personality Disorder (BPD) actually is. In a nutshell, BPD is a mental health condition marked by intense, fluctuating emotions, unstable relationships, and a distorted sense of self. It’s as though the emotional thermostat for someone with BPD is set much lower than usual; small changes in the emotional temperature can trigger extreme reactions.
One of my patients with BPD wrote and produced this song, capturing what it’s like to live with the condition. LISTEN NOW
Key Features of BPD:
Emotional Instability: People with BPD feel emotions intensely and for extended periods. They may have a hard time returning to a stable baseline after an emotionally triggering event.
Impulsive Behaviors: Many individuals with BPD engage in impulsive actions, such as reckless driving, binge eating, or overspending. These behaviors often serve as a way to cope with overwhelming emotions or a momentary relief from feelings of emptiness or insecurity.
Turbulent Relationships: Relationships can be particularly challenging. Those with BPD might idealize someone one moment and then suddenly believe that this person doesn’t care enough or is cruel. This can result from their difficulty in trusting others and their fear of abandonment.
Distorted Self-image: The way they see themselves can change quickly. One day they might feel good about themselves, but the next day they might feel they are bad or even evil. This unstable self-image can affect moods, relationships, and even one’s career or goals.
Chronic Feelings of Emptiness: A pervasive sense of emptiness or boredom is common, and it’s one of the most profound but least understood aspects of BPD. This emptiness can prompt desperate attempts to fill the void with drugs, food, or people.
The Impact on Families
Living with or caring for someone with BPD can be emotionally draining. The unpredictable swings in behavior and mood can create a climate of uncertainty and instability within the home. Family members often find themselves constantly on guard, anxious about when the next emotional upheaval will occur. This tension can lead to a chronic state of stress, affecting the health and well-being of everyone involved.
For families, the key to managing life with a loved one who has BPD is understanding the disorder and finding effective ways to cope. Support from mental health professionals, coupled with a strong network of emotional support, can make a significant difference. Learning to set boundaries, improving communication, and building empathy are crucial steps in creating a more stable environment for all.
How is BPD Diagnosed?
Diagnosing Borderline Personality Disorder is based on a specific set of criteria defined by mental health professionals. It is not a matter of checking off symptoms casually; rather, it involves a thorough evaluation by a qualified psychiatrist or psychologist.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is used by mental health professionals, there are nine main symptoms associated with BPD. These include emotional instability, impulsive behavior, intense but unstable relationships, chronic feelings of emptiness, efforts to avoid abandonment, a distorted self-image, frequent mood changes, inappropriate anger, and transient, stress-related paranoia or severe dissociative symptoms.
To be formally diagnosed with BPD, an individual must exhibit at least five of these nine symptoms, and these symptoms must be severe enough to significantly disrupt their ability to function in personal relationships, at work, or in school. It’s also important that these symptoms are not part of another medical condition or mental health disorder and are persistent over time.
Why Knowing the Criteria Matters
Understanding the criteria for a BPD diagnosis is crucial, not only for those seeking an explanation for their experiences but also for their families. It provides a framework that helps distinguish between normal emotional responses and those that may suggest a deeper issue. For families, this knowledge is vital as it guides how to approach support and intervention. It emphasizes the importance of professional evaluation and reminds us that while recognizing symptoms is possible, diagnosis and treatment planning should always be left to professionals.
Life in the Borderline Mind
BPD is never easy, and it is very real. For those diagnosed with Borderline Personality Disorder, everyday life can feel like navigating a maze without a map, where emotions fluctuate wildly and stability seems just out of reach.
“Sometimes, it feels like I’m on an emotional pendulum that swings rapidly from one extreme to another. I can feel completely overwhelmed by love in one moment and then, suddenly, unworthy of affection,” shares one person, reflecting a common experience among those with BPD.
Another person explains, “It’s like living in a storm. One minute the sea is calm, and the next, it’s chaotic. I struggle to maintain a sense of identity, and everything around me seems either black or white, with no in-between.”
The challenges of BPD involve intense emotional experiences, often described as feeling everything ‘too much’ and ‘too intensely.’ This emotional intensity can lead to significant difficulties in relationships, as another individual notes, “I fear abandonment so deeply that sometimes I unknowingly push people away, trying to end the relationship before I can be hurt.”
The Core Issue: Fear of Abandonment
At the heart of many struggles for those with BPD is an intense fear of abandonment. This fear can permeate every aspect of their lives, affecting how they interact with others and how they view themselves.
“The fear of being alone drives so many of my decisions,” one individual describes. “It’s like I’m constantly looking for signs that someone is going to leave me, which makes me react in ways that I later regret.”
Another shares, “This fear isn’t rational, and I know it. But knowing doesn’t make it go away. It’s always lurking in the back of my mind, shaping how I respond to every relationship.”
Understanding Through Voices
Hearing directly from those who live with BPD can provide invaluable insights into the daily realities of the disorder. While these quotes are representative, they are composite based on common experiences to respect privacy and confidentiality:
“I’m often misunderstood. People think I overreact, but for me, the feelings are very real and overpowering. It’s not just being sad or upset; it’s feeling consumed by those emotions.”
“Every relationship feels like walking on a tightrope. I’m constantly scared that one wrong move will make everything fall apart.”
These narratives highlight the profound impact BPD has on personal perception and interaction. The disorder can disrupt one’s sense of self and complicate interactions with others, making social connections and maintaining relationships challenging.
Moving Forward with Compassion and Understanding
Understanding the inner workings of a borderline mind is key to fostering empathy and offering appropriate support. For families, therapists, and even coworkers, knowing these personal experiences can be the first step towards building a compassionate environment that encourages stability and healing.
As we continue to explore BPD, remember that while the journey is fraught with challenges, with the right support and understanding, those with BPD can lead fulfilling lives. It’s about embracing the complexity of the condition and striving for a deeper understanding that paves the way for better support systems and healthier relationships.
Understanding the Origins of BPD
The question of how BPD develops and whether individuals are born with it is intricate and involves multiple factors. While there is no single cause of BPD, research suggests a combination of genetic, neurological, and environmental factors play crucial roles in its development.
Genetic and Biological Factors
While no specific “BPD gene” has been identified, studies indicate that genetics contribute significantly to the likelihood of developing BPD. For example, if a close family member has BPD, the risk of developing the disorder may be higher. This suggests a hereditary component, although the exact nature of this genetic transmission is still under investigation.
In addition to genetic influences, neurological factors also play a role. Brain imaging studies have shown that people with BPD may have structural and functional differences in areas of the brain that control emotions and decision-making. These differences may contribute to mood instability, impulsive behavior, and the intense emotional reactions characteristic of BPD.
Environmental Factors
Environmental factors are equally significant in the development of BPD. Many individuals with BPD have a history of trauma, such as physical or emotional abuse, neglect during childhood, or prolonged exposure to hostile conflict. Such experiences can profoundly affect personality development, especially how individuals regulate emotions and handle stress.
Furthermore, the interaction between a sensitive disposition (potentially due to genetic factors) and a challenging environment can increase the risk of developing BPD. This means that while some people might be more genetically predisposed to developing BPD, environmental triggers are often necessary to activate the disorder.
Psychological Factors
Psychologically, BPD can be seen as a way of coping with overwhelming emotions and situations that the person finds impossible to handle otherwise. The intense emotional experiences and unstable behaviors might be a maladaptive way to deal with a world that feels unsafe and unpredictable.
Are You Born With BPD?
Given the interplay of genetic and environmental factors, it’s not accurate to say that individuals are simply “born with” BPD in the way one might be born with blue eyes or brown hair. Instead, it is more about having certain predispositions that, combined with life experiences, lead to the development of the disorder. Early intervention and supportive environments can significantly mitigate the impact of these predispositions.
Moving Forward
Understanding the origins of BPD is crucial for developing effective treatment strategies and for reducing the stigma associated with the disorder. Recognizing that BPD is not the result of failures or flaws in character, but rather a complex interplay of genetic, neurological, and environmental factors, can help foster greater empathy and support for those affected.
As we continue to explore BPD, it’s important to remember that with appropriate treatment and support, many people with BPD can achieve stable and fulfilling lives. Therapies such as Dialectical Behavior Therapy (DBT) have been particularly effective, focusing on skills like emotional regulation and interpersonal effectiveness, which are vital for managing the symptoms of BPD.
The Family and Spouse Perspective
Living with someone who has BPD can be emotionally taxing. Family members and spouses often find themselves in a paradoxical situation where the behaviors that hurt them are the same ones that signal their loved one’s need for help and connection. This can lead to complex feelings of frustration, sadness, and a frequent desire to give up.
Frustration and Emotional Exhaustion
Family members and partners may experience a range of frustrating emotions due to the unpredictable and intense reactions of their loved one with BPD. One day might bring closeness and affection, and the next, coldness and rejection. This roller coaster of emotions, often driven by the fear of abandonment in the individual with BPD, can leave loved ones feeling helpless and perpetually on edge.
These emotional swings can be especially confusing and exhausting because they’re intertwined with expressions of love and dependency. A spouse might feel essential and valued one moment and utterly rejected the next. This dynamic often leads to a wearying cycle of emotional highs and lows.
“I Hate You—Don’t Leave Me”
The phrase “I hate you—don’t leave me” encapsulates a core dilemma in BPD relationships. It reflects the deep-seated fear of abandonment mixed with intense emotional turmoil that people with BPD often experience. This contradictory communication can be bewildering for family members who struggle to understand why their loved one pushes them away while simultaneously fearing their departure.
This pattern is often rooted in the individual’s past traumas or fears, where getting too close to someone has historically led to hurt. As a protective mechanism, they might push loved ones away to test their commitment or as a preemptive strike against anticipated pain.
The Emotional Experience of Spouses and Family Members
Navigating a relationship with a person with BPD can be profoundly disorienting for spouses and family members. The emotional inconsistency that defines “I Hate You—Don’t Leave Me” can create significant emotional distress, leaving loved ones feeling confused, unappreciated, and often overwhelmed.
Emotional Whiplash
Spouses and family members may experience what could be described as emotional whiplash—a constant and abrupt shift between affection and hostility. This can lead to a chronic state of emotional turbulence where loved ones:
Feel Undervalued: When affection turns suddenly into hostility, it can make spouses and family members feel as though their love and efforts are not only unappreciated but outright rejected.
Struggle with Guilt and Self-Blame: They may repeatedly question their own actions and words, wondering if they somehow caused or could have prevented the negative reactions.
Experience Emotional Exhaustion: The ongoing need to manage and respond to these intense emotional fluctuations can leave family members and spouses feeling drained, sometimes to the point of emotional numbness.
Living in Uncertainty
The unpredictability of interactions with a person who has BPD can create a perpetual state of uncertainty. For family members and spouses, this means:
Constant Vigilance: Always being on alert for signs of a mood shift, which can be tiring and stressful.
Walking on Eggshells: Modifying behavior in an attempt to avoid triggering a negative response, which can suppress their own emotional expression and needs.
Fear of Future Outbursts: Living with the anxiety of when the next emotional crisis will occur, impacting their ability to enjoy positive moments.
Coping Mechanisms for Spouses and Family Members
Given these challenges, it’s important for spouses and family members to have effective coping mechanisms in place:
Self-Care: Engaging in activities that promote personal well-being and mental health is crucial. This can include exercise, hobbies, and socializing with supportive friends or family.
Support Networks: Joining support groups specifically for families and partners of individuals with BPD can provide a sense of community and shared understanding, as well as practical advice.
Professional Guidance: Seeking their own therapy can help spouses and family members process their feelings, develop healthier coping strategies, and maintain their emotional equilibrium.
Education and Awareness: Understanding BPD and its impacts can demystify many of the behaviors associated with the disorder and reduce personal blame.
Conclusion
For spouses and family members, understanding the dynamics of BPD and learning to manage their own emotional responses are key to maintaining a balanced relationship. While the journey may be fraught with challenges, recognizing their emotional experiences and addressing their needs is crucial for both their well-being and the health of the relationship.
By acknowledging and addressing the intense emotional impact on spouses and family members, this discussion aims to foster greater empathy and provide strategies that can help maintain a semblance of balance and mutual respect within these complex relationships.
This topic can be difficult and overwhelming but you are not alone! If you are struggling right now, let’s talk. You can book an in-person or virtual visit.
Email or call anytime to schedule an in-person or virtual session. (817) 701-5438 | beckylennox2018@gmail.com
Speaking Truth,
