Borderline Personality Disorder
Is your behavior, or the behavior of someone close to you, threatening your well-being or the well-being of your family or relationship? Have you looked at that behavior and come up with no rational reasons for what is going on? The answer may be BPD more commonly known as BORDERLINE PERSONALITY DISORDER.
The term borderline may lead one to believe that the condition may not be serious as in someone may be in a borderline depressive state or be on the borderline of being depressed. Nothing could be further from the truth.
The condition might be more appropriately named
BEHAVIORAL PERSONALITY DISORDER.
To make this clearer I will simply list the traits attributed to this emotional issue and if five or more of the nine criteria sound familiar you may now know what you’re dealing with, either within yourself or with someone you love or are close to.
The diagnostic criteria for borderline personality disorder reads as follows:
A pervasive pattern of instability of interpersonal relationships, self-image, and affects [moods], and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
1. Frantic efforts to avoid real or imagined abandonment.
People with BPD feel isolated. Anxious. Terrified at the thought of being alone. Caring, supportive people are like friendly faces in the middle of the crowd, offering smiles, help, and warm hugs. But the moment they do something that suggests an imminent departure – or do anything that the BP interprets as a signal that they’re about to leave – the BP panics and reacts in a variety of ways, from bursting into rage to begging the person to stay.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
People with BPD look to others to provide things they find difficult to supply for themselves, such as self-esteem, approval, and a sense of identity. Most of all, they are searching for a nurturing caregiver whose never-ending love and compassion will fill the black hole of emptiness and despair inside them.
For someone with BPD, the potential loss of a relationship can be like facing the loss of an arm or leg – or even death. When their fears of abandonment seem to be confirmed, they may erupt into a rage, make accusations, sob, seek revenge, mutilate themselves, have an affair, or do any number of destructive things.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self
This trait refers to borderline patients’ profound and often terrifying sense that they do not know who they are. Normally, we experience ourselves consistently through time in different settings and with different people. But this continuity of self is not experienced by the person with BPD. Instead, borderline patients are filled with contradictory images of themselves that they cannot integrate.
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, shoplifting, reckless driving, binge eating).
People with BPD may also try to fill the emptiness and create an identity for themselves through substance abuse, bingeing and purging, indiscriminate sexual activity, shoplifting, compulsive shopping, drinking, or substance abuse.
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
About 10 percent of all people with BPD commit suicide. This does not include BPs who engage in risky behavior that results in death, such as drinking and driving. Self-mutilation is another BPD behavior that is very difficult for family members to understand. Examples include cutting, burning, breaking bones, head banging, needle poking, skin scratching, pulling out hairs, and ripping off scabs – all without suicidal intent.
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). [Dysphoria is the opposite of euphoria. It’s a mixture of depression, anxiety, rage, and despair.]
7. Chronic feelings of emptiness.
Patients commonly report that they feel empty inside, that there is “nothing to me,” that they are different people depending on whom they are with. This is very much associated with a lack of identity.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
Borderline rage is usually intense, unpredictable, and unaffected by logical argument. It is like a torrential flash flood, a sudden earthquake, or a bolt of lightning on a sunny day. And it can disappear as quickly as it appears.
Some borderlines, however, have the opposite problem: they feel unable to express their anger at all for fear they will lose control if they express even the slightest anger.
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.
Have you ever arrived home from work without remembering how you got there? You’ve traveled the route so many times that your brain had its own little adventure while your eyes and reflexes do the driving. This “out of it” feeling is a mild type of dissociation.
People who are severely dissociating, however, feel unreal, strange, numb, or detached. They may or may not remember exactly what happened while they were “gone.” The degree of dissociation can vary from the car-trip-home variety to the extreme dissociation characterized by multiple personality disorder (this is why it is now called “dissociative identity disorder”).