Borderline Personality Disorder (BPD) is characterized by difficulties regulating emotions, feelings of worthlessness, insecurity, impulsivity, impaired social relationships, self-harm, and high suicide rates. Despite being a common psychiatric disorder, with approx 1.6% of the US population suffering from it, it is widely misunderstood and stigmatized. What’s even more shocking is that self-injurious behaviors occur in 69-75% of cases and that people with BPD have a completed suicide rate between 3-9.5% (that’s 400 times greater than the general population). With such severe symptoms and risk of death, it’s shocking how little BPD is researched and understood, even among psychiatric healthcare providers.
Symptoms of Borderline Personality Disorder include:
- An unstable or dysfunctional self-image
- Feeling intense emptiness
- Unstable relationships that rapidly change from obsessive love to hatred
- A deep fear of abandonment and rejection
- Falsely perceiving abandonment and rejection
- Mood disorders (depression/anxiety)
- Impulsive and risk-taking behaviors
- Difficulty empathizing with others
I work in a psych lab that focuses on Borderline Personality Disorders, and I’ve heard horror story after horror story of psychiatrists being unable to diagnose patients with BPD, leading to mistreatment and overall lower quality of life. BPD patients end up in psychiatric outpatient and inpatient clinics at a disproportionate rate to the percentage of people who have BPD, in part because they are mistreated. Not only is it misunderstood, but it’s hard to treat because it is substantially comorbid with other psychiatric conditions. Additionally, people with BPD struggle with stability and thus are likely to chaotically use medical and psychiatric services, drop out of support programs, and take medications irregularly.
It’s clear that BPD is a public health crisis and that more research needs to be done to understand it. One common theory for the cause of BPD comes from attachment theory. Some attachment psychologists argue that BPD is associated with anxious-ambivalent attachment, arguing that the sporadic changes in emotion and unstable relationships represent the relationship they built as infants.
Treatment for BPD includes dialectic behavioral therapy (DBT), which teaches people how to regulate emotions and build healthy relationships; schema-based therapy, which highlights unhealthy and unorganized thinking patterns; mentalization-based therapy, which teaches people with BPD to separate their own thoughts from others; and psychiatric (medication) management.
Though it may be difficult to hold a steady relationship with people with BPD, they still want to form loving connections. People with BPD typically aren’t dangerous or violent. They also tend to be extremely observant, resilient, and sensitive to emotional changes.
I had not known much about BPD in the past (although I had learned about it to a certain extent in high school), so I am surprised that such a common mental health disorder is so unknown and ignored by the general public. It sounds like even professionals have difficulty learning about BPD, which leads to much pain and suffering for people with the disorder, but I hope that more people like you can raise awareness of BPD so that people with BPD can be treated sooner. I hope they will not only be treated medically, but also be treated with more fairness and respect by others.