On The Borderline – Coping With The Extreme

Borderline Personality Disorder - beautiful scenery reflecting extremes

By: Megan Earp

Having a Borderline Personality Disorder (BPD) throws your daily routine into chaos. One minute you could be extremely happy, looking forward to the day, the next you are lying on your floor with tears streaming down your face because something inside told you that you were sad.

These mood swings are one of the identifying factors of the illness, and even though there are roughly 4 million people (of that number, 75% are women) diagnosed with the illness in the United States, that number is still not accurate. Many people with BPD have not yet been diagnosed or they have been misdiagnosed.

Borderline Personality Disorder is often misdiagnosed as Bipolar Disorder

In one study, more than 40% of those with BPD had originally been misdiagnosed as having Bipolar Disorder. The reason for the misdiagnosis? One theory is that Bipolar Disorder is more easily treated with medication, so it’s commonly diagnosed so it can be managed with medication.

Currently, there are no medications that have been approved by the Food and Drug Administration (FDA) to alleviate symptoms of BPD. A misdiagnosis can be life threatening, and medications for Bipolar Disorder do not work for those with BPD,  even though about 20% of those diagnosed with BPD actually have Bipolar Disorder as well – they are still completely different illnesses. The number of actual people with BPD may be even larger as it often remains undiagnosed.

What is Borderline Personality Disorder (BPD)?

The following symptoms are what counselors look for in order to determine a diagnosis for this particular illness:

  • Efforts to avoid real or imagined abandonment, such as rapidly initiating intimate (physical or emotional) relationships or cutting off communication with someone in anticipation of being abandoned.
  • A pattern of intense and unstable relationships with family, friends, and loved ones, often swinging from extreme closeness and love (idealization) to extreme dislike or anger (devaluation).
  • Distorted and unstable self-image or sense of self.
  • Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating. Please note: If these behaviors occur primarily during a period of elevated mood or energy, they may be signs of a mood disorder—not borderline personality disorder.
  • Self-harming behavior, such as cutting.
  • Recurring thoughts of suicidal behaviors or threats.
  • Intense and highly changeable moods, with each episode lasting from a few hours to a few days.
  • Chronic feelings of emptiness.
  • Inappropriate, intense anger or problems controlling anger. Difficulty trusting, which is sometimes accompanied by irrational fear of other people’s intentions.
  • Feelings of dissociation, such as feeling cut off from oneself, seeing oneself from outside one’s body, or feelings of unreality.

Not everyone with BPD will experience every symptom and there are also varying degrees of each symptom. As someone diagnosed with BPD, it took years for the right therapist to ask the right questions.

I lived with many ups and downs, destructive relationships, substance abuse, and more. Life was not going the way I wanted it to, and when I finally hit rock bottom, I knew it was time to seek help. The process was long, yes, but in the end, it was the best move I made. It is hard to diagnose as there are many other possibilities for diagnosis, but the above list will be a great place to start a conversation with a licensed counselor.

Though BPD has historically been viewed as difficult to treat, newer, evidence-based treatment has proven successful and people have been known to show less severe symptoms and see an improvement in the quality of their life. Seeking treatment from a licensed professional is the best move to make and will only prove beneficial to you if you are experiencing the above symptoms.

A licensed professional will be able to discuss with you the symptoms you are having, and even view potential risk factors, which are:

  • Family History – People who have a close family member, such as a parent or sibling with the disorder may be at higher risk of developing borderline personality disorder.
  • Brain Factors – Studies show that people with borderline personality disorder can have structural and functional changes in the brain especially in the areas that control impulses and emotional regulation. But is it not clear whether these changes are risk factors for the disorder, or caused by the disorder.
  • Environmental, Cultural, and Social Factors – Many people with borderline personality disorder report experiencing traumatic life events, such as abuse, abandonment, or adversity during childhood. Others may have been exposed to unstable, invalidating relationships, and hostile conflicts.

If any of these symptoms or risk factors sound like you, please reach out to one of our licensed professionals today, and begin a path to a healthier you. BPD can be treated, and your life can improve, but the first step is seeking help.

It is possible to learn how to manage feelings better and to find ways to have healthier, more rewarding relationships. With therapy, you can learn how to reduce impulsive and self-destructive behaviors and understand the condition. With a strong commitment, and time, positive change is within reach.