Loneliness and abandonment are awful feelings that people would metaphorically do anything to avoid. But what happens when an individual commits to doing literally anything to avoid the feeling of abandonment? Borderline personality disorder (BPD) is a Cluster B personality disorder characterized by instability, impulsivity, unstable relationships, suicidal behaviors and ideation, mood swings, chronic feelings of emptiness, paranoia, and dissociation. When an affected individual perceives any sort of abandonment, for example, a friend leaving for an appointment, the individual may believe that the friend has left because they are insufficient or not enough for their friend to stay, when in reality, the friend simply has another commitment. These unstable relationships are best exemplified in relationships with caregivers and romantic partners. Individuals with BPD tend to form codependent relationships, often having what is known as a “favorite person” who they depend on for emotional validation and support.
When the favorite person offers the desired support, the affected individual will experience an extremely high mood, idealizing their favorite person. When the favorite person fails to provide the desired support, the affected individual is unable to self-regulate their own emotions and begins to devalue their favorite person. Individuals unable to self-regulate may participate in impulsive, dangerous behaviors—such as unsafe sex and excessive spending—and self-harm, including cutting and burning. They may also exhibit suicidal behaviors, making threats, gestures, and attempts to take their own life. Exposure to stressful situations can cause a person with BPD to experience violent mood swings, from depersonalization to explosive anger to severe depression. The emotional instability and fraught relationships with others cause ten percent of affected individuals to take their own lives.
BPD is more commonly diagnosed in women than men, though neither sex is more affected than the other. Symptoms typically present during young adulthood, though the disorder often remits with age. A childhood of abandonment, abuse, and neglect is cited as a cause for the development of BPD; there is also a genetic component, as individuals with affected parents or siblings are more likely to develop the disorder. BPD is also shown to be comorbid with depression, bipolar disorder, substance abuse issues, anxiety, eating disorders, post-traumatic stress disorder (PTSD), and attention deficit hyperactivity disorder (ADHD). Such an intense disorder can seem and feel like a lifelong struggle, but it is important for individuals with BPD and their loved ones to know that it is treatable and remission often occurs between one and eight years after starting treatment.
Treatment for BPD involves dialectical behavior therapy (DBT), which focuses on practicing mindfulness and internal validation. Cognitive behavioral therapy (CBT), schema-focused therapy, mentalization-based therapy, systems training for emotional predictability and problem-solving (STEPPS), and transference-focused psychotherapy (TFP) may also be employed to reroute negative thought patterns, distortions, and cope with mood swings and self-harm. While there are no drugs approved by the Food and Drug Administration (FDA) specifically for BPD, mood stabilizers can be prescribed to manage symptoms. BPD has a reputation for being the most painful mental disorder, resulting in destroyed relationships and an unstable sense of self. However, treatment and remission are possible. With hard work and dedication, those with BPD can enjoy healthy, meaningful relationships and thrive in life.
Works Cited
Aguirre, Blaise A. Borderline Personality Disorder in Adolescents : What to Do When Your Teen Has BPD : A Complete Guide for Families. Beverly, MA, Fair Winds, 2014. Accessed 9 July 2024.
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders.” Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), by American Psychiatric Association, vol. 5, American Psychiatric Association, 2022, www-psychiatryonline-org.libproxy.temple.edu/doi/full/10.1176/appi.books.9780890425787.x18_Personality_Disorders. Accessed 9 July 2024.
Jeong, Hyorim, et al. “Understanding a Mutually Destructive Relationship between Individuals with Borderline Personality Disorder and Their Favorite Person.” Psychiatry Investigation, vol. 19, no. 12, 25 Dec. 2022, pp. 1069–1077, www.ncbi.nlm.nih.gov/pmc/articles/PMC9806505/, https://doi.org/10.30773/pi.2022.0079. Accessed 9 July 2024.
Manning, Shari Y. Loving Someone with Borderline Personality Disorder. Guilford Press, 18 Aug. 2011. Accessed 9 July 2024.
Mayo Clinic. “Borderline Personality Disorder - Diagnosis and Treatment - Mayo Clinic.” Mayoclinic.org, 31 Jan. 2024, www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/diagnosis-treatment/drc-20370242. Accessed 12 July 2024.
Assessed and Endorsed by the MedReport Medical Review Board
Comments