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Manic-depressive psychosis or schizophrenia is much more well-known than borderline personality disorder. Meanwhile, this not so rare violation can make life unbearable for the borderliners themselves and, of course, for their loved ones.
For many, borderline personality disorder, or BPD, is a diagnosis vaguely familiar from the wonderful film Girl, Interrupted, starring Winona Ryder and Angelina Jolie. Unfortunately, this diagnosis is increasingly common not at all in the cinema, but in life. A borderline personality disorder is likely to be your friend or relative.
Researchers estimate that 2-3% of the world’s population suffers from borderline personality disorder. At the same time, many psychologists and psychiatrists note that BPD is not given enough attention. For example, in the International Classification of Diseases ICD-10, used by Russian doctors, there is no clear definition at all, it is considered as a kind of emotionally unstable disorder.
In the American DSM-5 Diagnostic and Statistical Manual of Mental Disorders, the definition of BPD is present, however, American experts also believe that this disease is deprived of attention. They believe that BPD exists “in the shadow” of a somewhat similar bipolar personality disorder. In the latter case, research is funded much more generously, and progress in this area is already evident.
Bipolar disorder is included in the list of disorders whose negative impact on society is being studied as part of the international Global Burden of Disease program, and borderline personality disorder is not on this list. Meanwhile, in its severity and ability to provoke suicide, borderline personality disorder is not inferior to bipolar.
The diagnosis of BPD also faces serious difficulties, and a single and generally accepted description does not yet exist. However, at least 6 signs can be distinguished, the severity and frequency of which suggests that a person suffers from a borderline personality disorder.
1. Instability of personal relationships
Those who suffer from BPD can be called “flayed people”. They are incredibly sensitive to the slightest emotional impact. A word or a look that most of us would simply ignore becomes the cause of serious trauma and painful experiences for them.
According to psychologist Marsha Lainen, author of her own treatment for BPD, Dialectical Behavior Therapy, “they exist with constant pain that others underestimate and try to explain with the wrong reasons.”
They perceive themselves as either the most beautiful people in the world, or the most insignificant creatures.
It is easy to understand that maintaining the stability of relations in such a situation is almost impossible. And people with borderline disorder’s perception of even their loved ones can change from “I love you” to “I hate you” in just a few seconds.
2. Black and white thinking
Eternal throwing between love and hate is a particular manifestation of a more general problem. Such people generally almost do not distinguish semitones. And everything in the world for them looks either very good or terribly bad.
They extend the same attitude to themselves. They either perceive themselves as the most beautiful people in the world, or as the most insignificant creatures who are unworthy of living. This is one of the sad reasons that up to 80% of patients with this diagnosis sometimes think about suicide. And 5–9% eventually, alas, realize this intention.
3. Fear of being abandoned
Because of this fear, borderliners often come across as unabashedly manipulative, tyrannical, or simply selfish. However, everything is much more complicated. They cling to the relationship again and again, strive to spend all their time in the company of those they love, and may even physically try to prevent them from leaving just for the store or for work, for the reason that parting is unbearable for them.
Fear of separation (real or self-imagined) from loved ones can provoke panic attacks, depression or anger in those suffering from BPD – typical symptoms are listed in the US National Institute of Mental Health.
4. Impulsive, self-destructive behavior
We all do stupid things from time to time. But one thing is the spontaneous purchase of an unnecessary thing or a sudden refusal to go to a party where they are waiting for us, and quite another are habits that threaten health and life.
These habits include addiction to alcohol and drugs, deliberately risky driving habits, unprotected sex, bulimia, and many other not-too-pleasant things. It is curious that the Russian researcher Tatiana Lasovskaya refers to such self-destructive behavior and the tendency to tattooing.
5. Distorted self-perception
Another typical feature of PCR patients is a distorted perception of themselves. Their strange and unpredictable behavior is often determined by how good or bad they think they look at the moment. Of course, the assessment can be infinitely far from reality – and change suddenly and also for no apparent reason.
People with borderline personality disorder find it very difficult to control their thoughts, emotions, and ways of expressing them.
This is how actress Lauren Ocean describes it in her short story What It’s Like To Live With Borderline Personality Disorder: “At times I feel caring and gentle. And sometimes I get wild and reckless. And it also happens that I seem to lose all personality and cease to exist. I sit and can think about everything in the world, but I don’t feel anything at all.” Ocean has been suffering from BPD since the age of 14.
6. Inability to control emotions and actions
After all of the above, it is hardly surprising that people with borderline personality disorder find it very difficult (and often impossible) to control their thoughts, their emotions, and the way they express them. The result is unprovoked aggression and outbursts of anger, although manifestations such as depression and paranoid obsessions are also possible.
Lauren Ocean remarks, “One of the most annoying things about BPD is how it affects my behavior towards other people. I can exalt a person to the skies. And I can not put him in a penny – and the same person!
People with borderline personality disorder suffer no less from their illness than those who have to endure their endless mood swings, outbursts of anger and other severe manifestations of the disease. And although it is not easy for them to decide on treatment, it is absolutely necessary.
The best way to deal with BPD today is psychotherapy. There is no cure for this disease, and medication is recommended only for patients whose borderline disorder is complicated by comorbid problems, such as chronic depression.