BPD Explained

I have spoken before about my personal experiences with Borderline Personality Disorder (BPD) here and here.  There are no two alike experiences of BPD.  Sure, there are similarities but each person expresses the diagnostic criteria of BPD in their own unique way.

bpdGenerally, a person must present with at least five (5) of the diagnostic criteria for a period of two weeks or more in order to receive a diagnosis of Borderline Personality Disorder.  They are also over the age of 18.

I accessed the list of symptoms from Psych Central, however the explanation with each criteria is in my own words.

  1. Frantic efforts to avoid real or imagined abandonment.  This can often present itself to other people as manipulation due to the extreme emotional response.  However the person has usually been abandoned by someone close to them in their formative years and is hyper sensitive to anything that they deem as someone leaving them.  This behaviour often results in the person leaving because they are unable to deal with the emotional outbursts.
  2. A pattern of unstable and intense interpersonal relationships.  This is where the term for people with BPD of ‘I hate you don’t leave me’ comes from.  There is generally no in between with their feelings for a person.  A person with BPD will go from thinking that person is the best person they have ever met, to wishing that they were dead.  There is no grey area.
  3. Identity disturbance.  This is the inability for the person with BPD to see themselves as an individual and how they fit in the world.  They may also be unable to determine their sexuality, which then exacerbates other symptoms of the illness.  The person with BPD may then also go through many changes of their outward self in order to find who they are.
  4. Impulsivity and self harming behaviours.  This is different to suicidal ideation.  These behaviours include risky sex, cutting/burning of the body, binging/restricting, and spending money recklessly.  Usually different self damaging behaviours rear their head, depending on what the person is able to access and the stress factors involved.
  5. Recurrent suicidal behaviour.  This includes suicidal thoughts as well as attempting to take their own life.  This behaviour is often labeled as attention seeking, however it is usually as a result of the person feeling overwhelmed by the intense emotional turmoil.
  6. Emotional instability.  Marsha Linehan, the Doctor behind the development of DBT, who also admitted that she has been diagnosed with BPD, has been quoted as saying that ‘People with BPD are like people with third degree burns over 90% of their bodies.  Lacking emotional skin, they feel agony at the slightest touch or movement’.  The intense reactive nature of their moods though generally last a few hours and rarely more than a week.  However these unstable mood patterns tend to cycle through extremely quickly, making the sufferer feel that they are in a constant mood state.
  7. Chronic feelings of emptiness.  This is the feeling of nothing.  Nothing can cheer you up, nothing can make you feel worse.  Everything is a non event.  These feelings of emptiness often lead the person with BPD to resort to self harming behaviours in order to feel something.
  8. Inappropriate, intense anger.  Anger on it’s own is not something that is inappropriate, however a person with BPD often has extreme outbursts that don’t match the trigger.  They often appear antagonistic and often have a hair trigger for extreme outbursts of anger.
  9. Transient, stress related paranoid thoughts.  It is a little known fact about BPD, but the Borderline of the name actually means that they person is ‘on the borderline’ between psychosis and neurosis.  This means that the symptoms, like stress related paranoid thoughts rarely last long enough to warrant a separate diagnosis.  These paranoid thoughts are often in response to feelings of being abandoned and it is thought that through the return of this person, or self soothing, these thoughts will quickly cease.

Each person will have a different presentation of these symptoms and the make up of these symptoms can also change throughout a persons life.  Once thought of as a diagnosis that was hopeless, BPD, through the development of DBT is no longer a psychiatric death sentence.

However there is still a lot of stigma around BPD, both in the wider community and even amongst those who are supposed to be helping us.  It is my hope that by continuing to speak out about this treatment and about the realities of my day to day life, I can help to reduce this stigma.

If you or someone you know is exhibiting these behaviours then I urge you to contact your GP to arrange an appointment with a psychiatrist.  There is treatment, it’s hard, but it’s so worth it.


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