What You Don’t Know About Borderline Personality Disorder

Borderline Personality Disorder (BPD) is one of the most highly stigmatized, misdiagnosed, and misunderstood mental health disorders—even among mental health professionals. Here’s what you don’t know about this psychiatric condition. A type of personality disorder associated with unstable moods, self-image, and relationships, as well as impulsivity and strong emotional reactions, BPD causes tremendous distress and difficulty coping with life’s challenges in those who have it. Unfortunately, the disorder’s associated stigma causes BPD individuals to feel shame, making the condition more painful. Indeed, nearly 80% of people with this disorder will attempt suicide during their lifetime, and as many as 10% will die by taking their own life. Borderline personality disorder is a serious mental health condition for which treatment is critical. It’s important to treat BPD as a brain health disorder, not a character problem.  The truth is that when it is properly diagnosed and treated, people do get better. Research shows that the quality of life for people with borderline personality disorder can significantly improve with treatment.

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WHAT IS BORDERLINE PERSONALITY DISORDER?

The hallmark characteristic of borderline personality disorder is difficulty regulating emotion. This difficulty makes nearly everything feel unstable for an individual with BPD, including moods, sense of self, thinking, behavior, and relationships. People with BPD experience emotions more intensely—both positive and negative ones. They can have powerful mood swings often with outbursts of destructive anger, as well as persistent feelings of emptiness, insecurity, self-doubt, and fear of abandonment. They display black-and-white thinking. One moment, they may idealize another individual and then quickly devalue them the next, vacillating from extreme closeness to extreme dislike. These mercurial emotions can result in unstable relationships and emotional pain. They have trouble calming down after an emotionally triggering event, which may also contribute to volatility in relationships, impulsivity, and recklessness. Unable to self-soothe, individuals with BPD may turn to risky behaviors such as self-harm. BPD usually begins to develop in the teen years, between 13 and 19, but new research shows it can develop later in life. About 1.4% of the adult U.S. population is estimated to experience BPD. Nearly 75% of individuals diagnosed with BPD are women. It’s now believed that men may be equally affected by BPD but are often misdiagnosed with PTSD or depression.

SYMPTOMS OF BORDERLINE PERSONALITY DISORDER

There’s a wide variety of borderline personality disorder symptoms. The following are among the most common:

• Distorted self-image – poor sense of self
• Extreme emotional responses – inappropriate or exaggerated emotional reactions to high-stress situations, ranging from deep sadness to intense anger
• Dramatic mood swings – moods fluctuate rapidly and often
• Impulsive behavior – exhibit risky behavior such as substance abuse, unprotected sex, overspending, reckless driving, etc.
• Relationship instability – a tendency to see others as all good or bad, as an ally or enemy, with these perceptions changing often
• Fear of rejection – have a deep, underlying fear that they will be abandoned, as well as extreme emotional responses and mood swings that may push people away, which can worsen symptoms
• Self-harm – have an increased risk of self-harming behaviors (cutting) and suicide

Any of these symptoms can run the gamut from mild to severe. While a person may experience one or more of these issues, people with BPD have a lot of them consistently, and they are pervasive across all aspects of their lives. Some of these symptoms, particularly mood instability and impulsivity, are also key symptoms of bipolar disorder, which leads to BPD frequently being misdiagnosed as BD. In fact, misdiagnoses happen a lot with BPD. Research shows that over 40% of people with BPD have been previously misdiagnosed with another mental health condition. Co-occurrence with other mental health conditions is common with BPD, especially with the following disorders:

• Bipolar disorder (in as many as 20% of BPD cases)
• Depression
• Anxiety disorders
• Eating disorders (anorexia, bulimia nervosa)
• PTSD
• Substance abuse problems

WHAT CAUSES BORDERLINE PERSONALITY DISORDER?

Research suggests a number of factors may contribute to the development of BPD, including:

• Genetics – Having a close family member with BPD increases your risk of the disorder five times.
• Trauma exposure – Adverse childhood experiences (childhood sexual abuse, neglect, or abandonment) or other trauma appears to be common with BPD. Additionally, traumatic brain injury can add to the development of BPD.
• Environmental – Exposure to environmental toxins like toxic mold, infections such as Lyme disease, and substance abuse are a few examples of environmental factors that can negatively affect brain function and contribute to mood and personality changes.

BORDERLINE PERSONALITY DISORDER IS TREATABLE

Until recent years, it was widely believed that BPD was an unremitting, chronic condition. There was very little hope for lasting improvement with treatment. What people don’t know is that research shows that the quality of life for people with BPD can significantly improve with treatment. More than a decade ago, a study published in the American Journal of Psychiatry found that after 2 years of treatment, roughly 50% of BPD participants no longer met the diagnosis criteria. What’s more, recovery can get better over time. Additional research has found that 10 years after treatment, 85% of BPD study participants no longer met the criteria for the condition, although some psychosocial issues persisted. The long-term prognosis for people with BPD is surprisingly better than for those with bipolar disorder or depression. Yet, the stigma continues. Thankfully, efforts are being made to reduce this stigma in the field of mental health, recent research indicates.

REFRAMING BPD AS A BRAIN DISORDER

When someone gets diagnosed with a personality disorder such as BPD, too often one assumes their personality or character is flawed. It’s important to correct this unhelpful and damaging assumption and reframe the condition accurately. The truth is that the organ of personality is the brain. Thus, if someone has an unstable personality, it suggests that the problem is related to imbalances in their brain. Indeed, that is what has been revealed at Amen Clinics through brain SPECT imaging. BPD brains often show overactivity in the frontal lobes (the area that controls impulsivity) and the anterior cingulate gyrus (ACG), which may result in stuck, good-or-bad/black-and-white thinking. The condition is much more about brain health than it is about the character of an individual.

BORDERLINE PERSONALITY DISORDER TREATMENT/S

The more comprehensive the treatment for BPD, the better the result. Here are some of the most common and effective treatments for borderline personality disorder.

1. Therapy

Eye movement desensitization and reprocessing (EMDR) therapy has been shown to be helpful in addressing and resolving trauma. Since trauma often plays a role in the development of the disorder, this is key. Also, dialectical behavioral therapy (DBT), a form of talk therapy, is specifically designed for people who experience emotions very intensely. Cognitive behavioral therapy can help people with BPD to correct their thinking. Working therapeutically with a qualified mental health professional, regardless of the type of therapy, is critical.

2. Medication

Medication is individualized and prescribed by a psychiatrist. Mood stabilizers have proven to be helpful. Medication that helps to calm brain overactivity and boost serotonin in the brain is beneficial.

3. Diet

Eating a brain healthy diet and eliminating troublesome foods—especially ones that are common allergens (sugar, soy, dairy, gluten, corn, artificial dyes, preservatives, and food additives) can be beneficial. Additionally, cutting out alcohol (and drug use) and limiting caffeine can be helpful.

4. Supplementation

Vitamin and mineral deficiencies have been linked to a number of psychiatric disorders. Getting plenty of omega-3 fatty acids, magnesium, vitamin D, and probiotics is important for people with borderline personality disorder.

5. Exercise and Mindfulness Practices

Physical activity offers mood-boosting benefits, while mindfulness practices soothe anxiety. Borderline personality disorder and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.