By Dr. Wendy Sims
May is a month we typically associate with Mother’s Day or Memorial Day. While we observe those holidays for a day, observing a loved one who has a personality disorder occurs most days. May is designated as Borderline Personality Disorder (BPD) Awareness Month. This is fitting given that living with BPD can often feel like mayhem, that is, it can feel like chaos, confusion or even destructive behavior. BPD manifests as an enduring pattern of emotional dysregulation that has significant negative effects on the person’s identity, relationships, and behavior.
Emotional dysregulation can be thought of as an individual having difficulty managing emotional responses. For people living with BPD, emotions are felt more intensely and change quickly. They usually respond to situations they perceive as stressful with higher levels of anxiety, depression and anger compared to what their peers in a similar environment would experience. Rather than tolerating emotional distress, people experiencing BPD can have a sense of urgency to reduce negative emotion by acting impulsively and are at risk for self-harm behavior, suicidal thinking, excessive spending, promiscuity and addictions.
Personality traits typically begin in adolescence but are not formally expressed until early adulthood. This corresponds to the developmental time when individuals are solidifying their identity and seeking close relationships. The identity or self-image of the individual with BPD is often poor and they go back and forth in relationships with experiencing feelings of intense affection and hostility. They seek attention yet do not trust relationships and fear being rejected or abandoned. This presents a conflict of pushing for relationships and pulling away from them. Persons with BPD will often think of themselves as ‘bad’. This view of the self is distorted, never the less, can contribute to the individual sabotaging goals just before they accomplish them.
There is often a question of how to tell the difference between a mood disorder such as Bipolar Disorder and BPD. Elevations and dips in mood, impulsivity and suicide threats occur in both conditions. One significant difference between a mood disorder and a personality disorder is the duration and frequency of the mood imbalance. For example, people with BPD can experience mood shifts within the same day and this pattern is consistent over many years of the person’s life, whereas people with Bipolar Disorder can experience mood shifts lasting weeks to months, referred to as episodes, experiencing periods of stability in between episodes. It is important to meet with a trained professional who can help properly identify symptoms you may be experiencing to get a proper diagnosis and treatment. BPD is a serious mental health issue affecting between 1.6% and 5.9% of the population.
Because BPD is enduring there is heightened stigma around the condition that individuals will not improve. The importance of raising awareness for BPD is to encourage individuals to seek help for the purpose of understanding that treatment can be beneficial to help learn skills of normalizing emotional responses, coping with distressing emotions, being effective in relationships, and developing a positive self evaluation. It is true that features of personality are inflexible and stable but developing new skills can alleviate some of the negative feelings and impairment that are associated with BPD.
To speak with a trained mental health professional contact MedPsych at 941-363-0878 for an appointment.