Most of us are only aware of illnesses such as depression, or anxiety when it comes to mental illness. However, personality disorders are also a very broad field in clinical psychology, and a lack of knowledge about these can lead to patients struggling to understand their conditions and seek help. This article will discuss Borderline Personality Disorder (BPD) – one of the ten recognized types of personality disorder, including its symptoms and how to differentiate it from Bipolar Disorder (BD). This should only be taken as a reference, if you have symptoms that are similar to BPD, BD, or depression, please consult your doctor to get the most accurate diagnosis.
The National Alliance on Mental Illness defines BPD as a condition characterized by difficulty regulating emotion. This means that people with BPD experience intense emotions for extended periods, and it is more difficult for them to return to a stable baseline after an emotionally triggering event.
If you have BPD, you are probably familiar with turbulent and rapidly changing emotions, as well as a lack of stability in your relationships and self-image. According to The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) - a scientific publication by the American Psychiatric Association (APA) to be diagnosed with BPD, a person must experience at least five of the nine symptoms listed below:
- Extremely fear of abandonment. Even if you are not really abandoned, the feeling is strong enough to cause you to upset, angry, or distressed. For example, you may be furious with a friend who arrives a few minutes late for a movie date, or if someone you adore moves away, you may experience feelings of betrayal and rejection.
- Stressful and unstable relationships shift between idealization and disregard for others (devaluation). You frequently idealize potential friends or lovers at first, then demand or insist on spending a significant amount of time with them and believing they are the best in the world. However, you may quickly shift from idolizing people to devaluing them and believing that they do not care enough, or that they are not good enough to deserve you.
- An unstable self-image or self-perception. You may feel as if you don't know who you are, and your likes and dislikes may shift frequently and rapidly.
- Impulsive behavior in two (or more) situations that could lead to unconsciously self-harm (e.g., unsafe sex, binge eating, reckless driving).
- Suicidal ideation, suicidal behavior, or self-harm behaviors that occur regularly.
- Emotional instability, or volatile, rapidly changing emotions. Anger, depression, or anxiety attacks can last for several minutes, hours, or days (however, it occurs rarely more than a few days).
- Persistent feelings of emptiness.
- Excessive, inappropriate anger or difficulty controlling anger, which may result in frequent outbursts, arguments, or physical fights.
- Stress-related paranoid thoughts or severe dissociation symptoms. You may feel disconnected from yourself and your emotions, or you may perceive the people and things around you to be distorted and unreal.
BPD symptoms, like those of personality disorders, tend to fade with age. Many people with BPD notice that their symptoms have lessened by the time they get older (usually in their 40s or 50s).
One of the most important factors that predispose a person to BPD, according to clinical psychologists, is genetics. People who have a family member with BPD are more likely to develop the disease than those who do not have a family member with BPD.
Secondly, environmental factors can influence how severe a person's condition becomes. People who have experienced a mentally or physically traumatic event in the past (violence, sexual harassment, parental neglect, abandonment, etc.) are at risk of developing BPD.
Furthermore, a lack of certain substances in the brain causes a decline in brain function, resulting in an imbalance of emotions and cognition in people with BPD.
All these symptoms and causes have led many people to believe that BPD and BD are related, as both diseases share symptoms such as rapid and unusual mood swings as well as impulsive behaviors, like you could be the happiest person on the planet one minute and then be depressed or extremely angry the next. However, there are some marked differences between these two types of mental illness.
To differentiate them, we must look at their nature. If BD is a mood disorder, BPD is a personality one. While both disorders are characterized by mood swings, people with BD have mania and depression that last for days or even weeks, whereas people with BPD have intense emotional pain and feelings of emptiness, desperation, anger, hopelessness, and loneliness in a short period of time (often only a few hours).
Therefore, when mentioning symptoms, a person with BD and a person with BPD will notice differences in quality, time, and cause. It is also important to note that you can experience only BD or BPD, or you can experience both.
Although BPD was once thought to be a life-long disease due to difficulties in diagnosing and developing a treatment plan, it is now treatable. It requires specialized approaches, such as psychotherapy and medications. Clinical psychologists may try dialectical behavioral therapy (DBT), cognitive behavioral therapy (CBT), and psychodynamic psychotherapy to see if the patient is well-adapted. Patients may be prescribed medication at the same time, but it should be noted that there is currently no specific medication to treat BPD.
Long story short, most BPD patients can get better if they are helped in time with the right treatments and support. Talking with a medical or mental health professional if you are experiencing extreme distress in your life, regardless of whether you think you meet the criteria for BPD, can have many benefits. There are numerous ways to reach out and numerous types of assistance available. You could either find a therapist with BPD treatment experience or speak with your primary care doctor, who can refer you to an experienced mental health professional.
Edited by: Tom Culf
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