Borderline Personality Disorder (BPD) is a serious condition that affects three times the numbers of women verses men. Women diagnosed with BPD have stormy and unstable relationships, problems regulating strong feelings, an unclear sense of self, chronic feelings of emptiness, and some may engage in impulsive and self-damaging behaviors such as suicidal thoughts and behaviors and self-injurious behaviors like cutting. Women suffering with BPD also struggle with trusting other people, and tend to be suspicious of other’s motives and behaviors. This type of thinking usually stems from their processing reality in a black-and-white manner, and acknowledging the nuances in their relationships with other people and themselves is difficult for them to appreciate. Black-and-white thinking results in people with BPD idealizing themselves, other people, and/or situations which can then quickly change into devaluing themselves, other people, and/or situations all of which causes stormy unstable relationships and an inconsistent self-image.
All too often I have seen women receive a diagnosis of BPD in error or based on a clinician’s impressions after a brief meeting. Although this disorder may appear easy to self-diagnosis, a valid diagnosis of BPD involves an extensive evaluation. BPD is a complex condition and a full discussion is beyond the scope of this post. Here are a few of the important facts and myths regarding the symptoms and treatment of BPD that I hope will be helpful to you for understanding this disorder:
BPD is a common disorder with estimates of 10 percent to 15 percent of the general population. Many women diagnosed with BPD also suffer from depression, anxiety disorders, substance abuse and eating disorders. It is not uncommon for women diagnosed with BPD to have been sexually, physically and /or emotionally abused during childhood.
To have a diagnosis of BPD, a person has to meet five out of nine total criteria, according to the Diagnostic and Statistical Manual of Mental Disorders. These criteria include the following:
• Problems with relationships (fears of abandonment; unstable relationships)
• Unstable emotions (frequent emotional ups and down; high emotional sensitivity)
• Unstable identity (clear sense of self; chronic feelings of emptiness)
• Impulsive and self-damaging behaviors
• Unstable thinking/cognition (suspiciousness; tendency to dissociate when under stress)
BPD usually develops during adolescence or early adulthood. In addition to sexual trauma being a factor in the development of the disorder, parental neglect and unstable family relationships has been shown to contribute to an individual’s risk for developing this disorder. Other studies suggest BPD may also have a genetic component; it is thought that individuals may inherit his or her temperament along with specific personality traits, particularly impulsiveness and aggression.
Women diagnosed with BPD are always difficult to deal with, likely to be physically aggressive, untreatable, depressed, and/or unable to live fulfilling and productive lives. These symptoms usually vary in their intensity. The majority of women and others diagnosed with BPD are genuinely very passionate, courageous, loyal, sensitive, thoughtful and intelligent individuals.
BPD is not treatable. This is one of the most harmful misconceptions about BPD. In fact, the opposite is true. Current studies indicate that rates of recovery from BPD are much higher than previously thought. Psychodynamic-psychotherapy once or twice per week aimed at helping women regulate their intense emotions, reduce self-destructive behaviors, create stable relationships, and develop a cohesive sense of identity has been shown to be an effective treatment. Group therapy that teaches mindfulness (paying attention to the present), interpersonal effectiveness, distress tolerance, and emotion regulation has also been shown to be helpful in treating BPD.
Developing a strong therapeutic relationship with a therapist that one trusts and feels safe and secure with in addition to being available by phone, e-mails or other means of communication in between sessions is a crucial component for effective treatment. Other treatment options include cognitive-behavioral therapy, dialectical behavioral therapy and schema-focused therapy. Additionally, family members of individuals diagnosed with BPD may also benefit from some kind of therapy. Family therapy can educate family members and loved ones about BPD and it can educate them about ways in which they can reduce their loved one’s symptoms.
Below are a few tips for coping with BPD:
• Seek professional help and try to stick with treatment even when you feel discouraged.
• Exercise regularly. Exercise has been shown to improve one’s mood, decrease anxiety, and reduce stress.
• Get at minimum of 7-8 hours of sleep per night. Getting proper rest helps with mood regulation and decreases mood swings.
• Educate yourself about the disorder. Consider joining a support group.
• Set realistic goals for yourself. Be patient and compassionate with yourself as you work on achieving your goals.
• Identify and seek out comforting situations, places, and people.
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