Borderline Personality Disorder

What is underneath the label?

Borderline Personality Disorder (BPD), also known as Emotionally Unstable Personality Disorder (EUPD), is a condition characterised by an ongoing pattern of rapidly changing moods, intense emotions, confusion about one's self-image or identity, impulsive behaviours and problems in relationships marked by fear of abandonment.

At DBT in Mind we don't see the diagnosis as an ultimate statement on who you are as a person but a singpost towards how your pain shows itself both to the outside world and within your internal experience. We successfully support people who live with the diagnosis and those who have some of the following traits by providing trauma-informed support when relevant.

DO YOU EXPERIENCE ANY OF THE FOLLOWING?

1) Efforts to avoid real or imagined abandonment, such as rapidly initiating intimate (physical or emotional) relationships or cutting off communication with someone in anticipation of being abandoned.

2) A pattern of intense and unstable relationships with family, friends, and loved ones, often swinging from extreme closeness and love (idealization) to extreme dislike or anger (devaluation).

3) Distorted and unstable self-image or sense of self.

4) Impulsive and often dangerous behaviours, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating.

5) Self-harming behaviours, such as cutting, burning, hitting, pinching, scratching or taking small overdoses.

6) Recurring thoughts of suicidal behaviours or threats.

7) Intense and highly changeable emotions, with some episode lasting from a few hours to a few days.

8) Chronic feelings of emptiness.

9) Intense anger or problems controlling anger.

10) Difficulty trusting, which is sometimes accompanied by fear of other people’s intentions.

11) Feelings of dissociation, such as feeling cut off from oneself, seeing oneself from outside one’s body, or feelings of unreality. 

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Not everyone with BPD experiences every symptom. Some individuals experience only a few symptoms, while others have many. Symptoms can be triggered by seemingly ordinary events. For example, people with borderline personality may become angry or distressed over minor separations from people to whom they feel close, such as travelling on business trips. The severity and frequency of symptoms and how long they last will vary depending on the individual and their unique presentation.

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TREATMENTS AND THERAPIES

Borderline personality disorder has historically been viewed as difficult to treat. But, with newer, evidence-based treatments, many people experience fewer or less severe symptoms, and an improved quality of life. Two examples of evidence-based therapies used to support people with BPD include Mentalisation Based Treatment (MBT) and Dialectical Behaviour Therapy (DBT) and they both entail weekly one to one and group components. It is important that people with emotion regulation difficulties receive evidence-based, specialised treatments from appropriately trained teams. Other types of treatment, or treatment provided by a doctor or therapist who is not appropriately trained, may not benefit the person.

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SEEK AND STICK WITH TREATMENT

Studies show that people with BPD who don’t receive adequate treatment are:

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1) More likely to develop other chronic medical or mental illnesses.

2) Less likely to make healthy lifestyle choices.

3) Borderline personality disorder is also associated with a significantly higher rate of self-harm and suicidal behaviour than the general public.

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