(Parental guidance is advised for this article)
Borderline Personality Disorder (BPD) is sometimes misdiagnosed because other conditions, overlapping with BPD, can confuse the manifestation of this illness. BPD is an intricate condition and can leave the sufferer and family members bewildered if not diagnosed properly. The difficulty with diagnosing BPD is that, not all the symptoms are always present, and one would generally place the focus on the symptoms currently causing disturbance in the person’s life (e.g. depression). The symptoms of BPD can change frequently (rapid cycling), and can also last for months. BPD generally has nine symptoms which can manifest themselves in various ways, and at different intervals in a person’s life. To be diagnosed with BPD one needs at least five of the nine symptoms (not all BPD's experience them in the same way):
1. FEELINGS OF ABANDONMENT
A borderline finds it difficult to self-soothe when they are alone during times when their mind torments them, causing them to feel abandoned. They also fear being abandoned during times when they are anxious. Perceived abandonment can lead to impulsive, explosive behaviours due to their intense inner turmoil.
2. UNSTABLE RELATIONSHIPS AND SPLITTING
Splitting is a psychological term characterized by the alternation between extremes of idealization and devaluation. When a borderline idealizes someone they can’t remember the bad things. When they devalue the person, they can’t remember the good things. Splitting causes emotional pain and confusion and can result in drastic reactions. It is an automatic self-defense mechanism that borderlines subconsciously use to protect themselves. If their partner breaks up with them, their mind may split their partner as "completely bad", remembering all the bad things they ever did to them, or said to them, because if all the positive memories of the person are forgotten in that moment, the breakup doesn’t feel so bad. The problem is that their mind later switches back to idealization, and then it hits them, creating the biggest loss ever, instead of a realistic view. Splitting is not always used to protect themselves. It can also be triggered if they see something they don’t like in a person or if their needs aren’t being met.
3. IDENTITY DISTURBANCE
Borderlines don’t always know who they are, or where they belong. They may run away or make frequent changes in their life because they feel they are in the wrong place, wrong job or wrong relationship. It can also lead to changing of goals. Co-occurring disorders within this category may include other personality disorders.
4. IMPULSIVENESS
Borderlines may struggle with behaviours such as reckless driving, spending sprees, binge eating, anger outbursts, fits of rage, frequent moving, running away, ending relationships abruptly, quitting jobs without notice or drug and alcohol abuse. Co-occurring disorders within this category may include addictive disorders, attention deficit hyperactivity disorder, bipolar disorder and eating disorders.
5. SELF-HARM AND SUICIDAL BEHAVIOUR
Borderlines tend to self-harm to relieve intense emotional pain/anger, or to feel something when they feel emotionally numb. When their soul is in complete turmoil, and the darkness surrounds them from all sides, due to the splitting their own life and sense of self, death seems like the only escape, leading to the risk of suicide. (If you feel suicidal always seek professional help).
6. INTENSITY, MOOD SWINGS AND DYSPHORIA
Borderlines struggle with intense emotions, mood swings and dysphoric mental states. They sometimes need someone to comfort them and make them feel that everything is "okay", because their own mind is not able in the midst of torment, but since people don’t know how to deal with these symptoms, they don’t receive the comfort they need, leading to reckless behaviours. Co-occurring disorders within this category may include bipolar disorder, depression or anxiety disorders:
"Among borderline personality disorder inpatients, 88% meet criteria for a lifetime anxiety disorder, including PTSD (56%), panic disorder (48%), social anxiety disorder (46%), specific phobia (32%), obsessive compulsive disorder (16%), generalized anxiety disorder (14%), and agoraphobia (12%)... Anxiety disorders are more prevalent among borderline personality disorder patients than other clinical populations." (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3643080/)
7. CHRONIC FEELINGS OF EMPTINESS
A deep, dark void may drive them to hunt for love, intimacy, drugs, alcohol, emotional stimulation or entertainment, hoping to find relief. Sometimes they hate being alone, other times they shut the world out.
8. ANGER OUTBURSTS
Their anger is highly intense and may lead to self-harm, suicidal behaviour, reckless driving, substance abuse, etc.
9. DISSOCIATION
Dissociation can be experienced in various ways:
• Depersonalisation ~ They feel detached from themselves or completely numb and emotionless.
• Derealisation ~ They feel detached from the world (e.g. compared to their intensity they may feel the world lacks emotional depth and colouring and because of it they may struggle to connect with people on a level that is satisfying).
• Amnesia ~ They may be confused about days and time, experience memory loss and forget details.
Episodes can be triggered by various factors (e.g. arguments, loss, stress, breakups, recent changes, perceived failures, cognitive distortions, etc.). Neurotransmitter imbalances may also be responsible. There is also evidence to believe that BPD is related to a seizure disorder, affecting the emotional parts of the brain. If you, or someone you know, are struggling with BPD symptoms, free self-help material is available at riseabovemhc.com.
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