Borderline Personality Disorder

Personality disorders are long standing patterns of inner experience and behaviour that are markedly different from what is expected by the person’s culture. These patterns are inflexible and pervasive across many situations. The onset of the pattern can be traced back at least to the beginning of adulthood, usually earlier.

To be diagnosed as a personality disorder, a behavioural pattern must cause significant distress or impairment in personal, social, and/or occupational functioning.

Most individuals with personality disorders lead pretty normal lives and often only seek psychotherapeutic treatment during times of increased stress or social demands. Most people can relate to some or all of the personality traits listed. The important difference is that the trait doesn’t affect most people's daily functioning to the same degree it might someone diagnosed with one of these disorders.

Personality disorders tend to be an integral part of a person, and therefore, are difficult to treat. They are patterns of interaction and functioning that you have come to rely on over time. The problem is the lack of flexibility in how you react. You don’t have enough of a variety of different strategies and are not good at choosing an appropriate strategy to fit a situation for the best result.

What Borderline Personality Disorder (BPD) Looks Like

The symptoms of borderline personality disorder include: a recurring pattern of instability in relationships, extreme efforts to avoid abandonment, identity disturbance, impulsivity, emotional instability, chronic feelings of emptiness, among other symptoms.

Borderline personality disorder is more prevalent in females (75 percent of diagnoses made are in females). Different studies find that borderline personality disorder affects between 1.6% and 5.9% of the general population. Like most personality disorders, borderline personality disorder typically will decrease in intensity with age, with many people experiencing few of the most extreme symptoms by the time they are in the 40s or 50s.

The main feature of borderline personality disorder (BPD) is a pervasive pattern of instability in interpersonal relationships, self-image and emotions. People with borderline personality disorder can often be very impulsive, including self-destructive behaviours like risky sexual activity, cutting and suicide attempts.

The unstable pattern of interacting with others has persisted for years and is usually closely related to the person’s self-image and early social interactions. The pattern is present in a variety of settings (e.g., not just at work or home) and often is accompanied by a similar lability (fluctuating back and forth, sometimes in a quick manner) in a person’s emotions and feelings.

These individuals are very sensitive to environmental circumstances. The perception of impending separation or rejection, or the loss of external structure, can lead to profound changes in self-image, thoughts, feelings and behaviour. They experience intense abandonment fears and unpredictable anger often believing that this “abandonment” implies they are “bad.” These abandonment fears are related to an intolerance of being alone due to the deep feeling of emptiness or being “incomplete”.

Overview Symptoms of Borderline Personality Disorder

  • Frantic efforts to avoid real or imagined abandonment
  • A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation of others, particularly in close relationships. For many these intense patterns don’t appear in everyday relationships where there is not emotional charge.
  • Identity disturbance, such as a significant and persistent unstable self-image or sense of self. People feeling and behave differently in different social situations often changing their style and even their views.
  • Impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating)
  • Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour
  • Emotional instability due to significant reactivity of mood (e.g. irritability, anger, depressivity or anxiety usually lasting a few hours and only rarely more than a few days)
  • Chronic feelings of emptiness, inadequate or incomplete
  • Inappropriate, intense anger or difficulty controlling anger (e.g. frequent displays of temper, constant anger, recurrent physical fights)
  • Transient, stress-related paranoid thoughts or severe dissociative symptoms