Borderline Personality Disorder (BPD) is a serious mental health disorder that affects the way a person thinks and feels about themselves. The degree to which they experience these feelings is extremely impactful on their ability to function in everyday life.

Not only does this affect a person’s behaviour and emotions, but it can lead to a pattern of unstable relationships due to their intense mood swings and the way they view themselves.

What behaviours will you see from someone with borderline personality disorder?

1. Fear of abandonment:

This is one of the biggest fears of someone with BPD. Even something that may seem minimal, such as a spouse being late home from work, has the ability to trigger a big fear response. In their attempt to keep their spouses/friends etc near, they might behave in a way that further pushes someone away, for example they may cause a fight, physically block a person from leaving or track the person they want to keep near.

2. Self-harm:
   Many people with BPD engage in self harming behaviours. Suicidal behaviours are usually present as well and this can include; thinking about suicide, threatening suicide and in many cases, attempting suicide. When suicidal thoughts/behaviours and self harming is present, it is important to have a safety plan and that often requires in-patient care at a psychiatric hospital or facility.

3. Intense mood swings:
   As mentioned in the intro, people with BPD have unstable moods and emotions. Whilst the mood swings are intense, they can pass quickly (minutes or hours). Often times the situation that creates an intense reaction, is something that is not perceived as a “big deal” by those around them, which can cause further frustration for the person with BPD.An important thing to note is that mood swings that last longer are more consistent with depression or bipolar disorder.

4. Feelings of emptiness leading to impulsive behaviours:
   Whilst we can all have periods in our lives where we experience this feeling to a certain degree, BPD can cause chronic feelings of emptiness. This uncomfortable feeling can lead to a person looking for unhealthy ways to fill that void.  Some examples would be; using drugs or alcohol, engaging in risky sex, spending money you don’t have, binge eating etc.

5. Shifting self image:
   For many people we have periods of time where we feel better about ourselves than others. For the person with BPD their view of themselves is unstable and constantly shifting. Often, they don’t know who they are and look for ways to “discover” themselves. This can lead to them changing their physical appearance frequently and changing other things that make up their “identity” including jobs, friends and so on..

6. Dissociation:
   Many report feeling paranoid or suspicious of other people and these feelings can lead them to dissociate, almost as if they are outside of their own body. For more information about dissociation, see our blog  https://brantmentalhealth.com/dissociation-and-did/
   Not knowing who they can trust/if they can trust feeds into their other insecurities and can make the world feel like a scary and unsafe place for them to be.

How are relationships impacted?
A person with borderline personality disorder will struggle with maintaining relationships with friends, family and romantic partners. The struggles listed previously certainly make it hard for people with BPD to have healthy and stable relationships, but they also have relationships that are short lived, but intense. The borderline personality may fall in love very quickly and hope that this new relationship is the one that will bring them the fulfilment they crave, only to be upset when it doesn’t provide what they were hoping for. They will often describe relationships as either perfect, or awful, with no middle ground. Those who have a relationship with someone with Borderline Personality will feel like they are on a rollercoaster (as does the person with BPD!)

What causes BPD?
There currently isn’t a definitive answer to this question, but Cleveland Clinic (Clevelandclinic.org) says that, “although anyone can develop BPD, it’s more common if you have a family history of BPD.”

The NHS (nhs.uk) also has this to add about people who are diagnosed with BPD, “being a victim of emotional, physical or sexual abuse, being exposed to long-term fear or distress as a child, being neglected by 1 or both parents…” can also be contributing factors.

What can be done for someone with BPD?
It’s important that not only the person with BPD, but their friends, family and partner can feel like there is hope, help and support to navigate this mental health disorder.

DBT:
Dialectical Behavioural Therapy (DBT) is widely considered as an effective therapy for someone with BPD. It is important however, to find a registered mental health professional who is certified in DBT and has experience working with people with BPD. It is also important that the person with BPD feels comfortable with the therapist, and this can take a while and may require seeing a few therapists before finding one that feels like the right fit.

Dialectical Behavioral Informed Therapy focuses on four core skills to help build a positive life around an individual suffering from BPD related concerns. The four skills are:

• Mindfulness,

• Distress tolerance,

• Emotional tolerance, and,

• Interpersonal effectiveness.

These core skills, through talk therapy and use of tools, can help individuals with BPD to develop awareness through mindfulness, learn techniques to tolerate distress and understand/regulate their emotions, and how to form and maintain healthy relationships.

Medication:
There is not a medication specific to those with BPD, however there are medications that can be prescribed to help manage some of the symptoms (depression, anxiety etc.) If medication is prescribed (by a family physician, or psychiatrist) it is crucial that they are monitoring the medication, its efficacy and making any necessary changes to the type/dosage as needed.

If you have a loved one with BPD it is important to seek your own mental health support. Individually or as a couple/family can be helpful as you process your own feelings around their struggles and as you find ways to better manage your reaction to their behaviours.

At Brant Mental Health Solutions we have a team of Registered Psychotherapists and Social Workers, many of whom have experience working with people with BPD and their families. Many of our team are certified in dialectical behavioural therapy and we are also able to facilitate referrals to a psychiatric program within our office. For more information, or to book a free consultation with someone on our team, please feel free to reach out to us at 519.302.2300 or email reception@brantmentalhealth.com.