More than 5 million people in the United States alone suffer from Borderline Personality Disorder (BPD), a mental illness that severely impacts interpersonal relationships and sense of self. People with BPD display an inability to regulate their emotions effectively, which can result in poor self-esteem, increased impulsivity, and highly unstable relationships with family, friends, and life partners.
One of the key symptoms of BPD is the fear of abandonment. Individuals with BPD have an intense fear of losing loved ones and will go to extreme lengths to avoid real or perceived abandonment. Even the thought of separation can trigger an intense fear of abandonment. For example, a therapist or case manager announcing that they will be on vacation for a week and that there will be other resources available to the client can make them panic or become very angry.
A pattern of unstable relationships is another symptom. People with BPD will tend to engage in frequent, intense, and rapidly changing relationships. They love family, friends, and therapists strongly in one moment and hate just as strongly in the next.
People with BPD very often show impulsive behavior. They frequently engage in risky and impulsive behavior such as excessive drug and alcohol use, unsafe sex practices, gambling, reckless driving, reckless spending, and binge eating.
People with BPD also often suffer from a distorted and unstable sense of self. Their constantly changing self-identity can lead to drastic changes in values, goals, and interests. Often, patients with BPD will see themselves as inadequate, unlovable, or bad. Further, they tend to sabotage their own efforts, for example, engaging in self-harming behavior right before reaching the next step in therapy, or behaving inappropriately at a job interview in order to not get the job they really wanted.
A strong sense of emptiness is another symptom of BPD. Self-harming or suicidal behaviors are also common. They are often used as frantic efforts to avoid real or perceived abandonment but have to be taken seriously as those behaviors can be genuine.
Difficulties controlling their emotions are another key problem for people with BPD. They often display disproportional or inappropriate anger, are prone to emotional outbursts, and may even engage in physical altercations. Lastly, people with BPD can experience dissociative symptoms or symptoms of paranoia when under a lot of stress.
Even though the illness can affect men and women, the majority of people with BPD are female. It is still unclear what exactly causes BPD, but studies suggest that it is a combination of social and environmental factors, family history, and brain structure.
The most effective treatments to date for BPD are Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT). DBT was developed specifically for people with BPD and targets all key symptoms of the illness. Medications are usually not indicated for symptoms of BPD but may be helpful when addressing co-occurring mental illnesses like depression and anxiety. Generally, the type of treatment should be based on the individual, the severity of the symptoms, and the presence of other mental illnesses.