11 Signs of Borderline Personality Disorder

There are a total of 10 distinct personality disorders, including OCPD, paranoid personality disorder, antisocial personality disorder, and narcissistic personality disorder. Personality disorders are characterized by pervasive and destructive patterns of behavior throughout time.And among these, borderline personality disorder (BPD) is often the most misunderstood.

The term "borderline" suggests that Borderline Personality disease is not a serious issue, which only adds to the uncertainty around the disease. At first, specialists thought BPD was a spectrum condition that ranged from neurosis to psychosis. John Oldham, MD, a professor of psychiatry and behavioral sciences at Baylor College of Medicine in Houston, noted that at the time it was not considered to be a separate condition.

Until the publication of the DSM-III in 1980, borderline personality disorder (BPD) was not recognized as a distinct mental illness. However, the term "borderline" has remained.

Since then, our knowledge and understanding of this complicated disease has expanded. Evidence suggests it may be "partly inherited genetically and partly a function of stressful experiences during growth and development that leads to some pretty significant interference in successful functioning," as Dr. Oldham put it, but scientists aren’t certain of the root reason.

Licensed clinical social worker and founding fellow of the Academy of Cognitive Therapy Wendy Behary in New Jersey verified many of her patients with BPD had experienced loss, trauma, or abandonment in childhood. However, as Dr. Oldham pointed out, just because you come from a dysfunctional family or had a rough background doesn’t imply you’re doomed to BPD. Simply put, you have that potential danger in your life.

Telltale Signs of Borderline Personality Disorder

About 1.6% of American people suffer from BPD. Behary argued that, while the number may appear low, it does not adequately reflect the whole BPD population. Because many of the symptoms of BPD coincide with those of other mental diseases including depression, bipolar disorder, and narcissistic personality disorder, a correct diagnosis of BPD is not always easy to come by.

And there is a spectrum along which the boundary occurs. "At one end there is a very low-functioning individual, who can barely manage day-to-day life, and at the other there is someone who is very high functioning," Behary added. It’s possible for people to live their entire lives with the stigma associated with mental health issues and never seek help.

If you or someone you know exhibits these symptoms, it’s time to consult the DSM-5-TR, the current diagnostic model for borderline personality disorder.

Self-Esteem Shifts

Those who suffer from borderline personality disorder frequently struggle with crippling self-doubt, which manifests itself as an inability to trust one’s own judgment. Dr. Oldham explained that people like this have so low self-esteem that they need a lot of attention from others to feel like they belong.

A feeling of inadequacy and incompleteness lies behind that, Dr. Oldham said. People with BPD may even mimic the activities of those around them since "their ability to be independent and autonomous is very impaired."

Trouble Empathizing

"There’s a real impairment in being able to see yourself from the outside and see others from the inside," Dr. Oldham said of the effects of this on interpersonal skills. To rephrase, those with BPD struggle more with both self-awareness and empathy.

Dr. Oldham elaborated, "There is a lack of understanding about how your own behavior impacts people, so when your emotions are out of control, it doesn’t register that this causes stress to others." This blind spot is one reason why people with borderline have so many problems keeping relationships together.

Chaotic Relationships

According to Behary, people with borderline personality disorder are disproportionately represented in abusive relationships. People with unmet needs from their upbringing typically remain in unhealthy relationships because they seek a partner who they believe can fulfill those needs.

Dr. Oldham noted that those who suffer from BPD are more likely to be overly needy, passionate, and distrustful in romantic relationships. It’s a self-fulfilling prophesy when "you drive the other person away because of your heightened anxiety that you’ll lose the person who is close to you."

Conflict is not limited to romantic partnerships. Friends and family members of people with BPD may go from being extremely close to being extremely distant. People with BPD who are otherwise highly functioning typically become aware of their condition during interpersonal interactions.

Avoiding Thinking About the Future

You don’t have to have every detail of your life planned out, but chances are good that you do have certain goals and objectives in mind. Individuals with BPD generally have no sense of personal motivation. Dr. Oldham observed that few people "have a clear idea of what they want from life or what they want to work toward."

Overwhelming Anxiety

The anxiety experienced by persons with BPD is unlike the occasional anxiousness or tension felt by the rest of us. Dr. Oldham said that a common trigger for these feelings is an overreaction to the conduct of others.

Having borderline personality disorder is characterized by an incapacitating urge to always feel valued and accepted. People with borderline may have explosive, inappropriate outbursts of emotion as a result of their chronically elevated levels of anxiety.

Constant Fear of Abandonment

BPD symptoms include an intense aversion to loneliness, rejection, and abandonment. According to David Mattila, a certified clinical social worker and cognitive and schema therapist in New York City, fears generate unreasonable emotions and jealous, paranoid behaviors, such as monitoring a partner’s email for signals they could bail.

According to Mattila, "This insecurity can even lead to more extreme and manipulative behaviors," such as telling a spouse, "If you don’t call me when you say you will, I’m going to kill myself." Everything boils down for someone with borderline personality disorder to a single goal: never being abandoned.

Frequent Mood Swings

Because mood swings are a common characteristic of BPD, the condition is sometimes misdiagnosed as bipolar. Dr. Oldham said that this is not the same "persistent mood state" seen in someone with bipolar disorder, which is marked by severe episodes of mania or depression that can linger for weeks at a time.

Instead, those with borderline personality disorder (BPD) are prone to extreme emotional reactivity to even little occurrences. Dr. Oldham said that someone with BPD would experience a dramatic increase in anxiety if a coworker failed to acknowledge their presence in the corridor. Overreacting and internalizing are typical responses to events that most individuals would not even consider significant.

Depression

It is common for BPD patients to be misdiagnosed with persistent depression. People with borderline personality disorder frequently suffer from depression, although their symptoms can seem different.

"It’s a very heavy, profound depression," Behary remarked. As the author puts it, "it’s loaded with this chronic feeling they have no value and a pervasive sense that nothing matters.”

Uncontrollable Anger

Those who suffer from borderline personality disorder often have responses that don’t appear to fit the situation. Mattila used the following scenario to illustrate his point: your spouse was meant to pick you up at 7, but didn’t show up until 7:30. "I’m breaking up with you, you don’t love me, I hate you, you’re never there for me," etc., are typical responses from someone with borderline personality disorder, as described by psychologist Dr. Paul Mattila.

According to Dr. Oldham, people with BPD often place the blame for their issues and feelings on those around them. "They can’t tolerate [admitting] that they’re the ones with the problem, so they blame others instead," Dr. Oldham explained. "Accepting that their rage and anger are not warranted by another person, but rather stemming from within, is almost toxic for them."

Inability To Control Actions

Those with BPD tend to act on impulse, whether it’s spending thousands of dollars on a new TV without thinking about how it would affect their finances or engaging in unsafe behaviors like having unprotected sex with several partners. According to Dr. Oldham, their thoughts are like the hyperactive motors in automobiles with damaged brakes; they just can’t help themselves. There’s no stopping them now.

Dr. Oldham noted that risk-taking behaviors can occasionally result in cutting or other forms of serious self-harm. According to the study’s authors, "it helps them turn off their emotions and produce release." This often occurs when a person with BPD experiences prolonged feelings of intense dissociation, detachment, or numbness.

Suicidal Thoughts

Dr. Oldham noted that a significant proportion of suicidal ideation and suicide attempts exists within the BPD community, despite not being a recognized indicator of borderline. A research published in May 2019 in Medicina found that up to 10% of people with BPD have attempted suicide.

Dr. Oldham warned that these individuals are at greater danger because of their impulsivity. As a result, "they might really see suicide as the only logical solution to stop the pain," instead of being so sad they can’t get out of bed.

How Do I Know If I Have It?

The American Psychiatric Association states that a person has to demonstrate deficits in self-functioning, such as problems with identification or lack of motivation, in order to be diagnosed with schizophrenia. They would also need to demonstrate difficulties in relating to others, such as difficulties in empathy or closeness. Any of the following symptoms is also possible in this group:

• Extreme nervousness
• Separation anxiety
• Depression
• instability of moods
• Out of control rage
• Impulsivity
• Risk-taking

Talk to your doctor or schedule an appointment with a mental health professional if you need clarification.

Where To Get Help

Psychotherapy, rather than medicine, is the main treatment for BPD, while medication may be suggested in some cases.

Dialectical behavioral therapy (DBT), a subset of CBT created in the 1980s, was recommended by Dr. Oldham for the treatment of BPD. Dr. Oldham further suggested that you research mentalization-based treatment, schema therapy, or any other type of therapy that piques your interest. Mattila stressed the need of seeking out a doctor with expertise in treating BPD.

You can also reach out to the National Education Alliance for BPD (NEABPD) and the Personality Disorder Awareness Network (PDAN) for further assistance and information.