Published on 28 May 2019
Borderline Personality Disorder (BPD) is mental illness marked by an ongoing pattern of emotions, self-image, and behaviour, resulting in impulsive actions and can cause problems within relationships.
People with BPD tend to view things in extremes, such as all good or bad. Their opinions or views of other people tend to change quickly, they can see someone as friendly for a moment and a traitor the next moment.
PhD student Dan Taylor from the University of Sunderland’s School of Psychology explores the foundations of BPD based on his own personal experience of living with the condition.
“You may be asking what even is BPD? The name itself is a bit of a misnomer, borderline of what?
Originally it was believed that those with BPD were on the borderline of psychosis and neurosis, and the misunderstanding of BPD only gets worse from there.
A ‘classical’ borderline presentation is associated with manipulative and unempathetic traits – pretty nasty stuff, which is unusual as very few people we know who are diagnosed with BPD actually fit this clinical picture.
Because of this, borderlines are often seen as “naughty” or hard to treat patients; getting fobbed off from one mental health professional to another, because even amongst trained professionals BPD is one of the most incredibly stigmatised disorders around.
This is shocking given that borderlines make up around 2% of the general population (that’s more than bipolar disorder and schizophrenia combined), 15% of inpatients, and around 50% of inpatients with personality disorders.
But if BPD isn’t manipulativeness or being on the borderline of sanity - though it may feel this way sometimes - then what is it?
I am by no means an expert in clinical psychology or personality disorders, but I do have BPD, so I have lived experience on my side.
There are nine main symptoms associated with BPD which are pretty varied, and you only need five of them to be diagnosed – which makes the presentation of BPD different from person to person.
I’ve heard people say that anyone could be diagnosed with BPD if the clinician tried hard enough, because a lot of the symptoms sound much like the human condition; which is why I think it’s important to really understand what it actually is.
Borderlines are sometimes referred to as consistently inconsistent. Which is about right to be fair. It’s rare that day-to-day feelings or experiences are much the same.
Usually the hallmarks of BPD are the fear of abandonment, unstable relationships and sense of self and mood instability; after that there’s a bit more variation in the symptomology you might see from personal to person.
For those curious, the symptoms are:
Frantic efforts to avoid real or imagined abandonment
A pattern of unstable and intense interpersonal relationships characterised by extremes between idealisation and devaluation
Identity disturbance: Markedly or persistently unstable self-image or sense of self.
Impulsive behaviour in at least two areas that are potentially self-damaging (eg spending, sex, substance abuse, reckless driving, binge eating).
Recurrent suicidal behaviour, gestures, or threats, or self-harming behaviour.
Emotional instability in reaction to day-to-day events
Chronic feelings of emptiness.
Inappropriate, intense anger or difficulty controlling anger
Transient, stress-related paranoid ideation or severe dissociative symptoms.
So how do these symptoms actually feel? How do they present in day to day life?
Let’s start with arguably BPDs most iconic symptom – fear of abandonment.
No one likes being broken up with, right? But BPD makes people leaving you feel like the emotional equivalent of having hot water splashed over you and then gives you a personality geared towards making sure this happens.
Essentially, when we’re abandoned, or think it might happen, we feel it more intensely and we can’t inhibit our emotional responses and behaviours as well as those without BPD.
To me, this makes complete sense. Interpersonal relationships can sometimes be a cure for the lack of sense of self we have.
Unfortunately, borderlines can be hard to deal with. We’re full on. A little too much for most.
Marsha Linehan, prominent psychologist and famous borderline, said that borderlines are like the burn victims of psychiatry, they have no emotional skin. So, it’s only natural that people want to put some distance between us, even if only temporarily.
It’s this lack of emotional skin that makes our moods so wild and erratic, sometimes going from unbearable sadness to crippling anxiety, to pure elation and explosive anger in a matter of minutes.
Imagine feeling things so deeply that you can’t help investing in a person to the point of self-detriment. Intensity comes natural to us, so we often want to talk to a person every day, especially when we feel so strongly for them. Now imagine that person leaves your life. It’s like losing a bit of yourself – they gave you your identity, remember.
Your very core has just been shattered to the point that looking into a mirror is like having a stranger look back and the emptiness begins creeping through every single cell of your body like intense muscle ache.
For those with BPD, life can be agonising. I think this is why I fundamentally disagree with the idea of borderlines being intentionally manipulative. Most of us are just trying to get through the day, by any means necessary.
We’re so desperate not to be alone, trying to keep these emotions at bay, we’ll do anything.
In my experience, borderlines can be some of the most loving and dedicated friends you could find. I know multiple borderlines who would do absolutely anything for their loved ones. We’re often very empathetic, creative and devoted to the things and people we love. Fundamentally a lot of us just want to be loved back.
If you have a friend or loved one with BPD, the best advice I could give is setting clear, consistent boundaries. We don’t have the best sense of self and it’s easy for us to get lost in other people.
You don’t have to treat us differently, just make sure you’re being clear about what you say or mean, and maybe give us some reassurance you’re not going anywhere every once in a while.”