Borderline Personality Disorder (BPD)What is BPD?
People struggling with BPD may have an intense fear of abandonment, struggle to maintain stable interpersonal relationships, and experience emotional instability. They may engage in risky behaviors, such as drug and alcohol abuse, gambling, or displays of intense anger. BPD usually begins by early adulthood and can severely impair a person’s ability to function on a day-to-day basis.
Clinically, the DSM V states that “Borderline personality disorder (BPD) is characterized by marked instability in functioning, affect, mood, interpersonal relationships, and, at times, reality testing” (the ability to distinguish reality from unreality.)
Those diagnosed with BPD often say that intimate, personal or important business relationships often end catastrophically, leaving them remorseful but unable to repair the damage. They are usually aware of being unable to regulate their emotions appropriately, leading them to seek help.
“I’m an observer to my own life.”
Dave describes what it’s like to have BPD
“It felt like a swirling, chaotic mess...”
Whitney describes what it’s like to have BPD
What Causes BPD?
The exact cause of BPD is unknown, but currently it is thought that a combination of genetics and environmental influences both factor into its development. People with a family history of BPD are at greater risk of developing the condition. Additionally, current research shows a correlation between adverse childhood experiences, especially abuse and neglect, and the development of BPD. The good news is that many people who seek treatment for BPD make improvements that allow them to live healthy, stable, and productive lives.
“It’s a process.”
Peter Fonagy discusses the development of BPD
How To Treat BPD
Currently, the gold standard to treat Borderline Personality Disorder is Dialectical Behavioral Therapy (DBT). Think of DBT as a skillset that provides a person tools to become mindful as well as effectively manage interpersonal situations, navigate distress and regulate their emotions. In addition to DBT, I incorporate traditional talk therapy (specifically, Psychodynamic Theory) to help clients process past events that are often times contributing to their condition.
Myth: BPD only affects women
Reality: The majority of clients who reach out to me for therapeutic services are adult men who have been formally diagnosed or suspect they suffer from BPD. Some are in a relationship with a partner with the condition and are trying to better understand how it affects their relationship.
Michael Cook, MA, LPCC