Just Emotional or Borderline Personality Disorder (BPD)?

I'm going to tell you this story about one time where I was told I was the worst therapist in the world, and I should take up knitting. I laughed, and was also sad, but not for why you might think I was sad, because the person who wrote that to me had no way to actually qualify whether I was the best or the worst or somewhere in between in mediocre, because she didn't even give me a chance. I had seen her for one session, actually for just maybe half of one session, because she showed up for a session and then bolted out the door, and then she came back, and then she bolted out the door, and then she came back. I wasn't quite sure what in the world was going on, but I basically got to say one and a half sentences pretty much. What I remember saying is, I can tell you're hurting. So, if that makes me the worst counselor in the whole wide world and that I should give it up and take up knitting, then so be it.

But I laugh so hard because she has no clue that I don't have the patience for knitting. It's just not how I'm wired. If she had said something else like photography, okay, maybe. But knitting just made me laugh. When I thought about it more, part of the issues were mother issues that she had and this sense of abandonment. It makes sense. Think of knitting and what do you think of a mom or a grandma? Right. I don't know if that was related or not, but it was very, very interesting.

What I give you from this is the fact that this person, more than likely, had I been able to actually have her in the room and actually diagnose her, could possibly have had borderline personality disorder. Borderline personality disorder is something that can be helped, can be overcome, and worked with. It needs some help because there's often an erratic nature to emotions, to anger, to flying off the handle, to having some internal difficulty with intense emotion regulation. If you feel like you're walking on eggshells and in fact, there's a book named Walking on Eggshells, but if you feel like that in your own life or in your relationship with others, that might be a good resource to get your hands on and take a look at. It is like walking and not knowing where the minefields are sometimes and possibly in your own life, but just explosions or erratic behavior or, like push and pull kind of where is this coming from?

So why are we talking about borderline personality disorder (BPD) today? Well, because we've been talking about another personality disorder and some of the symptoms of this other personality disorder. Over the last couple of weeks, we've talked about narcissistic personality disorder, narcissistic traits, not necessarily meaning narcissistic personality disorder, but we all have some narcissistic traits, but it's like a spectrum, and some people have more than others, and some actually qualify for the personality disorder. And one of the things that often happens with that disorder is something called gaslighting, like trying to make you feel crazy in your own mind by just kind of denying reality for someone else. If somebody denies your reality, denies how you're feeling, denies your memories, or denies what actually happened, you may be being gaslit, and that's not cool.

I just want to give awareness to some of these things you might run into in relationships as borderline may be one of them when you interact with people who have these conditions where you're left wondering which way is up or what just happened here? You just don't understand where everything went south, or it all blew up, and you don't know why, and all of a sudden, you're being painted as the bad person or the wrong person, and you can't see what you did wrong. You may be dealing with somebody who has a personality disorder of some sort, and it's very hard because it can really mess with your mind.

If you are the person dealing with the personality disorder, you may not even realize it because it may be something that you have been used to for so long. You may think you're temperamental, have anger issues, or you lash out, or you wonder why you can't get along well with people and why there seems to be something empty inside you or something just not quite the same as others. It could be that you are sensing something that may benefit from treatment, so I don't want you to get down on yourself. We all have stuff as human beings. I know that they say, what is or isn't neurotypical, and honestly, is there really neurotypical? I mean, is there really anybody's way of functioning that is exactly like somebody else's? 

We all have stuff, so that's why I don't like to label. I do think knowing a diagnosis can help you see your symptoms possibly more clearly or in a way that could get treatment much more easily and be more helpful to you. You may be noticing a sense of emptiness, erratic behavior, and a lot of vacillation, such as the experience where the client was in and out of the room although It doesn't have to be that dramatic. It could be I love you; I hate you or that kind of stuff, splitting. They're the best, or they're the worst, or, you know they can do no wrong, or they need to get out of my life because they're awful. There's a middle ground, but if you're not seeing the middle ground in how you look at others and you're not seeing it in somebody that you're in relationship with, that can also be indicative of traits of borderline personality disorder.

So, I'm not encouraging us to go around labeling people, but I am encouraging us to keep our eyes open when it feels like something is amiss within ourselves or within those with whom we are in relationships. It could be that there is something that would benefit from some education, skills building, tools, insight, and having a conversation that might say, hey, do you need help right now because this seems to be a bit hard for you. This is just to give you an insight so that you're aware that sometimes these things that don't quite make sense, that interfere with relationships or everyday life and functioning that seem to be overwhelming, may actually be indications that there is something going on that could benefit from treatment.

How Is BPD Acquired?

So, how is borderline personality disorder acquired? Like many things, there can be a number of factors. Genetics and heredity can play a factor as they can increase the risk situations. Environmental and social experiences can also contribute. The way the brain is structured and functions, the chemical connections, and the things that are environmental in nature like trauma or neglect can play into many different mental health issues, and borderline is no exception.

How Is BPD Diagnosed?

It is diagnosed through meeting criteria from the DSM V, which is the Diagnostic and Statistic Manual for Mental Disorders, and it's in its fifth edition. BPD is categorized as a personality disorder, and you must have at least 5 out of 9 different characteristics. These nine characteristics include:

  1. Frantic efforts to avoid abandonment, which includes both real and imagined scenarios of abandonment,
  2. Unstable and intense relationships, such as alternating between extremes of idealization and devaluation.
  3. Splitting or identity disturbance
  4. Markedly and persistently unstable self-image or sense of self impulsivity in at least two areas. These areas are potentially self-damaging, such as spending, sex, substance abuse, reckless driving, and binge eating.
  5. Recurrent suicidal behavior or self-harming behavior, such as threats or gestures or self-mutilation.
  6. Effective instability due to a marked reactivity of mood.
  7. Chronic feelings of emptiness.
  8. Inappropriate, intense anger or difficulty controlling anger, frequent displays of temper, constant anger or physical fights .
  9. Transient stress related paranoid ideation or severe dissociative symptoms.
If someone has five of those, they may qualify for a borderline personality disorder diagnosis. It is more prevalent in women, but that does not mean that it does not show up in men. That may be something that you may not expect or look for, but that doesn't mean that men cannot also have it. So even though it's not statistically as much as for women, men can also have borderline.

What Can You Do if You Have BPD?

If that is something that you are dealing with, either in yourself or with someone you care about, help is available. So don't worry about what people will think or if there's a stigma. This is like if you have a broken arm, you put a cast on it, you go get it taken care of because you can get help for these things. There is no shame in getting help for things that you need help for. That is wisdom and that is good stewardship. Don't let anybody ever stop you from taking good care of yourself or your loved ones because you, and they deserve it. If you have any questions on borderline personality disorder, there are a lot of resources out there that can be a help. Certainly, reaching out to a therapist can be a first line of action you can take, and then they can point you in the right direction. Maybe your primary care physician might be even the first line, and then they refer you to a therapist and then they find someone who can help you with medication, should it be needed. But don't let medication scare you off. Medication, if done correctly, can be a miracle that you've been praying for. So, medication is not the only end all, be all. There are a lot of behavioral and lifestyle tips that can be used first or in conjunction.

Sometimes it is misdiagnosed as bipolar disorder, and so you really need to have a thorough assessment to figure out what's really going on so that the person can tease out the different characteristics of what is being experienced. Going to therapy for this is very, very helpful. Dialectical behavior therapy, which is DBT, is very helpful. It helps with the regulation of thoughts and overwhelming emotions in order to help them to be used in a more helpful way to have some skills and some tools to better navigate it.

Unlike narcissistic personality disorder, where it's often very hard for those people afflicted to stay with therapy and think that there's something they could work on, self-improvement for borderline personality disorder actually can really be helped if toleration skills can be learned and managed so that they can get the help that they need. 

I also want to tell you about Rose Skeeters. She has the Borderline to Beautiful podcast, and she is amazing for a resource. If you want to follow another Christian woman who knows what she's talking about, is an expert in this area, and has worked through and overcome a lot of it herself, you may want to check out Borderline to Beautiful.

Hope that was informative today. And don't worry, as I sign off, I'm not going to go knit, not even close. Take care.