Care with compassion

Q. As a 27-year-old single woman, I struggle to comprehend myself. As someone who is doing well at work, has many short-term acquaintances, and a cheery attitude, it is difficult for me to accept that I am hurting internally. I have extreme mood swings, ranging from very happy to very unhappy. My relationships fluctuate frequently; one minute I'm extremely connected to someone, the next I feel completely alone. I'm not sure about myself; sometimes I feel fantastic, sometimes not. And I act impulsively, such as by using substances to attempt to feel better, and I have occasionally harmed myself in the past. I visited a doctor who recently diagnosed me with borderline personality disorder. I am unsure if I am bipolar. Please explain.

Seeking help, Miss Lost

Dear Miss Lost,

It takes immense courage to embark on a journey of self-discovery and seek assistance along the way. Borderline personality disorder (BPD) can indeed be a complex and often misunderstood diagnosis. As May marks BPD Awareness Month, mental health professionals aim to shed light on this condition, reduce stigma, and provide valuable tools for managing its symptoms.

Diagnosis

BPD encompasses a spectrum of challenges, pervasive patterns of instability in interpersonal relationships, self-image, emotions, and impulsivity. People with the diagnosis of BPD often struggle with intense fear of abandonment, leading to frantic efforts to avoid real or imagined separation. Their emotions can be tumultuous, with rapid shifts from intense joy to profound sadness or rage. This emotional instability can strain relationships and impair daily functioning.

Moreover, individuals with BPD may experience chronic feelings of emptiness, engage in risky behaviors such as substance abuse, self-harm, or reckless driving, and have difficulties controlling anger. Despite these challenges, it's essential to recognise that those with BPD are not defined by their diagnosis; they are individuals deserving empathy, understanding, and effective support.

Common myths and facts about BPD

Myth 1: BPD is the same as bipolar disorder.

Fact: While both disorders involve mood instability, they are distinct conditions with different underlying mechanisms and treatment approaches. Bipolar disorder is characterized by episodic shifts between manic and depressive episodes, while BPD involves pervasive patterns of emotional dysregulation, impulsivity, and unstable self-image. The former is a mood disorder, and the latter is a personality-related disorder.

Myth 2: BPD only affects women.

Fact: While BPD is more commonly diagnosed in women, it can affect people of all genders.

Myth 3: People with BPD cannot maintain stable relationships.

Fact: Individuals with BPD may experience challenges in relationships due to fear of abandonment and emotional dysregulation, but many can develop and maintain stable and fulfilling relationships with appropriate treatment and support. Building skills in communication, emotional regulation, and conflict resolution can improve relationship dynamics.

Myth 4: People with BPD are manipulative and attention-seeking.

Fact: Individuals with BPD often struggle with intense emotions and fear of abandonment, which may manifest as behaviors perceived as manipulative. However, these behaviors typically stem from underlying emotional pain and distress rather than deliberate manipulation.

Myth 5: All individuals with BPD engage in self-harming behaviors.

Fact: While self-harm is common among individuals with BPD, not everyone with the disorder engages in this behavior. Self-harm is often a coping mechanism used to regulate intense emotions or alleviate distress, but there are many other coping strategies individuals can learn and adopt.

Myth 6: People with BPD are untreatable and will never improve.

Fact: While BPD can present significant challenges, many individuals with the disorder can experience significant improvement in their symptoms and overall quality of life with appropriate treatment.

Dialectical Behavior Therapy (DBT) and mindfulness-based approaches, along with other forms of psychotherapy and medication, can be highly effective in managing BPD symptoms. Recovery is possible with the right combination of therapy, medication, and support.

Famous individuals with borderline personality disorder

Notable individuals, like comedian Pete Davidson, actress Winona Ryder, and the late Amy Winehouse have openly shared their experiences with BPD, contributing to greater awareness and understanding of the condition.

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