Borderline Personality Disorder…
The Other BPD
Borderline Personality Disorder (BPD), not to be confused with Bipolar Disorder, is the most consistently challenging condition I struggle to live with. For the benefit of myself, and others like me, I’m going to explore this life-threatening disorder. I’ll present information and offer a first-person account of what living with BPD is like and how it affects me personally.
I’m hypersensitive on an emotional level and extremely over-analytical, intellectually. My thoughts and feelings are balls in a lottery tumbler, and I never know when the next drawing will be or which ball will be drawn.
I’m a firm believer that reality is a matter of perception. That’s a terrifying truth, when you’re living with BPD and your perception of yourself and the world around you changes as frequently and drastically as the track on a rickety old roller coaster. Unfortunately, this isn’t a thirty-second thrill ride with built-in safety features. BPD is a dangerous psychological disorder I’ve had to deal with my entire adult life.
What is Borderline Personality Disorder?
BPD is a personality disorder that causes those afflicted to suffer extreme instability in self-image, behavior, and emotion. A disorder existing on the border of neurotic and psychotic behavior, BPD was recognized and named accordingly in 1980. This is a serious mental condition, and people living with BPD are highly prone to self-abuse and suicidal tendencies.
I consider this a life-threatening illness because approximately 10% of those diagnosed with BPD successfully commit suicide, and are prone to making decisions designed to threaten quality of life and mortality. I think it’s also noteworthy that this disorder rarely exists by itself, usually co-occurring with, and complicating, other mental conditions like depression and Bipolar Disorder.
There are nine criteria in the DSM-IV used to diagnose BPD. An individual typically needs to identify with at least five of these characteristics for an official diagnosis. Personally, I represent all nine, and I’ve endangered my life on several occasions as a direct result. I’m going to list the nine criteria here and offer an example of how each affected me one time or another.
DSM-IV Diagnostic Criteria & Me
 Frantic efforts to avoid real or imagined abandonment.
I’m constantly analyzing my behavior in an effort to assess whether or not I’m acting “normal,” because I live in perpetual fear that my girlfriend will abandon me if I show signs of mental illness. I have an unshakable sense of dread that if I can’t force myself to act “normal,” my six-year old son will think I’m “crazy” and be afraid of me, as I thought my father was crazy and I lived in fear of him.
 A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
My relationships with my immediate family members defined intense and unstable, paving the way for similar relationships I’d seek out as an adult. I choose emotionally abusive partners, who cheat on me and complicate my life, and my perception of my partner can change on a dime for no reason at all. One day, they’re the best thing that ever happened to me. The next day, I’m convinced they’re the source of all my pain and never really loved me at all.
 Identity disturbance: markedly and persistently unstable self-image or sense of self.
Sometimes, when I look in a mirror, I find my reflection disgusting and ugly … I have to look away. Sometimes, I think I’m attractive. Today, I might think I’m the best partner a woman could ask for. Tomorrow, I might think I’m a burden to my girlfriend and son … they’d be better off without me. One morning I was beaming with pride over my writing. The same afternoon I destroyed my last copy of the book I wrote, disgusted with my lack of talent.
 Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
During low times, I’m prone to reckless spending. I’ve maxed out all my credit cards, taken out unnecessary loans for frivolous spending, and had to claim bankruptcy. I’m ashamed to admit how much time I spent drunk or high behind the wheel of my car for years after my parents died.
I even prostituted myself to a suspicious man when I was a homeless teenager. I let him lead me into the woods, hoping his true intention was murder … it wasn’t. Most recently, I walked out on my family, and rented a condo, where I planned to die in self-induced isolation.
 Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
I struggled with suicidal thoughts and behavior for twenty years. My self-abuse began with digging my fingernails into my skin when I was a child. It progressed to cutting and cigarette burns as a teenager and, as an adult, I’ve broken my bones and doused myself with boiling water. I still struggle with the urge to hurt myself, and I’m constantly plagued with intrusive visions of self-mutilation.
 Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
Severe anxiety cripples my ability to function in society. I have Social Anxiety Disorder and I suffer debilitating panic attacks on a daily basis, which led to developing Agoraphobia. I have a positive attitude by nature, believe it or not, but my mood can become so dismal I feel a need to isolate myself completely. This often involves hiding in bed for hours, or days, and I can be impossible to get along with … every conversation becomes an argument at these times.
 Chronic feelings of emptiness.
Often, my life is dreamlike and I feel more like a ghost than a human being. I’m a phantom, operating in an unreal world, and it feels like nothing I do matters or has value. All my relationships are illusions, and I’m convinced I exist without substance or meaning.
 Inappropriate, intense anger or difficulty controlling anger.
Rage overcomes me, and I feel it well up inside me to the point that my skin starts tingling, flushes, and gets hot to the touch. I might have to lie down … just breathe. I’m fortunate that this symptom has never gotten out of control. I believe my experience in martial arts and meditation, my use of bodybuilding as a healthy venting mechanism, and my highly developed sense of self-awareness enable me to repress my frequent urge to smash things or lash out.
 Transient, stress-related paranoid ideation or severe dissociative symptoms.
I started dissociating when I was a child, a result of the abuse I endured. This psychological survival skill has been with me since, and to this day, I begin dissociating at the slightest hint of stress or panic. Sometimes I have a series of days when I weave in and out of dissociative states. This alien sensation ranges from, difficulty concentrating to catatonia, and it’s had a negative effect on my school ears, ability to work, and social acceptance.
Development of BPD
An exact cause of BPD is unknown, but many experts think this condition develops over time due to environmental and genetic reasons. Childhood trauma, like sexual abuse or losing a loving parent, has a strong connection to the development of BPD. There’s also evidence that brain function and structure are notably different in people with this disorder, suggesting genetic and biological origins.
Research consistently shows more activity in a part of the brain, called the Limbic System that controls emotions like fear and anger. This would help explain the emotional instability associated with this condition. Looking back on my parents’ behavior, either one of them might have had an undiagnosed case of BPD. I’ve written extensively about the severe abuse and loss I endured throughout my childhood, as well as my long relationship with self-injury.
Treatment for BPD
There is no cure, but the burden of living with BPD can definitely be reduced, symptoms can be controlled, and quality of life can be substantially improved. Proper diagnosis is crucial, and most will require treatment. This might include medications, psychotherapy, or both.
Dialectical Behavioral Therapy (DBT), currently recognized as the most effective form of psychotherapy to treat BPD, involves learning healthy coping skills, as well as recognizing and gaining control over symptoms and harmful patterns.
Anti-psychotic medication may be prescribed to support therapy, and help control chaotic and disorganized thoughts. Many people with this diagnosis won’t ever fully recover and might always struggle with some lingering issues.
It’s important to recognize the possibility you’ll have to maintain varying levels of treatment for the rest of your life. Living with BPD isn’t easy, and it can be a nightmare for those afflicted and the people who care about them. The good news is we can live more peaceful and happier lives with proper treatment, support, self-awareness, and of course … patience.
Photo credit: Flickr / Peter Alfred Hess