Borderline Personality Disorder

Have you heard of Borderline Personality Disorder (BPD)? Probably not. I hadn't until a relative was diagnosed following a suicide attempt. A person with BPD has a suicide rate 400 times greater than the general population.

RAW

You can find the official diagnostic criteria here, but the best explanation I've heard is a metaphor:

Imagine you have third-degree burns over 50% of your body. Even after the skin has supposedly healed, you remain extremely sensitive. You react to pain where others might not even notice a sensation. It is constant. It is not something you can just ignore. For others, it is more like severe eczema. When they have a flare-up, the pain is undeniable. That is what BPD is like, on an emotional, psychological plane.

If you have BPD, a prolonged gaze from someone might feel like they are staring at you. If someone cancels a date or get-together you may feel like you've been rejected. Criticism may feel like words of hate.

And the emotional response to these stimuli is out of whack - from desperation to rage. For that reason, there are many who prefer the term Emotional Dysregulation. 

THINKING ERRORS

A particular kind of thinking characterizes the challenge for those living with the disorder. In the Essential Family Guide to Borderline Personality Disorder, Randi Kreger walks us through an eight-week "empathy exercise" to show what it's like inside the mind of someone with BPD.

Week one: Sit down with your notebook and recall every time you were ever publicly humiliated or ashamed, starting with grade school.

Week two: Go over your life from as early as you can remember. Think about times when each member of your family said or did something that caused you a great deal of pain. Then conjure up all those feelings you had at that time. Next, do the same thing for all your love relationships.

And on it goes, in the same vein.

For many of us, these are the kind of thoughts that disturb us as we're trying to fall asleep at night. Those gut-churningly awful feelings that shred our self-esteem and can keep us from building relationships. For someone with BPD, these thoughts and feelings are CONSTANT.

FLAWED COPING MECHANISMS

Because of this chronic inner pain, sufferers develop some rather dysfunctional coping mechanisms and thinking errors. Self-harm is very common, as are physical and verbal outbursts of anger or rage. Impulsive behaviour, like gambling, promiscuity, or substance abuse, are very common. You may recognize them as "drama queens" or "trouble children."

They can be so hurtful and manipulative that many professionals (therapists, doctors, psychiatrists) refuse to treat them.

My dear one was not diagnosed with it, officially, for several years -- years when she and her family went through various kinds of hell.

THERE IS HOPE

Even following diagnosis, it was not until her parents started taking a course based on dialectical behavior therapy (DBT) that things began to improve for the family. The course explained what BPD is and offered skills for "emotional effectiveness" -- things to build relationships.

They also met other parents whose children faced nearly identical challenges. The private stories that they could share with no one else were finally spoken. They cried and laughed together and built each other up. As one parent said, "It has been a godsend. Between the course and the community, I feel much stronger and better able to be an effective parent to our daughter."

The DBT course itself is one of the few proven forms of treatment for people with Borderline. Unfortunately, it can be hard to get into a course and, as with many mental disorders, those who suffer often don't think they need it. Let's face it: it's painful to face one's disabilities head-on.

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SOME FACTS (from The Essential Family Guide to Borderline Personality Disorder)

• Officially, 2% of the population has BPD, though it could be higher.
• It is more common than schizophrenia.
• It is twice as common as anorexia.
• 20% of hospital psych admissions have BPD (more than for major depression).
• 10% of adults with BPD commit suicide.
• 33% of youths who commit suicide have features of BPD. [BPD is not usually diagnosed before the age of 21 as personality features are still quite changeable before that age.]
• BPD can co-occur with other illnesses, such as bipolar disorder, depression or Asperger syndrome.
• No FDA-approved medication exists for BPD.
• More than 50% of individuals with BPD are severely impaired in employability.
• 12% of men and 28% of women in prison have BPD.

To learn more about Borderline Personality Disorder and support for families in the Ottawa area, visit on-bpd.ca/wordpresspub.

You may also want to watch this video. It's long, but very informative and worth watching if you or someone you love has BPD.