What is Borderline Personality Disorder?
Borderline personality disorder (BPD) affects people’s way of thinking, mood, behaviour and relationships. The statistics show that around 1 in 100 people live with borderline personality disorder. For people with BPD, facing several challenges like unstable emotions and a confused sense of identity is a reality. BPD can affect people’s self-image as well as understanding what your likes or dislikes are.
People with a borderline personality disorder diagnosis may experience enhanced mood swings, instability in building relationships, and impulsivity. There are certain instances of people having high-functioning or quiet BPD; however, they still experience intense mood swings, anxiety, negative self-image and fear of abandonment.
People with a BPD diagnosis often have a history of neglect, abuse or childhood trauma and often live with pessimistic expectations of the future and negative emotions. During challenging times, people with BPD may be prone to substance misuse and other self-destructive behaviours.
BPD Symptoms
In most cases, the signs and symptoms of borderline personality disorder are known to appear during late teenage years or early adulthood. Stressful events, childhood trauma or a history of abuse and neglect often trigger the symptoms.
The symptoms can vary from manageable to severe and may include:
- Intense fear of abandonment – fear of being rejected or abandoned, even without reason
- Unstable relationships – intense emotional attachments with sudden shifts in mood
- Negative self-image – difficulty with self-identify and self-worth while also feeling uncertain about life goals and values
- Impulsivity – impulsive behaviours are a common symptom of BPD
- Self-harm – some people might display self-harming behaviours as a coping mechanism for emotional pain
- Intense mood swings – severe mood swings that are known to last for hours and even days
- Feelings of emptiness – some people may feel a sense of emptiness despite being engaged in a variety of activities and being surrounded by others
It’s important to note that not everyone diagnosed with borderline personality disorder experiences all of these symptoms. A mental health professional can give a precise diagnosis and develop an individualised care plan that will focus on improving the quality of life for people with BPD.
Causes of BPD
Healthcare professionals believe that borderline personality disorder isn’t caused by one single factor. Instead, It is a combination of multiple factors that often appear due to a stressful event or trauma. Some of the most common causes for BPD include:
- Familial medical history – data shows that BPD may run in families, meaning that if one family member has BPD, other family members are more likely to develop borderline personality disorder
- History of childhood abuse and trauma – about 70% of people with BPD are known to have a history of physical or emotional abuse or experienced a traumatic event as a child
- Brain development changes – for some people with BPD, there is a miscommunication between parts of the brain that control behaviour and emotion, which can be reflected in behaviour challenges and impulse control
Risk Factors for Borderline Personality Disorder (BPD)
There isn’t one clear cause that was determined as the sole reason for developing borderline personality disorder. However, researchers suggest that some risk factors are known to lead to the development of BPD.
Family History
Family history is considered one of the most significant risk factors for developing BPD. The research suggests that people with a family history of BPD and other mental health conditions face an increased risk of developing BPD. Family history can contribute to the development of BPD due to the:
- Modelling parent behaviour
- Genetic predispositions
- Relationships between parents and children
Although family history is a risk factor, it doesn’t guarantee that someone will develop BPD. Also, there are people without a family history who have developed borderline personality disorder.
Brain Structure
The brain’s structure is another risk factor that may contribute to developing borderline personality disorder. Some BPD symptoms have been connected to differences in key brain regions, which are known to contribute to challenges with impulse control, self-identity, memory processing and emotional regulation.
The differences in serotonin levels and neurotransmitter systems can also affect mood stability and impulsivity. While the brain structure is only one of the factors, understanding its role can help develop a therapeutic approach that will address the neural underpinnings of BPD.
Social and Environmental Factors
Social and environmental factors also play a crucial role in developing BPD. Childhood trauma, neglect or disrupted emotional development can lead to developing BPD. Cultural influences and pressure from society are also known to contribute to the expression of some of the BPD traits. However, it is essential to understand that these factors interact with people’s challenges and can shape the course of the condition and treatment strategies.
Triggers of BPD
Borderline personality disorder has multiple triggers, which often correlate with environmental and emotional stressors. These triggers can lead to worsening of the symptoms, and some of the triggers include:
- Major life stress
- Criticism from others
- Interpersonal conflicts
- Rejection
- Abandonment
- Transitions
- Unstable or abusive relationships
- Trauma
- Abuse
- Substance misuse
Recognising the triggers and working with professionals can help create a holistic and personalised care plan and coping strategies to minimise the adverse effects. Psychotherapy, dialectical behaviour therapy and other therapies are known to provide the skills to manage these triggers and regulate intense emotions while improving overall functioning.
Other Conditions That Can Co-occur With BPD
Borderline personality disorder may co-occur with other mental health challenges as well. These conditions intensify the symptoms and will often require a combination of various therapy strategies. A precise diagnosis and a person-centred approach are essential in addressing all other mental health challenges, which can help promote symptom management and better recovery.
Some of the most common mental health challenges that occur with BPD include:
- Anxiety disorders
- Eating disorders
- Depression
- Bipolar disorder
- Personality disorders
- Post-traumatic stress disorder
- Substance misuse
BPD and Self-harm
People with BPD often engage in self-harming behaviours like burning and cutting, as well as many other forms of self-destructive behaviours.
Self-harm is often used as a coping mechanism to manage negative emotions and stress. Understanding the connection between self-harm and BPD is essential for health professionals to provide the most effective strategies for treatment and help people find other ways of coping and managing their emotions.
BPD Meltdown
Borderline personality disorder can also lead to emotional meltdowns, which involve intense emotional reactions caused by rejection, abandonment or stress. During a meltdown, people may experience impulsivity, intense mood swings, and difficulty calming down.
Quiet BPD
Quiet borderline personality disorder is a sub-type of BPD, and most of the symptoms are known to manifest inward. On the contrary, borderline personality disorder manifests in symptoms such as anger, mostly towards others.
Quiet BPD is not an official diagnosis, but it refers to one of the subtypes of BPD. However, psychologists worldwide haven’t fully consented to the number of subtypes of personality disorders. Quiet BPD shares the same feelings of emotional instability in self-image and relationships, but people internalise these feelings rather than externalising them.
Treatment Options for BPD
How is borderline personality disorder treated? Treating borderline personality disorder is a complex process that requires multiple approaches to achieve the best outcomes, as well as support from a mental health professional.
Some of the treatment options for BPD include:
- Family Therapy
- Self-help strategies
- Lifestyle changes
- Supportive therapy
- Group therapy
- Psychotherapy
- Medication
The most prominent element when supporting people with BPD is advocating for acceptance and emotional comfort. Reducing the social stigma and increasing awareness around BPD is crucial in creating an inclusive community which will support people with mental health challenges.
Mental Health Support with Unique Community Services
At Unique Community Services, we deliver humanised care to people with BPD in their homes while empowering them to overcome challenges and help them reach their full potential.
Our highly skilled clinicians are constantly working to create a nurturing environment for people with BPD, and they always prioritise the independence of the people we support. We deliver CQC-regulated care for people with complex care needs, with offices in Bristol, Manchester and Leeds.
If you need more information on how we can support you, contact us today.
