Part I: The Profile
Borderline Personality Disorder is a mental illness characterized by emotional intensity, volatility, and an unstable sense of self. The symptoms of the disorder are often the result of frantic attempts to regulate the extreme emotions experienced by a person with BPD—no matter the cost. These attempts manifest themselves in impulsive behavior (excessive spending, unprotected sex, substance abuse, reckless driving, binge eating etc.), splitting,(idealization of a person followed by devaluation), recurrent suicidal behavior, gestures or threats, and self-injurious behavior. While these maladaptive patterns of behavior usually serve their intended purpose for someone suffering with BPD, they oftentimes come at the expense of ruining interpersonal relationships by hurting others and themselves.
I was diagnosed with BPD at around nineteen years old. Prior to my official diagnosis, I was diagnosed with Major Depressive Disorder and had already racked up a couple of hospital stays from a suicide attempt at seventeen and severe suicidal ideation the following year. Treatment for my depression was mildly successful. I was on a concoction of meds that turned me into a zombie and more or less inhibited my ability to feel, but even they couldn’t stop my mood swings from wreaking havoc from time to time. After a while, my diagnosis just didn’t seem to fit anymore, and after coming across an article about Borderline Personality Disorder I decided it was time to bring it up to my psychiatrist.
I’ve always been intimidated by my psychiatrist, even though he’s a perfectly nice guy and has been an integral part of my recovery. Most of my appointments consisted of us exchanging polite pleasantries, him writing me a prescription for new meds, and him sending me on my way after five minutes. It took me a while to say the words “I think I have
Borderline Personality Disorder”, but I did and much to my surprise he validated my concerns and added it to my chart. When I asked him why he never formally diagnosed me he said it was because diagnosis isn’t that important since many symptoms overlap, and that Borderline Personality Disorder is a big label to have—it will stick with you forever.
Borderline Personality Disorder is highly stigmatized and people with BPD are often demonized in the media, online, and even by clinicians(some will refuse to treat someone on diagnosis alone). I remember sitting in my psychology class as an undergrad and anytime there was even a mention of BPD, many of my classmates would have a story or two about how someone they knew with BPD was an emotional wreck , couldn’t “get over” anything that happened to them, and would purposely seek to destroy other peoples lives for the fun of it.
Out of all the mental illnesses we discussed in that class many people said they wouldn’t want to work with a borderline client. It took everything I had not to call them out and storm out of the lecture hall. One Google search and you’ll see people telling others to stay away from all people with BPD and that anyone with the disorder will ruin your life. Movies and tv exaggerate the experience and showcase the worst and most destructive parts of it, without really getting into the causes and internal experiences of those with the disorder. While some of the criticism is valid, it is important to note that everyone diagnosed with Borderline Personality Disorder is different, and no two borderline experiences are the same. Like with all mental illnesses the biggest difference in prognosis is if someone is willing and ready to seek treatment and if they stick to it. However, that can be difficult to do.
Most people are aware of the borderlines who act out their emotional pain onto others, but few are aware of borderlines who act in and turn their emotional pain onto themselves. While not widely discussed, there are four subtypes of BPD: impulsive, petulant, discouraged, self-destructive. The symptoms of each manifest themselves differently. Impulsive borderlines tend to bore easily and are thrill-seekers. Petulant borderlines anger easily and are afraid of being rejected and abandoned, and feel that they are unworthy. Discouraged borderlines are dependent and are often rely on others to get their needs met. They often struggle with chronic feelings of emptiness and are unable to be alone. Self-destructive borderlines struggle with bitterness and hating themselves. They are high strung, often engage in self-injurious behavior, and are likely to have a comorbid condition such as an eating disorder or substance abuse disorder.
I am a “quiet” borderline and fall between being discouraged and self-destructive. While I do have the thoughts that usually accompany the behaviors of the other sub-types, I rarely act on them and instead turn my emotional experiences inward. As a result, I feel empty, alone, misunderstood and envious towards those who are able to express their feelings outwardly. I struggle with feeling invalidated and that my symptoms aren’t severe enough to warrant help. This often leads me to sabotage progress with current goals, isolate myself from friends and family, and not seek out treatment when I feel that I need it.
This is the first part of a 3-part series. The next post will cover "My Early Experiences in Navigating the World With BPD".