*This page is for informational purposes only. Only your licensed mental health professional can confirm a diagnosis or offer treatment.
Borderline Personality Disorder can be summed up as a relationship disorder. BPD is the name for a mental illness that affects your relationships:
I’ll go into a lot more detail here, but that’s a good starting point.
LIFE WITH BORDERLINE PERSONALITY DISORDER
People with BPD feel empty all the time. You may refer to the feeling as depression, but it’s more persistent than typical depression and it doesn’t seem to ever stop.
Just like anyone would do, you try to make the feeling of emptiness go away, to fill the void, or at least distract yourself. One of the things that makes BPD different from depression is the lengths that people with BPD will go to feel better.
You’re willing to do just about anything to make the feeling of emptiness stop. You find new friendships and romantic partners; reinvent yourself by trying out new hobbies or new haircuts; seek out thrills like driving too fast or having sex with strangers; engage in addictive behaviors like drinking or gambling or shopping. But it never seems to work.
Instead, you feel more panicked and overwhelmed when it doesn’t work out. You’re angry at yourself for even trying. You believe that you’ll never feel better, and you don’t want to live like this.
SYMPTOMS OF BORDERLINE PERSONALITY DISORDER
A person with BPD typically experiences many of the following symptoms:
It’s important to note that no two people are alike. Even two people who have the same diagnosis might have completely different symptoms. And two people with the same symptoms might feel or act very differently.
WHAT CAUSES BORDERLINE PERSONALITY DISORDER?
The causes for BPD fall into two main categories: biological, and interpersonal. While no two people with BPD have the same history, most people with BPD share some common elements in their background.
Interpersonal factors in childhood:
The more we learn about human development, the more this becomes a “chicken or egg” type of question. Does trauma change the way a brain develops? (yes) Or do different types of brains process traumatic events differently? (also yes)
There is also a lot of overlap between symptoms of BPD and symptoms of Complex PTSD (CPTSD). It’s possible to have both, but it’s also possible to have one and not the other. Learn more about the differences and similarities here.
WHAT’S AN INVALIDATING ENVIRONMENT?
The invalidating environment is a unique predictor of BPD, meaning it is almost always found when we look into the histories of people with Borderline Personality Disorder. An invalidating environment occurs when you express your feeling or perception of events, and you are either ignored, punished, or mocked.
There are a couple different types of invalidation, and I’ll do my best to give examples of them.
No parent is perfect, of course. Everyone makes mistakes and occasionally hurts their child’s feelings. But if your caregivers consistently invalidate your experiences, you may grow up:
There are multiple therapies for treating Borderline Personality Disorder. The most common is DBT, or Dialectical Behavior Therapy, which is a skills-based therapy that teaches you how to manage strong emotions and work on relationship skills. I talk about DBT more below.
Therapy is all about building relationships. In fact, studies show that your relationship with your therapist is more important than your diagnosis or the type of treatment used.
This can be really frightening and frustrating for someone with BPD. After all, how do you treat a relationship disorder by building another relationship?
If you're doing it right, you won't always like your therapist. Your therapist should be gently pushing you outside of your comfort zone, and sometimes that will suck. But you should always trust your therapist.
HOW DOES THERAPY WORK FOR BPD?
Therapy helps you practice new skills for managing your own emotions, and skills for interacting with others. You practice them with your therapist, because there's really no downside - your therapist is not going to get angry at you or take offense if you aren't perfect. The more you practice, the more easily you'll see those skills apply outside of therapy, in your real life.
When treating BPD, the first goal is to address the symptoms that are putting you in the most danger. So if you're having suicidal thoughts, or self-harming, the first thing we will work on in therapy is how to minimize those feelings and urges.
The second goal is to develop coping skills that help you recognize your feelings while strengthening your relationships with yourself and others. The third goal is to put those skills into practice on a regular basis.
WHAT IS DBT?
DBT, or Dialectical Behavior Therapy, is a skills-based treatment proven effective for BPD. Research shows that the skills taught in DBT are the most important part of treatment. DBT skills help to relieve high-intensity symptoms like suicidal thoughts, self-harm, and impulsive behavior. When I work with people who have Borderline Personality Disorder, I incorporate DBT skills into the first several structured sessions to make sure you are getting the most benefit out of treatment.
HOW DO I FIND A THERAPIST TO TREAT BPD?
The first step in finding a therapist for any mental health treatment is to do a little research. Look into the various treatments available, and see which ones you think would work best for you. Then, look around for someone who offers BPD treatment. If you're using a database like Psychology Today or Therapy Den you can even sort by diagnosis, and only therapists who treat Borderline Personality Disorder will show up.
The next step is to talk to the therapist. Most therapists offer a free consultation where you can ask questions and see if they're the right fit. Ask them about their training, if they're trauma-informed, and how they approach treatment for Borderline Personality Disorder.