What is Borderline Personality Disorder?

Borderline Personality Disorder (BPD), is a problem. There is nothing glamorous about it, yet there is nothing fearful about it either. It is a mental disorder that responds to treatment, mainly psychotherapy. There is a huge difference between mild and moderate and severe borderline personality disorder and it is associated with a high suicide rate. 

To understand it, you’ll have to know what a personality is and how it develops, and what can go wrong. People with BPD are battling a condition, like a broken leg, diabetes or depression, but because the symptoms are in the getting-along-with-people area, it is highly stigmatized.

What is a personality?

We cannot see a personality. It’s basically a stable and enduring unique pattern of thinking, feeling, behaving, and relating to self, others and the world. Our personality is a mask we show the world; the way we relate and resonate with others.

What goes to make up a personality?

1. Things that you are born with: characteristics of your body, your intelligence, and mannerisms from your parents (he thinks like his grandfather, she is shy like her mother).

2. Things experience in life: love and nurture from your parents, things you learn at school, traumatic and good experiences, how you respond to them, the values you are taught, and the influence of the society around you.

These, together with things we may not understand, make up your personality.

How does a personality develop?

Life lessons, events, values and your reactions get added to what you were born with. Little by little your personality grows. It develops normally if things that you inherited are healthy, you received love and nurturing, and you handle good and bad experiences of life reasonably well. A personality is developed by 18-25. At this age or a little before, a personality disorder is noticed.

What goes wrong?

None of us have a perfect personality as none of us had a perfect childhood. People with borderline may have been born with a heightened fear and anger response in the brain’s amygdala, the brain may process chemicals differently, we don’t know. We do know that trauma, particularly early, is not good news: abuses, loss of carers, lack of love, and so forth. We know that love protects against the effects of trauma. People born with a vulnerability who experience trauma are at the highest risk of developing BPD or other mental conditions.

What does “borderline” really mean?

The term “borderline” originated with Dr. Adolf Stern.[i]  He saw that some people didn’t fit into the 1930s classification of being either neurotic (having an understandable illness like anxiety or depression) or psychotic (having a harder-to-understand illness like schizophrenia). They were on the borderline: understandable in some things like feeling anxious, but doing un-understandable things like self-cutting. In the 1960s, Otto Kernberg talked about a Borderline Personality Organization. It became an official diagnosis in 1980.

What are the features of borderline?

The main feature of BPD is instability: in mood, relationships and how the person sees themselves. Other features include difficulty controlling anger, fear of being alone or abandoned, feeling empty, engaging in risk-taking behaviour, self-harming, and being suicidal at times.

Not all people with BPD self-harm and self-harming doesn’t always mean BPD. Most people who self-harm do not have borderline, but most people who have borderline self-harm.

People battling borderline are as intelligent, interesting, talented, diligent and enterprising as the rest of us, and include many high profile people, including doctors and lawyers I’ve treated for the condition.

The instability is the result of trauma, lack of stable nurturing, and over-reactive stress responses. Now everyone seems threatening to them, yet the person is trying to get love just like anyone. Some studies say BPD occurs almost equally in males and females, but this is controversial, clinically it is diagnosed in females much more.

Why so much stigma?

The symptoms of borderline are in the getting-along-with-people area, so many people can inadvertently get hurt by someone’s borderline behaviour. Beneath the disorder, however, is a wonderful person wanting a decent life. Encourage them on their wellness journey as much as you can.

[i] Gunderson, John G. Borderline personality disorder: A clinical guide. American Psychiatric Pub, 2009. Page 1.