Navigating Borderline Personality Disorder (BPD)

What is Borderline Personality Disorder? 

BPD involves experiencing persistent feelings of loneliness and fear of abandonment. Symptoms of BPD include heightened anger, anxiety and depression, coupled with struggles related to self-image and identity. Without proper management and support, daily functioning and relationships can be significantly affected. In addition, people with Borderline Personality Disorder are more likely to experience suicidal ideation or engage in self-harm.

Impact on Daily Life

Borderline Personality Disorder impacts various facets of personal life, presenting challenges such as:

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  Feelings of loneliness and fear of abandonment: Individuals with BPD struggle with chronic feelings of loneliness and a genuine fear of being abandoned by important people in their lives, which can amplify distress reactions.
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  Difficulty Managing Emotions: It can be extremely challenging to cope with distress and manage emotional triggers. This struggle can lead to intense bouts of anger, depression, or anxiety.
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  Stigma: People with BPD have described experiences of feeling stigmatized within the medical field or feel that there is stigma attached to BPD in general. Stigma contributes to feelings of shame, diminished self-confidence and reduces a sense of acceptance.
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  Relationship Challenges: Intensified emotions can translate into defensive reactions and emotionally volatile behaviour, which can foster a pattern of instability in relationships. Individuals with BPD tend to view things as ‘black or white’, leading to rapidly changing perceptions about relationships.
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  Risk of Harm & Impulsivity: People with Borderline Personality Disorder act impulsively, which can include engaging in high risk behaviours that pose potential harm to themselves. People with BPD are also more likely to experience suicidal thoughts, suicide attempts and/or self-harm.
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  Feeling ‘Stuck’: It is common for people with BPD to have experiences of being in and out of the hospital, receiving a misdiagnosis, or experience disconnection with professionals they have worked with, contributing to a sense of being stuck in their struggles.

Strategies & Coping Mechanisms

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  Seek Support: Finding the right professional to work with is essential. There are specific therapy approaches, like Dialectical Behavioural Therapy (DBT), that are designed for BPD. Attending psychotherapy with a trusted professional can improve coping strategies and guide the establishment of healthy personal and relationship dynamics.
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  Education & Awareness: Individuals with BPD, who often feel very disconnected from themselves and others, can benefit from developing a greater awareness of thoughts and emotions. Increased information and understanding can improve one’s sense of control, sense of self, and coping strategies. This can be achieved through working with a professional or accessing available resources.
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  Engage in Meaningful Activities: “Meaningful” activities will look different for every person, varying from working to meditation. Meaningful activities provide a sense of belonging and connectedness which allows for self-exploration and reflection.

Understanding the Diagnosis Process

A diagnosis can be helpful for people who believe they have BPD and have difficulty managing symptoms on their own. However, a diagnosis is not mandatory to seek mental health support related to Borderline Personality Disorder. It is important to determine if pursuing a diagnosis aligns with your mental health needs.The diagnostic process requires people to share emotions, thoughts, reactions and sometimes challenging life experiences. Making an informed decision about pursuing a diagnosis is essential.

Benefits of a Borderline Personality Disorder Diagnosis?

For those grappling with BPD, a diagnosis can sometimes be a helpful step toward mental health management. Benefits of pursuing a diagnosis include:

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  Accessing Appropriate Support: A formal diagnosis will provide an avenue to the proper support systems, including therapists who specialize in working with the BPD population and the exploration of specific medication options.
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  Improved Symptom Understanding: A diagnosis can foster an increased understanding and awareness of BPD symptoms increasing one’s ability to manage triggers and symptoms or provide direction in seeking support. This can be a validating experience and help people to conceptualize their experience and acknowledge the need for support.
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  Increased Safety & Support: With a BPD diagnosis, people can access additional support which can increase safety and assist in talking with loved ones about BPD.
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  Tailored Therapeutic Interventions: A formal diagnosis will act as a guide for providers in designing a specific treatment plan. This ensures you are receiving the proper support and guidance based on your specific needs.
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  Consideration of medications: The decision to utilize medication is a personal choice and should be discussed in detail with your Physician or Psychiatrist. However, having a diagnosis can assist you in facilitating the discussion with your health care provider about the right medication for managing symptoms.

What to Expect in the Diagnostic Process  

Obtaining a BPD diagnosis involves providing in-depth information related to emotional management, daily mental health challenges and relationship patterns. Key components of the diagnostic process include:

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  Assessment: An initial meeting with a qualified mental health professional (typically a psychologist or psychiatrist) to discuss symptoms of Borderline Personality Disorder, history and experiences.
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  Clinical Interview: As follow up to the assessment, the clinical interview is an in-depth discussion delving more into thoughts, emotions, behaviours, and the impact of BPD symptoms in your life.
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  Psychometric Testing: Some providers will also use standardized questionnaires as an additional tool of the assessment process, referred to as ‘psychometrics’. The questionnaires are used to gather specific information about symptoms of Borderline Personality Disorder that cannot always be clearly expressed during the assessment or interview.
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  Borderline Personality Disorder and the DSM-5: All diagnoses are made based on specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The assessing professional compares your information and symptoms against a checklist of criteria outlined in the DSM-5. The criteria in DSM-5 for BPD is related to emotional management and reactivity, impulsivity, relationship patterns, and suicidal ideation or self harm.
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  Collaboration: The diagnostic process should be a collaborative approach. It is okay to express your thoughts, ask questions, and advocate if you disagree with something that is being proposed. Upon receiving a diagnosis, you should be provided with proper information and resources.

Preparing for Therapy Services or Diagnosis:  

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  Request a consultation: If possible, research and consult with a few different mental health professionals, specifically those experienced in working with Borderline Personality Disorder. Determining who you feel most confident in and who you feel most comfortable with is part of making an informed decision about services.
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  Take your Time & Ask Questions: Feeling nervous while discussing vulnerable topics is quite normal, so take your time when answering the questions. If at any point you are uncertain about the purpose of a question or how the information will be used, you have every right to seek clarification, and should expect to receive a reasonable response.
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  Be Patient & Advocate for Yourself: Diagnosing BPD can be complex as there are overlapping symptoms with several other mental health diagnoses. Assessments can take some time or require a few sessions. Take your time in selecting the right professional to work with and if you disagree with a diagnosis, it is important to voice your concerns.

Conclusion

Seeking the right support for Borderline Personality Disorder can be a constructive step in effectively managing your mental health. Psychotherapy and/or diagnosis can provide people with an opportunity for increased understanding of self and access to appropriate support and treatment for Borderline Personality Disorder, leading to improved coping skills and emotional regulation strategies. If you are wondering whether you or someone you know may be struggling with BPD, don't hesitate to reach out to a mental health professional for guidance and support.

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