Like most personality disorders, borderline personality disorder is a profoundly misunderstood condition within many communities and populations.
You may wonder why such a stigma still exists, particularly in the developing world, where people can talk about their mental health much more freely than they could just a few decades ago.
However, despite improved research and mental health initiatives, including the emergence of social media platforms where people get to discuss their emotional challenges openly, we still have a long way to go.
What is borderline personality disorder?
People with borderline personality disorder (BPD) experience a cascade of emotions and symptoms associated with their condition, which they find difficult to control. It impacts the way they think and feel about themselves and others.
Various psychological theories posit that borderline personality disorder involves emotional and behavioural dysregulation components. (Linehan, 1993).
However, according to some researchers, the correlation between these two elements has remained vague and elusive.
In other words, BPD is a complex mental health disorder that impacts individuals across various life outcomes, including interpersonal relationships, self-identity, behaviour, and emotions.
Let’s look at some common characteristics associated with borderline personality disorder.
Borderline personality disorder traits
Borderline personality disorder is a severe mental health condition affecting around one to three per cent of the population.
According to the literature, approximately ten per cent of those in outpatient settings are diagnosed with BPD.
Often considered a ‘disorder of dysregulation’, borderline personality disorder is one of the most commonly diagnosed mental health disorders clinically.
Traits
Emotional dysregulation is a core hallmark observed in BPD patients.
Those with borderline personality disorder may have issues controlling their emotions and behaviours to the extent that they cannot pursue personal goals or aspirations.
In addition, they may find that they cannot function or behave effectively in various settings, social or otherwise.
Emotional dysregulation in BPD patients
Some researchers define emotional dysregulation as ‘the inability to respond to and flexibly manage emotions.’ (Components of emotion dysregulation in borderline personality disorder: a review, National Library of Medicine, Ryan W. Carpenter and Timothy J. Trull)
People with BPD frequently experience intense negative emotions that can leave them feeling profoundly vulnerable.
These vulnerabilities can lead to a range of adverse coping mechanisms, including:
- Self-harm or self-injurious behaviours
- Suicidal ideation
- Substance abuse
Emotional sensitivity
Shaking off negative emotions is not a simple process for those with BPD.
For example, imagine a person’s car breaks down on the motorway or they misplace their house keys. These are painfully common occurrences that we’re all likely to face at some point but rarely do we take them personally.
However, such events can create a cascade of negative emotions for those with BPD – including anger, fear, and aggression.
Practical therapeutic approaches to treating borderline personality disorder
Researchers report that cognitive therapies such as cognitive behavioural therapy and dialectical behaviour therapy can effectively treat BPD patients.
As well as other factors, cognitive therapies focus on teaching emotion regulation skills to patients who missed out on this vital learning in childhood for whatever reason.
Emotional regulation skills are not something we are naturally born with; these are learned skills.
However, if, for whatever reason, children are not taught how to regulate themselves by their parents or caregivers, they will continue to experience emotion regulation problems in adulthood.
Emotion regulation skills
Linehan’s biosocial theory suggests that those with borderline personality disorder are sensitive from birth.
But what does all this mean?
Experiencing emotions at a more profound, accelerated level can make it significantly challenging for people to control their feelings and behaviours in various contexts.
Linehan reported that increased sensitivity in BPD patients could lead to various complications and adverse effects within many situations and contexts, impacting a person’s ability to learn practical regulation skills.
Emotional dysregulation symptoms
It might make more sense to explain what emotion regulation is rather than what it isn’t.
For example, those with healthy emotion regulation skills respond constructively to distress, which can look like this:
- Behaving and reacting appropriately when stressed
- Recognising, understanding, and accepting emotional experiences
- Engaging in healthy strategies to manage distressing or highly-charged emotions
Borderline personality disorder symptoms
Those with borderline personality disorder experience intense emotions and have trouble regulating how they feel; one of the core features of BPD is emotional dysregulation, which can cause various challenges for the individual, including:
- Disturbed patterns of thinking or perception
- Impulsive or risky behaviours, such as substance abuse, unsafe sex, or reckless driving
- Problematic or intense but unstable relationships with others
- Stress-related changes in behaviour and thinking
Another key symptom of BPD is emotional instability, which is part of the diagnostic criteria for this condition.
What are the risk factors associated with borderline personality disorder?
As mentioned, emotion regulation is a learned skill that develops during childhood.
However, early trauma or other adverse childhood experiences can disrupt the learning and developmental process, resulting in the individual learning unhelpful coping methods.
For example, in times of distress, a person may resort to destructive behaviours, including violence, aggression, self-harm, or other reckless behaviours.
Unfortunately, the strategies adopted by children who grew up in healthy environments are markedly different from those with a history of trauma or other adverse experiences.
Children who were taught to self-soothe when distressed experience significantly fewer emotional and social problems than those who were not taught these essential skills.
Common risk factors
In our experience, various factors contribute to the development of mental health disorders such as borderline personality disorder and emotional dysregulation, including:
- Changes in brain structure
- Childhood trauma
- Abusive or neglectful parents
- Problems with developing secure parental attachments
The link between dysregulation and borderline personality disorder
Studies show a significant link between emotional dysregulation and borderline personality disorder.
The inability to control or regulate emotions is a prevalent symptom of BPD, with studies showing critical differences in brain activity between BPD patients and control groups.
For instance, a study published by Biological Psychiatry examined data from 154 BPD patients and 150 control participants.
The researchers found significant differences in brain activity patterns in those with BPD (compared to control groups), which may explain the intense and unstable emotional experiences associated with borderline personality disorder. (Doctor Anthony Ruocco, et al., University of Toronto.)
Complications
You may face various challenges and complications if you have BPD.
The symptoms associated with BPD can create an avalanche of challenges and complications across various life outcomes.
Let’s look at some of these issues in more detail.
Borderline personality disorder: a misunderstood condition
Since borderline personality disorder is a complex condition frequently misunderstood by those outside the clinical community, living with BPD can present various challenges that only professionals can fully understand.
However, awareness of these issues can significantly benefit those with BPD and their loved ones.
If you have BPD, you are likely familiar with most of the symptoms, including the inability to control your anger, rage, or disappointment and profound difficulties in coping with all of the above.
But all this says nothing about the complications such symptoms can present.
Let’s explore these further.
Problems regulating anger
When emotions are felt to the extreme, your responses are likely to match this intensity. For instance, profound mood swings are usually accompanied by intense bursts of anger that occur seemingly out of the blue.
All this brings us back to Linehan’s point on sensitivity, where BPD patients experience emotions to the extreme.
For example, constructive feedback from a well-meaning co-worker or loved one may spark intense rage or anger in those with BPD, leading to destructive coping strategies such as self-harm or substance use.
Intense mood swings and agitation
Common symptoms of BPD include intense mood swings and severe irritation.
Those with BPD often experience difficulties managing moods and expressing emotions, which may cause extreme anxiety and agitation.
Interpersonal relationship problems, self-identity issues, and problems at work are just some of the complications BPD patients face due to their condition.
Fear of abandonment
Fear of rejection or abandonment is a prevalent feature of BPD.
Individuals with BPD often fear they are being rejected by others or will be abandoned at some stage.
The above can lead to specific, unhelpful behaviours, including clinginess, constantly seeking reassurance, or pushing other people away to avoid future rejection or abandonment.
Unfortunately, many of these behaviours can result in chaotic or unstable relationships. In addition, the inability to regulate emotions can exacerbate underlying relationship issues.
For instance, a person may seek constant reassurance or push others away, leading to their worst fears coming true (in this case, rejection or abandonment).
Finding recovery
Fortunately, there are various ways that those with BPD can find recovery.
Treatments such as cognitive behavioural therapy and dialectical behaviour therapy can help if you struggle with emotional regulation or borderline personality disorder.
Finding recovery at Centres for Health and Healing
Studies show dialectical behaviour therapy (DBT) can effectively treat borderline personality disorder.
At Centres for Health and Healing, we use an individualised treatment approach to treating various addictions and mental health disorders, including borderline personality disorder.
We provide dialectical behaviour therapy to patients with various mental health issues, including depression, substance use disorder, and BPD.
DBT aims to promote a healthy balance and avoid the all-or-nothing-thinking patterns common in individuals with personality disorders and other mental health issues typically arising from intense emotions.
Our dialectical behaviour therapy program focuses on several essential components that help address the complex challenges that BPD patients commonly face, including:
- Core mindfulness
- Distress tolerance
- Emotional regulation skills
- Interpersonal effectiveness
Living with borderline personality disorder can be profoundly challenging. However, specific treatments can help you manage your symptoms and improve your overall well-being.
Contact our treatment centre in Toronto for further support and information.
