What is BPD or Borderline Personality Disorder? A handy guide for my community:
Typically the major symptom is emotional dysregulation - which means feeling emotions at 150%-200%. Yet paradoxically, folk with BPD struggle to define the feelings they are feeling. Also typical - complete lack of self worth. Worthlessness. What could cause this?
It's a chronic trauma response. Chronic childhood trauma usually with parents either absent or ill equipped to support their child. Sexual abuse is a common occurrence. This can lead to a child developing a heightened sense of parent's/carer's emotions to avoid negative consequences - becoming the "empath".
Diagnosis is typically a long road - the industry avoids these people and will go so far as to avoid mentioning traits in notes in an effort to shield the patient from the stigma - ultimately unhelpful. BPD folk like to 'woo' healthcare providers as another major symptom is...
Abandonment issues. Everybody leaves and the cycle feeds into itself. Self isolating to avoid losing more people. No self worth so no reason to think you're worthy of support. This is why BPD has one of the highest suicide rates 12-15% suicide with the remainder contemplating it because they see their mental health condition as the cause, not the response.
In recent years C-PTSD has become a popular patsy to side step this stigma (and believe me, there are few things in this world stigmatised as BPD) but unfortunately C-PTSD doesn't capture the scope of BPD.
Other common traits:
- rage (if not outward then directed inward, also not necessarily constant)
- substance abuse to manage symptoms
- dialectical (black & white) thinking (technically defined as an inability to hold opposing truths or, to live in the grey area)
- unstable relationships
- impulsivity
- dissociation (zoning out or going numb to escape -this is the antipode of emotional dysregulation, I call it the logic prison and believe this is where most severe self damage occurs in BPD)
- common comorbid eating disorders (a range of these, anorexia/bulemia/orthorexia - it's about control mixed with worthlessness and self harm)
- self harming behaviours (very large range of these that are very confronting to people around us)
Other features:
- nuerodivirgent foundation (autism, ADHD, OCD)
- 4-6% of population affected
- commonly diagnosed in women but gender split is 50/50 (there are more than two genders though), men are usually forcibly diagnosed after institutionalisation or incarceration)
- 75% identify as queer ( BPD and how to support it needs to become common knowledge health literacy in the queer community)
- high tolerance to acute pain (especially self inflicted), very low tolerance to chronic pain, both physical and emotional
- dysregulation of pain (experienced like an emotion)
- a chaotic inner dialogue and an inability to process uncomfortable emotions
More:
- hyper fixation on "favourite persons" especially an inability to define our self without others and frantic efforts to avoid losing them
- "splitting" behaviour ie. switching from worship to derision & often back again (creating unstable relationships) usually due to conflict but sometimes due to delusion/confusion/double empathy problem
- meltdowns in which mental processing is severely compromised (I call it the bottleneck)
- known as the most painful mental illness
- exceptionally poorly understood by society & the mental health industry despite being more common than other well known mental illnesses
- social chameleons often viewed as manipulative (due to that abandonment fear)
- maladaptive behaviour ie. response to issues that create further problems due to an inability addressing issues that create uncomfortable emotions
- likely common in self-identifying alcoholics
- unmanageable intrusive thoughts
- commonly hereditary and commonly due to mentally ill parenting
A pervasive common experience is a lack of boundaries. It's not that we don't have them more that we never developed them due to grooming behaviour from carers. Poor boundaries regarding everything, very poor response when folk don't reciprocate with low boundaries. Getting better is about developing solid personal boundaries (around a stable sense of self).
Diagnosis of BPD revolves around the 9 defining traits of BPD in the DSM. This is done by psychiatrists. If you tick 5 boxes or more, you will be given the diagnosis. This leads to healthcare treating your condition as black & white (the irony) depending on how you report or observation of you (OBJECTIVE). After you have the label healthcare services will be wary of you (someone that is in desperate need of consistent healthcare to recover).
Severe empathy leads to higher frequency of these people in helping professions (if not disabled by it). It's not considered a disability or disease but an affliction that is a personal responsibility. Shortened life span and decrease in quality of life due to all of the above mentioned.
How to fix it: begin to develop a sense of self. Learn to create foundations that never existed. Learn what the criteria from the DSM-V are and how it applies to you but recognise this as a response, not a foundation. Develop skills from Dialectical Behaviour Therapy (DBT - yet be aware of the similarities to ABA or Applied Behavioral Therapy). Attempt to learn about sobriety and start to manage your comorbid conditions. Reach out for support services, use everything you can access. Create art. Create LOTS of art.
Art is play. Art is self expression. When you develop an art practice you create an avenue for flow, flow is healing.
Ultimately, be kind to yourself. Learn to be kind to yourself. Shift your self talk, no more self disparaging inner monologue. Begin to develop radical self acceptance & see that emotions are a construct of experience. Neural networks are highly established from a life of trauma & forging new ones takes time & reinforcement. Again RADICAL self acceptance. You're allowed to fuck this up, you will fuck this up, repeatedly. The objective here is not to erase this part of you but to learn to hold it with love and move forwards. You're trauma responses are valid.
A common problem is creating an identity out of the diagnosis. Diagnosis exists in the medical world to create a treatment protocol but giving someone without a sense of identity a pathology usually leads to attaching to it, the ultimate self fulfilling prophecy. You might have BPD but you are not BPD itself. That part of your picture is blank for now and you get to colour it in with what is truly authentic to who you are.
What helped me? Seeing others that had what I have. Recognising my empathy for them and realising I am equally worth that kindness, especially to my self. Deciding to cut out the people who can't or don't support you the way you need. Stop being there for them. You have to stop letting people hurt you so they won't leave. You have to stop engaging with people that don't respect your sense of self or constantly use you for their own validation. You only liked them because you saw yourself in them (literally) because you don't have your own sense of self. If they are someone you can't leave behind you need to start learning about attachment styles and tell them to concurrently heal with you. If they care, they'll listen.
If you can, access therapy that understands what BPD actually is. This is very hard to find, many people can't comprehend the scope of BPD to provide effective care. Meltdowns and rage burn bridges quickly and effectively. Just remember, you learned this, how to react like this. It was created in you, not by you. It is not you.
I changed my name. I caught the ball that my parents dropped and made the game my own. My rules. My boundaries. My self worth.
There's so much more to all of this but I couldn't have got to where I am without first understanding what I've shared. The truth is, I'm autistic with a ton of chronic trauma. This isn't recognised by the healthcare industry. I hope the autistic community can recognise this type of neurodivergence and that its misunderstanding is the foundation of so much darkness in the world.
People with BPD are fallen angels. In the darkness we only forwards our trauma but when we find the light, holy shit we get shiny.
#BPD #borderlinepersonalitydisorder