Borderline personality disorder
Borderline personality disorder (DBP) gives the sufferer the feeling of being 'on a roller coaster'. Extreme sensitivity can trigger intense reactions (such as saying hurtful things or acting dangerously, impulsively or inappropriately) following which it is very difficult to regain composure and which are often accompanied by feelings of guilt, embarrassment and shame.
What is borderline personality disorder?
Borderline personality disorder is characterised by a high degree of instability in interpersonal relationships, self-image and mood, but also by a pronounced impulsiveness that begins within early adulthood and manifests itself in various contexts.
Underlying the disorder appears to be a combination of hereditary or internal biological factors and external environmental factors, such as traumatic experiences during childhood.
Symptoms of borderline personality disorder
The symptoms of DBP can manifest themselves in different ways, but the ones that most characterise it are:
- Fear of abandonment: terror of being abandoned or left alone. Even harmless things like coming home late from work or going away for the weekend can generate intense fear. This is why people try to avoid these situations and make incredible efforts to keep the other person close.
- Unstable relationships: intense, short-lived relationships. They fall in love quickly, invest in the relationship and the other person, only to be quickly disappointed. Relationships are experienced as either perfect or horrible, with no nuances in between.
- Unclear or unstable self-image: The sense of self is typically unstable. Sometimes one feels good about oneself, but at other times one hates oneself. One does not have a clear idea of who one is or what one wants from life. As a result, one often changes jobs, friends, lovers, religion, values, goals, and even sexual identity.
- Self-destructive impulsive behaviour: harmful, impulsive behaviour in pursuit of strong emotions and feelings. One may go on shopping sprees, eat compulsively, drive recklessly, steal, have risky sex, or overdo drugs or alcohol. These dangerous behaviours help you feel better in the moment, but in the long run they can be a problem.
- Self-harm: suicidal ideation, suicide attempts and self-harm. Sufferers of DBP may think about suicide, attempt suicide, threaten to commit suicide or actually attempt suicide. Acts of self-harm include all those behaviours that may cause harm (cuts and burns) without suicidal intent.
- Extreme mood swings: emotionally unstable. They go from being happy to feeling discouraged in the 'blink of an eye'. Although mood swings are intense, they resolve fairly quickly, usually within a few minutes to a few hours.
- Chronic feelings of emptiness: a sense of 'emptiness' and discomfort, which one tries to fill through drugs, food or sex. But nothing is really satisfying.
- Anger outbursts: intense anger, inability to control oneself, shouting and throwing objects. Such anger, however, is not always outwardly directed. In fact, it may be self-directed and one may spend a lot of time angry at oneself.
- Paranoia and loss of contact with reality: paranoia, suspiciousness and lack of trust in others. When under stress, they may lose contact with reality, and thus feel foggy, distanced, or out of touch.
How can we help you?
It is important to remember that it is not possible to diagnose borderline personality disorder (DBP) on one's own and that it is always a good idea to consult a mental health professional in order to receive an accurate diagnosis.
Psychotherapy is indicated as the first treatment for DBP. For it to be effective in alleviating symptoms, it is essential to rely on one's therapist, but this is often difficult for sufferers of this disorder.
Cognitive behavioural therapy (CBT) is the treatment of choice. It helps to identify and modify erroneous beliefs and/or dysfunctional behaviours that condition the emotional experiences, self-concept and relationships with others of people with DBP. TCC contributes to the reduction of symptoms such as mood swings, anxiety, suicidal behaviour and self-injurious behaviour.
TCC, however, also makes use of the dialectical behavioural therapy (DBT) which aims to stabilise the patient and help them develop self-control skills. Through Mindfulness and present-moment awareness, it teaches how to regulate intense emotions, reduce self-destructive behaviour, manage stress and improve interpersonal relationships.
In addition to DBT, the Schema Therapy. This type of therapy combines elements of TCC with other forms of psychotherapy and is based on the idea that each of us has basic needs that require satisfaction. If, in the growing environment, such satisfaction is lacking, then one may experience a state of frustration that contributes to the construction of a negative view of oneself and others. Thus, what are called Precocious Maladaptive Patterns are structured, which condition relational and emotional development over time.
Finally, psychotherapy is often accompanied by drug therapy, which is unlikely to be decisive. In fact, no specific drugs have yet been approved for DBP. However, mood stabilisers may be prescribed to reduce anxiety, aggression and impulsivity, as well as emotional dysregulation.