Understanding Borderline Personality Disorder (BPD)

By Kaley Barnhill

Kaley is member of the GLPG marketing team and a contributor to the Current.

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Have you ever felt like your emotions are constantly swinging from one extreme to another, making it difficult for you to maintain stable relationships or a consistent sense of self? If so, you’re not be alone. Borderline Personality Disorder (BPD) is a mental health condition that affects millions of people worldwide, often leaving them feeling misunderstood and overwhelmed. By understanding Borderline Personality Disorder (BPD), you can take steps towards managing it effectively and improving your quality of life.

“BPD is not about seeking attention or being manipulative; it’s a real struggle with emotional regulation and stability.” — Dr. Marsha Linehan, creator of Dialectical Behavior Therapy (DBT)

In this article, we’ll explore the key symptoms of BPD, discuss effective treatments such as DBT, shed light on the lesser-known “quiet BPD,” and provide practical tools for managing symptoms outside of therapy. Understanding BPD starts with the right information, so let’s dive in.

Understanding Borderline Personality Disorder (BPD) & Its Effects

Borderline Personality Disorder (BPD) is a complex and often misunderstood mental health condition. Characterized by pervasive instability in moods, self-image, and interpersonal relationships, BPD can make daily functioning challenging. Individuals with BPD may experience intense episodes of anger, depression, and anxiety that can last anywhere from a few hours to a few days. 1.6% of the general population is estimated to have Borderline Personality Disorder.

Genetic, environmental, and social factors all contribute to the development of BPD. One of the hallmark symptoms of BPD is the fear of abandonment, which often leads to frantic efforts to avoid real or imagined separation or rejection. This fear can manifest in various ways, including overly dependent behavior or sudden and intense anger at perceived slights or separations. Additionally, relationships with people with BPD tend to be unstable, swinging between extremes of idealization and devaluation, a phenomenon often referred to as “splitting.”

Other common symptoms include a distorted and unstable self-image, chronic feelings of emptiness, and impulsive behaviors that can be self-damaging, such as substance abuse, reckless driving, or binge eating. Self-harm and suicidal tendencies are also severe concerns associated with BPD. Mood swings are frequent and can be triggered by everyday events, making emotional regulation a pivotal challenge for those affected.

These symptoms tend to appear in early adulthood but can emerge during adolescence. The intensity of the symptoms may fluctuate over time, with some individuals experiencing more severe impairments during periods of high stress or relational difficulties. Understanding and recognizing these signs are crucial steps in seeking appropriate treatment and support for those living with BPD.

What are the main symptoms of Borderline Personality Disorder?

People with Borderline Personality Disorder (BPD) often experience intense and unstable emotions that can change rapidly. These emotional shifts can make managing everyday life as well as relationships particularly challenging. Early childhood trauma, such as abuse or neglect, is a significant risk factor for developing BPD and BPD often co-occurs with other mental health disorders, such as depression, anxiety disorders, substance abuse, and eating disorders.

Additionally, individuals with BPD may exhibit patterns of unstable and intense interpersonal relationships. You might view others in all-or-nothing terms, alternating between idealization and devaluation, which can create a cycle of dependency and conflict. This phenomenon is sometimes referred to as “splitting.”

Another significant symptom is an unstable self-image or sense of self. If you have BPD, you may often struggle with feelings of emptiness and may frequently change your sense of who you are. This can lead to impulsive behaviors such as substance abuse, binge eating, or reckless driving, as a way to fill the void or cope with your ever-changing emotional landscape.

Fear of abandonment is another hallmark of BPD. The intense fear that people you care about will leave you can lead to frantic efforts to avoid real or imagined abandonment. These efforts can sometimes manifest in behaviors that may seem irrational to others, such as clinging, outbursts of anger, or even threats of self-harm.

Individuals with BPD may engage in self-destructive behaviors, including cutting, burning, or other forms of self-injury. This is often a way to cope with emotional pain or to feel some form of control over their turmoil. Those with BPD may also experience suicidal ideation and even make attempts. If you or someone you love is experiencing this, please reach out for help immediately, at 988 or visit 988lifeline.org.

Furthermore, those with BPD might experience periods of paranoia or dissociation, especially during times of stress. These episodes can make it challenging to distinguish between reality and your fears or emotions, which can further complicate your relationships and daily functioning.

What is Quiet BPD?

Quiet BPD, also known as “high-functioning” borderline personality disorder, is a sub-type of BPD where those experiencing it  exhibit the intense internal turmoil associated with the disorder without the more outwardly dramatic behaviors. Unlike traditional BPD, people with Quiet BPD might not lash out or display their distress in visible ways. Instead, you internalize your struggles, leading to silent suffering that may be just as intense.

In Quiet BPD, the signs can be much more subtle. You might find yourself grappling with mood swings, a chronic sense of emptiness, and intense emotional reactions, but keeping these emotions bottled up. This can make it challenging for others to recognize that you are struggling, often leading to misunderstandings and feelings of isolation. You might also engage in self-destructive behaviors that aren’t immediately apparent, such as self-harm in less visible areas or substance misuse.

If you suspect that you or someone you care about might have Quiet BPD, it’s important to seek professional help. Treatment can provide much-needed support and understanding, helping to manage symptoms and improve quality of life.

Identifying Quiet BPD Symptoms

Unlike traditional BPD, where emotional volatility is outwardly visible, Quiet BPD tends to manifest internally. If you have Quiet BPD, you might find yourself suppressing your intense emotions, leading to significant inner turmoil. Here are some signs that could indicate Quiet BPD:

• Internalized Emotions: While you may appear calm on the outside, inside, you might be experiencing intense emotional pain and turmoil.
• Self-Isolation: You might withdraw from others, avoiding relationships to protect yourself from perceived rejection or abandonment.
• Chronic Feelings of Emptiness: Even when everything seems fine, you may constantly feel empty or numb.
• Self-Criticism: You could struggle with a harsh inner critic, often blaming yourself for any perceived shortcomings or mistakes.
• Pervasive Shame: You might feel intense shame over your feelings or behaviors, leading you to conceal your struggles from others.
• Difficulty Trusting Others: Establishing trust can be challenging, and you may frequently doubt the intentions of people around you.

In essence, Quiet BPD is characterized by the inward experience of typical BPD symptoms, which can make it harder for others to recognize your struggle and for you to seek help. Recognizing these signs is the first step toward managing and treating Quiet BPD effectively.

Effective Treatments for BPD

While living with Borderline Personality Disorder can be difficult, there are ways to treat it.

• Dialectical Behavior Therapy (DBT): DBT, developed specifically to help individuals with BPD, combines cognitive-behavioral techniques with principles of mindfulness, emphasizing the balance between acceptance and change. Research has demonstrated that DBT is effective in reducing suicidal behaviors, psychiatric hospitalizations, and treatment dropouts, especially among parasuicidal individuals and those with co-occurring substance use disorders. Patients undergoing DBT often report an improved quality of life and enhanced ability to manage their emotions and relationships. It’s structured around four key components: 
• • Mindfulness: DBT teaches mindfulness skills to help you stay present and fully engaged in each moment. This helps reduce impulsivity and emotional vulnerability.
  • Distress Tolerance: These skills focus on increasing your ability to tolerate and survive crises without resorting to self-harm or other destructive behaviors.
  • Emotion Regulation: Learn to understand and manage intense emotions, reducing emotional ups and downs.
  • Interpersonal Effectiveness: Improve your relationships by learning to communicate more assertively and set healthy boundaries.

• Schema Therapy: Focuses on identifying and changing deeply ingrained patterns of thinking and behavior that contribute to emotional difficulties.
• Mentalization-Based Therapy (MBT): Aims to improve the ability to understand one’s own and others’ mental states, enhancing emotional regulation and interpersonal functioning.
• Transference-Focused Psychotherapy (TFP): Utilizes the relationship between therapist and patient to explore and resolve problematic interpersonal dynamics.
• Pharmacotherapy: Medication can also play a supportive role in managing BPD. While no medication is approved specifically for BPD, certain medications can help alleviate symptoms such as mood swings, depression, and anxiety. Antidepressants, antipsychotics, and mood stabilizers may be prescribed based on individual needs.

Ultimately, the most effective treatment plan for BPD often involves a combination of therapy, medication, and support from loved ones. It’s crucial to work with healthcare professionals to tailor the approach to your unique needs and circumstances.

Tools for Managing BPD Outside of Therapy

Managing Borderline Personality Disorder (BPD) outside of therapy can feel overwhelming, but there are several practical tools and strategies that can help you maintain stability and improve your quality of life. Here are some of the most effective ones:

1. Journaling

Keeping a daily journal can help you track your emotions, identify triggers, and recognize patterns in your behavior. By writing down your thoughts and feelings, you not only gain insight into your mental state but also create a safe space to express yourself. This practice can be incredibly grounding and calming.

2. Mindfulness Practices

Mindfulness is a core component of Dialectical Behavior Therapy (DBT) and can be practiced outside of therapy as well. Techniques like deep breathing exercises, meditation, and guided imagery can help you stay present and reduce anxiety. Practicing mindfulness regularly can improve your emotional regulation and promote inner peace.

3. Exercise

Physical activity is a proven way to improve mood and reduce stress. Whether it’s going for a walk, practicing yoga, or hitting the gym, incorporating regular exercise into your routine can help manage the symptoms of BPD. Aim for at least 30 minutes of physical activity most days of the week.

4. Building a Support Network

Connecting with supportive friends, family members, or support groups can provide invaluable emotional support. Sharing your experiences and concerns with others who understand or empathize with what you’re going through can help you feel less isolated and more supported. Online forums and local support groups can be excellent resources.

5. Creative Outlets

Engaging in creative activities such as painting, writing, music, or crafting can be therapeutic and provide a positive outlet for your emotions. Creativity allows you to express yourself in ways that words may not, offering a sense of accomplishment and joy.

6. Developing a Routine

Establishing a daily routine can provide structure and stability, which can be particularly beneficial for individuals with BPD. Having a predictable schedule for activities like meals, sleep, exercise, and relaxation can help reduce feelings of chaos and improve your overall wellbeing.

7. Self-Soothing Techniques

Learning self-soothing techniques can be incredibly helpful during times of distress. These can include listening to calming music, taking a warm bath, using scented candles, or practicing gentle yoga. Find what works best for you and make self-soothing a regular part of your self-care regimen.

8. Reading and Education

Educating yourself about BPD can empower you to better understand your condition and find new ways to manage it. Books, articles, and online resources can provide insights, coping strategies, and hope. A highly recommended resource is the Skills Training Manual for Treating Borderline Personality Disorder by Marsha Linehan. 

By incorporating these tools into your daily life, you can proactively manage the symptoms of BPD and work towards a more balanced and fulfilling existence.

Living with BPD

Living with BPD can certainly present its own set of challenges, but it’s important to remember that having BPD does not mean you can’t lead a fulfilling and meaningful life. While the emotional intensity and interpersonal difficulties can be taxing, with the right strategies and support, you can navigate these obstacles and find joy and satisfaction in your everyday life.

Remember, progress can sometimes be slow, and setbacks may occur. It’s important to practice self-compassion and recognize that setbacks are a natural part of any journey. Celebrate your progress, no matter how small, and continue to utilize the skills and strategies that work best for you.

Ultimately, while BPD is a part of your life, it does not define who you are or dictate your ability to live a fulfilling life. By understanding Borderline Personality Disorder (BPD), actively engaging in your treatment, utilizing effective tools, and leaning on your support network, you can cultivate a richer, more joyful existence. Start your mental health journey today, book an appointment instantly at Find My Therapist.