BPD, A Discussion

“People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement.”  – Marsha M. Linehan

Many people have seen Girl Interrupted, a movie about a young female with Borderline Personality Disorder (BPD), but what is Borderline really about?

Borderline Personality Disorder: The personality disorder which sits on the borderline between neurotic (anxiety) and psychotic personality disorders.

An individual with Borderline Personality lacks a sense of self, experiences a deep emptiness, and fears abandonment above all else. There are patterns of intense and unstable relationships for a Borderliner, emotional instability, regular outbursts of anger, occasional acts of aggression, and frequent impulsive behavior. Suicidal threats or incidents of self-harm are commonplace for us.  

Some symptoms of BPD are: emotional instability, reckless spending, "black and white" thinking, and disassociation (usually during painful events). These symptoms make it difficult for us to live our lives in the manner most people do, and can cause ongoing issues within relationships and working environments. These symptoms are often hard to treat and, sadly, can lead to isolation for many.

It was once thought that BPD was caused by poor parenting but both biological and environmental factors can place a person at risk for developing this disorder (around 60% of the risk is genetic).  Abnormalities in a Borderliner's brain affect the proper functioning of pathways that serve behavioral, emotional, informational, impulsive and cognitive functions.  “Some research supports a biological basis for the disorder. First, there are indications that erratic mood swings, social cognitive difficulties and maladaptive behaviors may be used by prefrontal and temporolimbic dysfunction.” (Swift, 2009). 

          Although these genetic factors place a person at risk. environmental aspects of our lives such as poor parenting can be the most critical factor in our disorder.  Repeated emotional, physical, sexual abuse; and inconsistent, unsupportive care are almost always in the mix. 

          In my case there are many factors that have contributed to a couple of my alters having this disorder (my defining diagnosis is Dissociative Identity Disorder and only a select few of my identities are affected by BPD).  I experienced a traumatic birth in which the doctor overseeing the process used a powerful vacuum on my head for an unreasonable amount of time (I was born in Indonesia in 1987, whereas if I were born in the United states at that time or afterward I would have been born by C-section).  My mother recalls with helpless dismay that had large dark bruises on my head for several weeks following my birth.  Research I have done suggests that this kind of birth (as well as birth assisted by forceps) permanently damages a newborn's brain to varying extents.  My behavior from infancy onward shows clear signs of brain damaged and even if BPD were not in my genes, this damage made me completely susceptible to the disease.  A rare hormone disease characterized by a brain tumor which was most likely cause by childhood trauma also increased the risk of me developing Borderline Personality.  I have also experienced several instances of abandonment, physical and sexual abuse that my clinicians an I agree have intensified my disorder.  

          Treatment of BPD is difficult, but can be done. Therapy, specifically psychotherapy, is usually the first treatment.  There are several types that can be used as treatment. Cognitive behavioral therapy (CBT), Dialectical behavior therapy (DBT), and medication are used in an attempt to make the patient aware of what’s going on and get through painful events.  When therapy and medication simply isn’t enough, hospitalization can be used to stabilize. 

          I have had therapy for many years, been on many different kinds of medication, been hospitalized and lived within the walls of two different rehabilitation facilities.  It took a lot of work, bravery, time and money to get to the place I am in now.  Still, I feel there are miles to go before I sleep.

          Living with BPD is difficult but there is hope. If you are struggling with this disorder or know someone who is, please research and offer help to them. One option is to read about the disorder on the we, and there are several books about BPD available to the public. Be supportive, open minded and honest with yourself and with whomever you talk to if you have or feel you might have Borderline Personality Disorder.