What Is Borderline Personality Disorder?
Borderline personality disorder (BPD) creates unrealistic but very real feelings of being unstable or alone. Some people with this condition suffer significantly if they are left alone. They may be impulsive and display actions that push other people away from them. Yet, most people with BPD fear abandonment and need to feel they belong.
What causes BPD? This very misunderstood mental health disorder can have serious consequences, especially when left untreated. It was first called BPD in the 1930s. At that time, professionals believed people with these symptoms were in a state of mental illness between neurosis and psychosis but that they did not have the same level of mental health break that a condition like schizophrenia offers.
Over time, we’ve learned that BPD is a type of mental health disorder. A good way to understand what makes it different is to consider it a type of disorder related to emotional regulation rather than a disorder of thought processes. Most often, people with BPD develop the condition in early adulthood, though it can occur at any age. People with it can see improvement if they seek help and learn more about what their emotions and thought patterns mean.
What Types of BPD Exist?
There are several distinctive types of BPD. These are categorized based on the way a person expresses the traits and symptoms they feel. Some people are less likely to express their feelings outright, while others may be hard to control and self-harming. Common distinguishing types include:
- Petulant Borderline BPD: Those within this subgroup are likely to be easily disappointed and pessimistic about life and activities. They resent various aspects of life and may be stubborn to change. They are defiant and tend to be critical of everything around them. They also push people away, especially when they feel the need for attention. They hope the person they are pushing away demonstrates that they will not leave.
- Self-Destructive Borderline BPD: In this area, a person is likely to have self-punishing behavior. Some are masochistic. Many are introverted and very moody. They are most likely to act out in anger or resentment. In some situations, they will conform to expectations and then lash out. Many are at a higher risk of suicide.
- Discouraged Borderline BPD: In this type, a person is less likely to be assertive and more likely to express their condition as being depressed. They are more likely to self-harm than others. They feel unable to control life around them.
- Impulsive Borderline BPD: In this area, a person will be irritable, impulsive, and easily distracted. They may display a constant pattern of attention-seeking behavior. Here, a person is more likely to threaten suicide or self-harm. They can also be very unpredictable in behavior, overly dramatic, and routinely emotional about everyday activities.
In all situations, those with BPD can have a milder form or a severe form of the subtype. They do not have to display all of these symptoms to be classified in any one group.
What Causes BPD?
What Causes BPD? Genetics
Genes you inherit from your parents may make you more vulnerable to developing BPD. A study found that if 1 identical twin had BPD, there was a 2-in-3 chance that the other identical twin would also have BPD. However, these results have to be treated with caution, and there’s no evidence of a gene for BPD.
Problem with brain chemicals
It’s thought that many people with BPD have something wrong with the neurotransmitters in their brain, particularly serotonin. Neurotransmitters are “messenger chemicals” used by your brain to transmit signals between brain cells. Altered levels of serotonin have been linked to depression, aggression, and difficulty controlling destructive urges.
Problem with brain development
Researchers have used MRI to study the brains of people with BPD. MRI scans use strong magnetic fields and radio waves to produce a detailed image of the inside of the body. The scans revealed that in many people with BPD, 3 parts of the brain were either smaller than expected or had unusual levels of activity. These parts were:
- The amygdala – plays an important role in regulating emotions, especially the more “negative” emotions, such as fear, aggression, and anxiety
- The hippocampus – helps regulate behavior and self-control
- The orbitofrontal cortex – which is involved in planning and decision making
Problems with these parts of the brain may well contribute to symptoms of BPD.
The development of these parts of the brain is affected by your early upbringing. These parts of your brain are also responsible for mood regulation, which may account for some of the problems people with BPD have in close relationships.
Several environmental factors seem to be widespread among people with BPD. These include:
- Being a victim of emotional, physical, or sexual abuse
- Being exposed to long-term fear or distress as a child
- Being neglected by 1 or both parents
- Growing up with another family member who had a serious mental health condition, such as bipolar disorder or a drink or drug misuse problem. A person’s relationship with their parents and family has a strong influence on how they come to see the world and what they believe about other people. Unresolved fear, anger, and distress from childhood can lead to a variety of distorted adult thinking patterns, such as:
- Idealizing others
- Expecting others to be a parent to you
- Expecting other people to bully you
- Behaving as if other people are adults and you’re not
Treatments and Therapies For BPD
Borderline Personality Disorder has historically been viewed as difficult to treat. But, with newer, evidence-based treatment, many people with the disorder experience fewer or less severe symptoms, and improved quality of life. People with BPD must receive evidence-based, specialized treatment from an appropriately trained provider. Other types of treatment, or treatment provided by a doctor or therapist who is not appropriately trained, may not benefit the person.
Many factors affect the length of time it takes for symptoms to improve once treatment begins, so it is important for people with BPD and their loved ones to be patient and to receive appropriate support during treatment.
Tests and Diagnosis
A licensed mental health professional—such as a psychiatrist, psychologist, or clinical social worker—experienced in diagnosing and treating mental disorders can diagnose BPD by:
- Completing a thorough interview, including a discussion about symptoms
- Performing a careful and thorough medical exam, which can help rule out other possible causes of symptoms
- Asking about family medical histories, including any history of mental illness
BPD often occurs with other mental illnesses. Co-occurring disorders can make it harder to diagnose and treat BPD, especially if symptoms of other illnesses overlap with the symptoms of BPD. For example, a person with BPD may be more likely to also experience symptoms of depression, bipolar disorder, anxiety disorders, substance use disorders, or eating disorders.
Seek and Stick with Treatment
NIMH-funded studies show that people with Borderline-Personality Disorders who don’t receive adequate treatment are:
- More likely to develop other chronic medical or mental illnesses
- Less likely to make healthy lifestyle choices
Borderline-Personality Disorder is also associated with a significantly higher rate of self-harm and suicidal behavior than the general public. People with Personality Disorders who are thinking of harming themselves or attempting suicide need help right away.
Psychotherapy is the first-line treatment for people with Borderline Disorder. A therapist can provide one-on-one treatment between the therapist and patient, or treatment in a group setting. Therapist-led group sessions may help teach people with Borderline Personality how to interact with others and how to effectively express themselves.
It is important that people in therapy get along with, and trust their therapist. The very nature of Borderline Personality illness can make it difficult for people with the disorder to maintain a comfortable and trusting bond with their therapist.
Two examples of psychotherapies used to treat Borderline Personality disorder include:
- Dialectical Behavior Therapy (DBT): This type of therapy was developed for individuals with Borderline Disorder. DBT uses concepts of mindfulness and acceptance or being aware of and attentive to the current situation and emotional state. DBT also teaches skills that can help:
- Control intense emotions
- Reduce self-destructive behaviors
- Improve relationships
- Cognitive Behavioral Therapy (CBT): This type of therapy can help people with BPD identify and change core beliefs and behaviors that underlie inaccurate perceptions of themselves and others, and problems interacting with others. CBT may help reduce a range of mood and anxiety symptoms and reduce the number of suicidal or self-harming behaviors.
Because the benefits are unclear, medications are not typically used as the primary treatment for Borderline Personality cases. However, in some cases, a psychiatrist may recommend medications to treat specific symptoms such as:
- Mood swings
- Other co-occurring mental disorders
Treatment with medications may require care from more than one medical professional. Certain medications can cause different side effects in different people. Talk to your doctor about what to expect from a particular medication.
Reclaim Your Life From BPD
BPD is a condition that should not be taken lightly. We Level Up California rehab institute can provide you, or someone you love, the tools to treat Personality disorders with professional and safe care. Feel free to call us to speak with one of our counselors. We can inform you about this condition and give you clarity to questions such as “What causes BPD?” by giving you relevant information. Our specialists know what you are going through. Please know that each call is private and confidential.