Borderline Personality Disorder (BPD) is characterized by a pervasive pattern of instability in interpersonal relationships, self-image, affect, and marked impulsivity, beginning by early adulthood and present in various contexts. It is worth noting here that diagnosing borderline personality is currently somewhat controversial, since a diagnosis of BPD can still technically be made despite different permutations of the diagnostic criteria (listed below) being present.
DSM-5 diagnostic criteria for BPD:
A. Five (or more) of the following criteria must be met:
Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
Identity disturbance: Markedly and persistently unstable self-image or sense of self.
Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
Chronic feelings of emptiness.
Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
Transient, stress-related paranoid ideation or severe dissociative symptoms.
B. The above features are pervasive, persistent, and represent a departure from typical behavior, and are not better explained by another mental disorder.
Treatment for BPD
Psychological treatment for BPD typically involves a type of therapy called Dialectical Behavior Therapy (DBT). DBT is a form of cognitive-behavioral therapy that focuses on teaching individuals with BPD skills to regulate their emotions, manage interpersonal relationships, and cope with stress.
DBT typically involves individual therapy sessions, group therapy, and skills training. In individual therapy, the therapist works with the individual to develop specific goals and strategies for managing their symptoms. In group therapy, individuals with BPD work together to learn and practice DBT skills, such as mindfulness, emotion regulation, and interpersonal effectiveness.
Skills training in DBT is designed to help individuals with BPD learn practical strategies for managing their symptoms and improving their quality of life. Skills training typically covers four modules:
Mindfulness: Learning to be present and aware of one's thoughts and feelings in the present moment.
Emotion regulation: Developing strategies for managing intense and overwhelming emotions.
Interpersonal effectiveness: Learning to communicate effectively with others and manage interpersonal relationships.
Distress tolerance: Developing coping strategies for dealing with stressful situations and managing intense emotional states.
DBT has been shown to be an effective treatment for BPD, and can help individuals with BPD improve their emotional regulation, reduce impulsive behavior, and develop more stable and fulfilling relationships. However, it is important to note that recovery from BPD can be a long and difficult process, and may require ongoing treatment and support.
Self-help for BPD
It is important to note that Borderline Personality Disorder (BPD) can be a complex and challenging condition to manage, and seeking professional help from a mental health provider is crucial. With that said...
Here are ten things that a person with BPD can try to help manage their symptoms and improve their quality of life:
Practice mindfulness: Mindfulness meditation and breathing exercises can help individuals with BPD become more aware of their thoughts, feelings, and bodily sensations, which can improve emotional regulation.
Keep a mood diary: Keeping track of moods and symptoms can help individuals with BPD identify triggers and patterns in their emotional states.
Learn relaxation techniques: Practicing relaxation techniques, such as progressive muscle relaxation or guided imagery, can help reduce stress and anxiety.
Build a support network: Building a support network of family, friends, or support groups can provide emotional support and help reduce feelings of isolation.
Develop healthy coping strategies: Developing healthy coping strategies, such as exercise, creative expression, or self-soothing activities, can help individuals with BPD manage stress and difficult emotions.
Practice self-care: Engaging in self-care activities, such as taking a bath, reading a book, or spending time in nature, can help improve mood and reduce stress.
Learn communication skills: Learning effective communication skills, such as active listening and assertiveness, can help improve interpersonal relationships.
Set boundaries: Setting healthy boundaries in relationships can help individuals with BPD feel more in control and reduce feelings of being overwhelmed.
Develop a crisis plan: Developing a crisis plan with a mental health provider can help individuals with BPD know what to do in case of a mental health emergency.
Pursue therapy and medication: Seeking professional help from a mental health provider, such as a therapist or psychiatrist, and following prescribed medication regimens can be effective in managing BPD symptoms.
