The Pain of Living with BPD
G. Pacana
3/6/20242 min read
“This painful mental illness is not fair, but saying it is not fair does not change anything. Thinking that you should not have to work so hard to get through everyday life with someone with BPD does not change the fact that this is what you need to do.”
― Valerie Porr M.A., Overcoming Borderline Personality Disorder
BPD affects individuals in profound and multifaceted ways. The core aspects of BPD include intense emotional instability, a distorted self-image, impulsive behaviors, and unstable relationships. The emotional experience of someone with BPD is characterized by rapid and extreme fluctuations, with individuals often shifting from feelings of euphoria to intense anger or profound depression within a short time.
The pain associated with borderline personality disorder has been described as one of the most intense among psychiatric disorders, with individuals experiencing severe emotional symptoms as well as chronic physical pain.
The experience of emotional dysregulation, a core symptom of BPD, can feel overwhelming and uncontrollable. Individuals may find themselves rapidly shifting between emotional states, moving from feelings of intense anger to deep sadness in a short time. These intense emotions are not only difficult to manage but also contribute to a sense of chronic emptiness and identity confusion. This instability can lead to significant distress as the person struggles to understand and manage their emotional responses.
Emotional dysregulation also manifests in difficulties with episodic anxiety, depression, problems with shame, anger, and the expression of anger. These emotional experiences are not only intense but can also lead to impulsive behaviors as attempts to regulate or escape from the emotional pain. Such behaviors include self-harm, substance abuse, disordered eating, or engaging in risky sexual activities.
The disorder can lead to significant impairments in functioning and quality of life, making everyday tasks and relationships exceedingly difficult to navigate.
Many individuals with BPD also experience chronic physical pain, which is likely a manifestation of the body's response to the chronic stress, emotional dysregulation, and heightened sensitivity to physical sensations.
Clinical observations and studies indicate that patients with BPD may have a complex relationship with physical pain. They can exhibit a high tolerance to acute self-inflicted pain, such as during episodes of self-mutilation, where they may report feeling little to no pain. However, when it comes to chronic endogenous pain, individuals with BPD may be less tolerant and more sensitive to pain.
Endogenous pain refers to pain that originates from within the body, often without a clear external cause. It is typically associated with conditions or diseases that affect the body's tissues, nerves, or internal organs. An example of endogenous pain is the discomfort or pain associated with conditions like fibromyalgia, where widespread musculoskeletal pain is experienced without an external injury. Another example is the pain from migraines, which involves severe headache pain and other symptoms without external physical trauma to the head.
Physical symptoms associated with BPD include unexplained pain or discomfort in various parts of the body, including headaches, muscle aches, joint pain, and abdominal pain. These symptoms likely result from the body's response to emotional stress and are magnified by the individual's heightened sensitivity to physical sensations.
BPD is also associated with negative physical health outcomes, increasing the risk for chronic diseases like diabetes, heart disease, arthritis, and obesity. These health issues also contribute to the physical discomfort experienced by individuals with BPD.
In short, living with BPD is a complex and often painful experience characterized by severe emotional symptoms as well as chronic physical pain. While the disorder presents significant difficulties, treatment and support can offer a path toward stability and an improved quality of life.
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