The Reality of Living With BPD
G. Pacana
2/8/20243 min read


“People with borderline personality disorder (BPD) frequently dread abandonment, struggle to establish healthy relationships, experience powerful emotions, act impulsively, and may even develop paranoia and dissociation. They also have significant problems with relationships, particularly with those closest to them. Their erratic mood swings, rage outbursts, chronic abandonment concerns, and impulsive and irrational behaviors can make loved ones feel powerless, abused, and out of sorts.” – Dr. Elizabeth Lombardo, Ph.D.
Borderline personality disorder is a complex mental health condition that affects millions of people worldwide. It is characterized by intense emotional instability, impulsive behavior, difficulty maintaining stable relationships, and identity confusion. Individuals with BPD frequently experience fear of abandonment, rejection sensitivity, and extreme anxiety, which sometimes leads to short-lived periods of dissociation or paranoia. And with a mortality rate of 10%, BPD is the most deadly of all psychiatric disorders.
BPD generally begins in early adulthood and persists throughout a person's life. While the cause of BPD is not completely understood, it is believed to originate from a combination of environmental, physiological, and genetic factors. Environmental factors often include an abusive childhood marked by physical or sexual abuse or an emotionally invalidating parenting style.
BPD and emotional regulation
Emotional regulation is the most significant struggle for individuals with BPD. Someone with BPD will experience intense mood swings, ranging from deep despair to extreme anger or irritability, often without apparent reason. These emotional fluctuations are often overwhelming and lead to impulsive behaviors, including self-harm or suicidal thoughts.
The impact of BPD on relationships
One of the most challenging aspects of living with BPD is its impact on relationships. Individuals with BPD have a difficult time maintaining stable, healthy connections with others. This is because of a number of factors, which include black-and-white or dichotomous thinking. People with BPD tend to view themselves and others in black and white and have a difficult time accepting the reality that good people sometimes do “not so good things.” For the person with BPD, others are either “good or "bad," "angels and devils.”.
Fear of abandonment, real or imagined, is another serious impediment associated with BPD and often leads to frequent conflicts, impulsive behavior, and a tendency to idealize or devalue others. These relationship patterns can be exhausting and overwhelming for both parties involved, often resulting in a cycle of instability and chaos.
BPD nearly always co-occurs with other mental health disorders such as depression, anxiety, PTSD, bipolar disorder, eating disorders, or substance abuse disorders. These comorbid conditions further complicate the treatment process and intensify the overall impact on an individual's life. Therefore, it is essential for mental health professionals to conduct a thorough assessment and provide integrated treatment that addresses all co-occurring conditions.
In addition to the overwhelming and intense symptoms associated with BPD, the disorder remains highly stigmatized and misunderstood. Many individuals with BPD face judgment, discrimination, and a lack of understanding from society, friends, and even healthcare professionals. The portrayal of BPD in the media often perpetuates misconceptions and reinforces negative stereotypes. This stigma can prevent individuals with BPD from seeking help and support, further exacerbating their struggles.
While BPD is extremely challenging to manage, there is hope for improvement and recovery. Treatment for BPD typically involves a combination of therapy, medication, and support. Dialectical Behavior Therapy DBT has the most promising results in helping individuals with BPD develop skills for emotional regulation, distress tolerance, and interpersonal effectiveness. Other therapeutic approaches, such as cognitive-behavioral therapy (CBT) and schema therapy, are also beneficial. In addition, medications, such as mood stabilizers or antidepressants, are be prescribed to manage specific symptoms.
Borderline personality disorder is an extremely hard condition that can have a profound impact on an individual's life. Understanding the true impact of BPD is crucial in order to provide effective treatment and acceptance for those who are affected. In addition, by breaking the stigma associated with BPD, promoting awareness, and offering compassion, individuals with BPD can embark on a journey of recovery in an environment that is both accepting and supportive.
“Individuals with BPD need to seek ongoing support and continue with treatment even after symptoms have improved, as the disorder can resurface during times of stress. However, with proper management and support, it is possible to lead a fulfilling life with BPD.” – Ketan Parmar, MBBS, DPM, Psychiatrist, Psychologist
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