Is Borderline Personality Disorder a Life Sentence? Part 1

What is Borderline Personality Disorder?

If you are not familiar with Borderline Personality disorder (BPD), let’s start with a run-down of what it entails. This disorder is a pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts.

Borderline personality disorder (BPD) is a mental disorder that is characterized by unstable moods, behavior, and relationships. BPD is also commonly known to include chronic feelings of emptiness, instability in your self-identity, and some concerns of self-injury.

It can include symptoms such as Frantic efforts to avoid real or imagined abandonment, A pattern of unstable and intense interpersonal relationships,  persistently unstable self-image, Emotional instability leading to extreme changes in mood expression, Inappropriate, intense anger or difficulty controlling anger, High stress responses, dissociation, and paranoid ideas.

How Common is it?

Many clinicians are reluctant to diagnose clients with this disorder because of the negative perceptions that people associate with it. This may be due to the fact that most patients that have been diagnosed with BPD represent extreme cases that are more likely to have negative outcomes.

When people hear about BPD, they almost instantly think that their friend or loved one or whoever has the disorder is doomed and will have the disorder affect every aspect of their life forever. Those who have extreme cases of BPD and are chronically suicidal, may have difficulty returning to what they believe their normal life should be. Clinicians who have these suicidal patients may feel that they need to be hospitalized for their own safety; however, even in patients who have expressed suicidal ideation, there are many who never actually attempt suicide or express these ideations once they have completed treatment.

Individuals who have Borderline Personality Disorder and do not seek treatment, are likely to continue their same struggles throughout life.  Research has shown that younger patients with BPD are less likely to commit suicide and are more likely to complete treatment and reach remission, so the earlier clients can pursue treatment, the better.

So Does Treatment Work?

While BPD is a serious mental health disorder, research has shown that those who have BPD and go through treatment are able to resolve most, if not all of their problematic symptoms and live normal lives. However, remission should not be confused with recovery. There may be many cases in which a patient appears to have overcome their BPD symptoms, but the effects only last for a short amount of time and they have to continue treatment. Many patients that have BPD and get their symptoms under control may never have to return to therapy and may never experience more of the serious symptoms.

More intensive models of treatment tend to be most effective. Dialectical Behavior Therapy (DBT) is considered one of the most effective models for treating BPD (however, there are other effective models as well). DBT focuses on developing healthy coping

skills, practicing mindfulness, and changing destructive thought patterns to think and behave more constructively. One of the benefits of DBT is the model is more intensive, usually recommending consistent individual therapy, group therapy, and check ins to help the individual learn to manage their intense emotions in the moment. BPD is an intense condition, so it requires and intensive approach with intentionality on the part of the client. With hard emotional work and a lot of time, people can recover and no longer qualify for the label.

Borderline personality disorder can be scary and intimidating and may seem like it is one of the worst diagnoses that a mental health professional could give a person, but the truth is, it is not a life sentence. The cases most talked about include the most severe symptoms and many times milder cases are not diagnosed either by a lack of recognition by therapists or an aversion to the label. In cases where BPD is diagnosed early on and is treated effectively, the symptoms can be managed and you may be able to live full and healthy lives.

August 2020, Amelia Forsmo, Administrative Volunteer

Sources:

• Paris, J. (2012). The outcome of borderline personality disorder: good for most but not all patients.
• Diagnostic and Statistical Manual of Mental Disorders, 2000 American Psychiatric Association.
• Jenny Beall, MA, LPCC.