Is Borderline Personality Disorder a Life Sentence? Part 2

What Does BPD Actually Look Like?

With so many listed symptoms, you may be scratching your head and wondering, what does Borderline actually look like. Sometimes personality disorders are easier to conceptualize if you have a person or character in mind. When thinking of Borderline Personality Disorder, I would direct you to think about Marie Baron (the mother from Everybody Loves Raymond), Tiffany Maxwell or Pat Solitano (the lead characters from Silver Linings Playbook), Rebecca Bunch (The star character from Crazy Ex-Girlfriend).

These are some great examples of what this disorder can look like; but, of course, keep in mind each individual is different and their expression of this disorder may be different too. For example, some BPD clients may react to stressful situations with hostility or aggression, but certainly not all. Some may present the abandonment fear by desperately clinging to their relationships, while others may go through life with a “I’m going to break up with you before you break up with me” approach acting like they don’t care about potential rejection.

There can be a lot of stigma associated with this label, because the behaviors of individuals who struggle with BPD can be very difficult to manage. In real life these individuals are often experienced as enjoying creating drama, manipulative, having intense mood swings, toxic in relationships, and difficult or exhausting to engage with. That doesn’t mean you can diagnose your mother-in-law as borderline simply because she is difficult or petty.

So Is BPD The Same As Being Moody Or Bipolar?

As a clinician, one of my biggest pet peeves is the misdiagnosis of individuals with the label bipolar when the clients actually meet criteria for Borderline Personality Disorder. In popular culture when people report having “mood swings” people assume this is related to their misconceptions of Bipolar disorder. Even many emergency rooms and medical professionals wildly mislabel mood swings as evidence of Bipolar. In reality bipolar is a distinctive disorder including manic episodes or times of intense highs (with very specific criteria and lasting at least 3 days) in addition to times of intense lows.

You may remember my example of a character portraying BPD, Pat from Silver Linings Playbook. If you are familiar with the movie, the character reports being diagnosed with bipolar. This is in my opinion another mischaracterization of the disorder as he seems to have more pervasive disordered emotional regulation and impulsivity rather than displaying any evidence of specific manic episodes. While a Borderline client may experience intense emotional shifts, these are usually more rapid such as mood swings throughout a period of hours rather than days or weeks.

Clients with BPD often experience anxiety and depression in addition to the BPD symptoms, but if you imagine what it might be like living with these symptoms, you may understand how that seems likely. Additionally, the impulsivity associated with BPD is more a consistent element of the person’s personality, rather than a symptom of a manic episode as in bipolar.

BPD Is Heavily Associated with Trauma

While some research suggests that there are genetic components to BPD, it is very heavily associated with trauma. I tend to believe that this disorder is primarily environmentally caused. Meaning, if you were raised in a traumatic home situation by an emotionally unstable parent; how likely is it that you would arrive in adulthood unscathed. Every client I have worked with who has had a BPD diagnosis has had a significant trauma history or significant toxicity in the relationship with a primary caregiver.

Childhood pain can be difficult to overcome and has an important impact on our perceptions and behavior. Most of our personality or life style are developed in childhood and we continue growing into that personality throughout our lives shaped by trauma, and more positively, shaped by personal insight and intentional change.

Is there Hope for Someone with BPD?

It can help you to empathize with someone displaying these difficult personality characteristics to consider the painful childhoods they must have endured. Remember that these individuals are not necessarily trying to be manipulative or hurtful, they are trying to cope with their feelings and have never learned how to do that or be in relationships in a healthy way.

I always encourage clients that it makes sense why you have developed unhealthy patterns: as a child this helped you to survive or protect yourself, but the good news is as an adult you can choose to be different. Adults have the power over their situations and can make different choices and do the hard work of becoming emotionally healthy individuals.  The earlier and more intentionally people approach getting healthy (usually through therapy) the more effective treatment can be.

It’s not easy to overcome the hurts and hang ups of our past, but we do not have to be defined by them. We are all broken people in different ways, but there is always hope to grow and change. If you or a loved one came to mind when reading this, I would encourage you to reach out to a good counselor to start the healing journey today.

August 2020, Jenny Beall, Counselor, Threads of Hope Counseling.