When Self-Regulation Seems Near-Impossible: Borderline Personality Disorder

Nearly 75% of people diagnosed with BPD are women. Recent research suggests that men may be equally affected by BPD, but are commonly misdiagnosed with PTSD or depression. 

We all have mood swings, and some are more intense than others. As a therapist, I teach my clients how to self-regulate, or soothe, when a strong emotion washes over them; I have to practice those same techniques when I feel an especially heavy emotion. Although many of us are able to regulate our thoughts and emotions with practice, others struggle with it. The diagnosis of Borderline Personality Disorder may shed light for those struggling in this area. My wish is that by introducing this disorder, I may bring hope to those who want to understand and correct the cycles they find themselves stuck in.

Borderline Personality Disorder (BPD) is a condition characterized by difficulty regulating emotions. People who experience BPD feel intense emotions for extended periods of time, which makes it difficult to return to a stable baseline. Ordinarily, people can tolerate the ambivalence of experiencing two contradictory states at one time. People with BPD, however, feel emotions so strongly that they cannot see past whatever they are currently feeling. If they are in a bad state, for example, they have no awareness of the good state. They view things in extremes–all good or all bad. This includes their opinions of other people; an individual who is seen as a good friend one day may be considered an enemy the next. This unpredictable pendulum of emotions affects how they see everything, including themselves and their role in the world, resulting in impulsivity, insecurity, changing interests and values, and self-image issues. Difficulties with self-regulation can also result in dangerous behaviors such as self-harm and suicidal thoughts and behaviors.  

Listed below are the symptoms of borderline personality disorder. While this list is fairly comprehensive, it is important to remember that not everyone with BPD experiences every symptom. Some individuals experience only a few symptoms, while others have many. And these symptoms can be triggered by seemingly ordinary events and then be otherwise dormant.

  • An intense fear of abandonment, even going to extreme measures to avoid real or imagined separation or rejection
  • Unstable personal relationships that alternate between idealization (“I’m so in love!”) and devaluation (“I hate her”).
  • Distorted and unstable self-image.
  • Risky and impulsive behaviors (excessive spending, unsafe sex, substance abuse or reckless driving).
  • Self-harming behavior (including suicidal threats or attempts, often in response to fear of separation or rejection).
  • Long periods of intense depressed mood, irritability or anxiety.
  • Chronic feelings of boredom or emptiness.
  • Dissociative feelings—disconnecting from your thoughts or sense of identity or “out of body” type of feelings (severe cases of stress can also lead to brief psychotic episodes).
  • Wide mood swings lasting from a few hours to a few days, which can include intense happiness, irritability, shame or anxiety
  • Inappropriate, intense anger, such as frequently losing your temper, being sarcastic or bitter, or having physical fights

The causes of BPD are not entirely understood, though scientists believe that this disorder is caused by a combination of factors. First, genetics: although no specific gene has yet been directly linked to this disorder, research has found that people who have a close family member with BPD are at higher risk of developing the disorder themselves.  Secondly, environmental factors like abuse or parental separation from a parent during childhood. Third, the neurological makeup is different in individuals with BPD than those without–particularly the parts of the brain which control emotions and decision making. This disorder commonly makes itself manifest by early adulthood.

Borderline personality disorder does not have to dictate your quality of life. Only 20% of the most serious cases necessitate psychiatric hospitalization and the vast majority of those stabilize and lead productive lives after their hospitalization. Please do not get discouraged if you have been diagnosed with BPD; you can learn to live a satisfying life with rewarding relationships. Help is available. Recovery options include therapy, medications, and group, peer and family support. The ultimate goal is for a person with BPD to self-direct their own treatment plan and to learn to regulate their emotions. Contact me to today to get started on the road to healing and recovery.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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