TW (trigger warning): suicidal thoughts, self-harm
Studies and surveys estimate the prevalence of Borderline Personality Disorder (BPD) to be 1.6% of the total population, with the first symptoms beginning in late adolescence or early adulthood. [1]
What do we mean by borderline?
BPD is a long-term condition characterized by intense emotions, low self-image, instability in interpersonal relationships, a constant sense of inner emptiness, impulsive behaviour, avoidance of abandonment from people close to them, self-harm and suicide attempts. [2], [3]
When and how do we get the diagnosis?
In general, personality disorders begin to be visible as early as adolescence and affect multiple areas of life: family, school, career, friends, relationships, etc. However, they are diagnosed from the age of 18 because adolescent personalities are considered to be still developing. [4], [5]
We spoke to two young women who were diagnosed with BPD in early adulthood, and they shared with us the difficulties they faced before and after their diagnosis. To maintain the anonymity of the interviewees, we use two fictitious names, Maria and Elena.
In 2020, at the age of 21, Maria was diagnosed. In hindsight, the symptoms of the disorder had started to appear as a teenager.
“I had many very unstable relationships, I reacted horribly when the relationships ended or if there was even the slightest chance of breaking up. On numerous occasions I even threatened to hurt myself, had ugly jealous rages, etc.”
Her partners gave her an identity and that is why she felt so empty when they left. The instability in her interpersonal relationships was also mirrored in her relationship with her mother, whom she sometimes saw as the best mother and sometimes the worst. This type of extreme oscillation between “best” and “worst” is known as splitting. Splitting is a common symptom among people with borderline and other mental disorders, influencing them to see the world in absolute, black and white terms.
At the suggestion of a friend who suspected she might have BPD, she sought the expertise of a professional. Receiving the diagnosis felt like a liberation, her problems finally had a name, but that didn’t mean they were solved.
Today, Maria feels lost because she always planned to take her own life and never thought she would get to this point. The way she perceives herself changes drastically every few days (sometimes even more frequently), and her emotional state changes abruptly, from the smallest thing. She is always looking for something that gives her pleasure, but never manages to fill the emptiness inside.
Unlike Maria, Elena was studying psychology, where she had the opportunity to learn more about personality disorders at a theoretical level. After reading the borderline symptoms in the DSM (Diagnostic and Statistical Manual of Mental Disorders), she suspected, like Maria, that something was wrong. It was hard for her to open up to other people, to talk about her concerns, as borderline in the public eye was associated with “parasuicidal” behaviors, and her type is quiet.
“Quiet borderline means suffering more in silence and keeping up appearances. People fail to understand how you can get frustrated from the simple fact that you didn’t clean a spoon properly, and then start hating yourself for not getting a trivial thing right. Many see it as an overreaction.”
Frequently, people who are diagnosed with BPD do not realize that they have a medical problem and tend to blame themselves and develop defense mechanisms to cope. Maria has a long history of self-harm. She started hitting herself from the age of 9-10. When she was 11-12 years old, dissociative symptoms appeared and she became delusional when she was under great stress, upset or when she received bad news. She had the feeling that her life was a nightmare and she was about to wake up from it. She was slapping and punching herself to wake up from that “nightmare”.
For Elena, borderline meant suffering in silence and pretending that nothing was really happening in her life. When she felt emotional pain, the defense mechanism she found, or refuge, was in daydreaming. She did not cut herself because she could not hide her scars in summer, but she realized she was living between two extremes: either she blamed herself or someone else for the problems in her life. When she blamed herself, that is when the self-harm started. Sometimes she would hit walls and end up ignoring the pain as long as she got what she wanted.
What are the benefits of therapy after diagnosis?
Recent studies show that properly applied treatment reduces the symptoms of borderline personality disorder. The first treatment option, unlike other types of diseases, is therapy. [6]
Both Maria and Elena have sought the support of a psychotherapist in their process of adjusting their inner balance. Over time, they have found that therapy helps them to have better control over their thoughts and feelings, with the therapist helping them to change certain attitudes and behaviors. The women told us that getting back to balance is a difficult and arduous process. For example, in a conflict, they were always trying to find out who was guilty and who was right, which constantly provoked extreme feelings, such as agitation or grandiomania.
Most of the time, they were the problem that triggered the conflict, and psychotherapy came as a voice of reason to guide them in the recovery process and to help them manage much better the moments when the wound of abandonment opened.
After her psychotherapy sessions, Elena learned a number of valuable lessons, and she shared three important ones with us: “you are the one who makes the choices in your life; blaming others doesn’t solve your problems, and ego wounds matter.”
Maria and Elena’s confessions give us a much clearer insight into how borderline can affect your life before and after receiving a diagnosis. Being diagnosed with BPD can be hard to digest at first, but with time it can become a liberation, as the problems you suffer from have a name and you can start to work on them in small but sure steps under the guidance of a psychotherapist, as the interviewees have done. And remember, try to be kind to yourself in this fight!
In case you’re wondering how you too could help someone with BPD, our article “Borderline – with one foot always at war” offers some useful tips on this. Other resources you can use are: our discord server (an online space where you can talk about your mental health with different people, including a channel with discussions about personality disorders), Borderline Romania (a Facebook community for people with BPD), the episode “Borderline” of the In My Rhythm podcast and Psych2Go (a Youtube channel where you can watch animations about borderline: “7 Hidden Signs of Borderline Personality Disorder” or “9 Things About Borderline Personality Disorder You Need to Know“).
Sources used:
[1] Borderline Personality Disorder
[2] Borderline Personality Disorder Facts and Statistics
[3] History of the Term ‘Borderline’ in Borderline Personality Disorder
[4] What are Personality Disorders?
[5] Borderline – with one foot always at war
[6] Treating BPD
[7] Treatment – Borderline personality disorder
*Daydreaming = dreaming with your eyes open or fanciful, seemingly purposeless, fantastical thoughts that fulfill the individual’s desires, expectations, in the plane of imagination.
*Splitting = term used in psychiatry to describe a person’s inability to have opposing thoughts, feelings or beliefs. Some might say the person sees the world in terms of black and white, all or nothing.
*Parasuicide = a series of self-injurious behaviors, which may or may not be intended to lead to death.
*MajorDepressive Disorder (DSM-IV-TR and DSM-5) = a disorder characterized by constant sadness or a major depressive episode, unaccompanied by episodes of mania or hypomania.
