What Is Borderline Personality Disorder?
Borderline personality disorder shows up often enough on TV, but the versions you see on screen rarely match the real thing. Knowing what the condition actually involves, and how it affects a person day to day, puts you in a better position to build a personal development plan that helps you manage the symptoms. At the center of it sits a deep fear of instability and of being abandoned. Being alone can feel almost unbearable for someone with the disorder, and that fear tends to spill over into a range of symptoms that get in the way of ordinary functioning.
The condition usually surfaces in early adulthood. That early stretch is often when it hits hardest, and for many people it eases as the years go on. With the right treatment and a plan built around your particular struggles, a full and satisfying life is genuinely possible.
What causes it is not fully settled. Researchers point to childhood trauma and environmental factors as likely contributors. A few other threads come up repeatedly in the research. One is genetics: the disorder appears to run in some families. Another involves differences in the brain. Changes in areas tied to impulsivity, emotional regulation and aggression may be part of the picture, and mood-regulating chemicals such as serotonin may contribute when they are not working the way they should.
The symptoms cover a fair amount of ground. A person's self-image and sense of identity can shift quickly, dragging their values and goals along with them. Mood swings can run wide and intense, sometimes stretching across several days. Anger can flare out of proportion to whatever triggered it. Relationships tend to follow a pattern of intensity and instability.
These symptoms are usually not switched on all the time. People tend to cycle through them, and both the severity and duration vary a lot from one stretch to the next. You might be dealing with anger one week and stress-related paranoia another.
For a diagnosis, a clinician works from the DSM-5. The process generally includes a detailed interview to assess your current state, a full physical examination and a look at your medical history, a complete psychological evaluation, and a careful review of your symptoms. Being thorough and completely honest during all of this matters more than it might seem. Leaving out even a small detail can slow down an accurate diagnosis and delay the start of treatment.
Treatment leans on talk therapy and medication. Therapy works on several fronts: gauging how well you can function, bringing down impulsiveness, teaching you about the disorder itself, giving you tools to sit with difficult emotions, and helping you read other people's feelings so your relationships have a better chance.
No medication targets the disorder directly. Doctors may still prescribe antipsychotics, antidepressants or mood stabilizers to address impulsiveness, anxiety, depression and aggression, the kinds of problems that can get in the way of treatment and slow recovery.
A personal development plan gives you something to lean on when the fear of abandonment or instability takes hold. If the disorder brings anxiety with it, the plan can also give you ways to head off panic attacks in moments when you feel unmoored or left behind. It doubles as a tool you and your provider can use to check whether your treatment is actually doing its job.
This is not a rare condition. Odds are you have met at least one person living with it. If they had good treatment and a solid plan in place, chances are you never would have guessed. Staying in regular contact with your provider, and being honest about what you are going through, is what keeps the treatment working in your favor.
References: Mayo Clinic, borderline personality disorder overview; PsychCentral, "Personality Disorders: Life in a Bubble" (2013).