What is Borderline? Is it when someone almost has a mental disorder?
The word “borderline” can be confusing, but the disorder stands alone and is not tied to another diagnosis. Borderline Personality Disorder (BPD) is under the umbrella of personality disorders in the Diagnostic and Statistical Manual IV (DSM-IV-TR), the text used by mental health professionals to diagnose patients. Personality disorders develop in early adulthood, affect most areas of a person’s life, are long standing and are part of their personality. This is different from someone with a phobia, one episode of major depression (not permanent) or post-traumatic stress disorder (not inherently part of their personality).
BPD is characterized by unstable and volatile relationships. People with BPD are constantly scared of and will react strongly to the thought of abandonment. They are confused about who they are and feel empty inside. They can be emotionally erratic, are impulsive in ways that may be self-destructive (e.g. overspending, substance abuse, unprotected sex), and have increased suicidal behavior. Most people have had some of these traits at one time or another, but by distinction they do not cause significant issues in one’s life. This disorder is thought to affect 2% of the population, 75% of whom are female. Treatment for those suffering from BPD is imperative because the successful suicide rate is estimated to be 8%-10% compared to 0.011% in the general population.
It is often the case that most people affected with personality disorders don’t seek treatment for the personality disorder itself, but for another disorder like depression or anxiety. Research shows Dialectical Behavioral Therapy (DBT), a form of talk therapy, is the most effective way to treat BPD. DBT was created by Marsha Linehan and explores thoughts and behaviors that are problematic. Mindfulness, focusing on the present moment with non-judgment and compassion, is integrated for times when discomfort is inevitable. Medication, specifically selective serotonin reuptake inhibitors, or SSRIs, are used to treat the emotional swings and impulsivity in BPD, but do not treat the disorder completely. The good news is that research indicates personality disorders resolve themselves over time. In one study, those diagnosed with BPD were reassessed 10 years later and most no longer qualified for the diagnosis.
This disorder is very painful for those who suffer with it and is difficult for those around them. If you, or your loved one is struggling with BPD, the best thing to do is to find a therapist.
So-Mai Brown Marriage and Family Therapist Intern