Battling with Borderline Personality Disorder (BPD)

Date : 20-04-2020

“……I don’t know what is happening to me. I am scared that my boyfriend is going to leave me, but I am also puzzled whether I am serious about this relationship or not. I feel empty most of the time. My emotions are swinging from one extreme to another. One minute I feel fine and the very next minute I lose all control over myself. Do I sound crazy?”

Sneha (name changed) was in tears when she shared her feelings during the therapy session. 

She had ongoing interpersonal issues with her friends and colleagues. She also reported irritability, low mood, anger outbursts and suicidal thoughts. These symptoms had been plaguing her from the age of 18. She has attempted suicide twice in the past, by overdosing on prescribed medications. According to her boyfriend, she is manipulative, unpredictable and constantly seeking attention. Sneha gradually started to realize that her colleagues and friends have been ignoring her and refusing to talk to her due to her mood swings. She feels that no one is able to understand her. She is detached from her parents as she had an uncongenial family environment during her childhood and reported to have a restrictive upbringing. 

What do you think? Is she having any psychological problems?

We are dealing with a lady with Borderline personality traits here. There are many people who share similar traits like Sneha. They generally have an intense fear of abandonment (it could be real or imagined) – and will go to all lengths to avoid it. Most of them get into unstable, intense relationships such as idealizing someone one moment and then suddenly believing that the person doesn’t care enough and they cut off the relationship with them. People with these traits are not sure about their relationship stability and most of them are found to be vindictive. Suicidal gestures or threats are often seen in them, especially in response to the fear of separation or rejection.

Impulsivity is one of the core traits in Borderline cases  – suddenly quitting a job after a trivial issue at office, ending a relationship abruptly, getting into multiple relationships etc. Their self image and identity keeps changing. They generally find it difficult to trust others, sometimes accompanied by an irrational fear of other people’s intentions. Like Sneha, individuals with borderline traits may feel that their emotions are out of their control. Much like the weather, their mood constantly fluctuates between extremes. It is extremely confusing for their friends and relatives.

However, not everyone with borderline personality disorder experiences every symptom. Hence, making a diagnosis is very crucial as  it can negatively affect their interpersonal relationships; marital life (leading to divorce) , social activities and over all self image. In addition, anxiety, depression, alcohol or other substance misuse are commonly seen comorbidities.

Though the traits are seen in both gender, it’s more in females ; the ratio is 3:1 in clinical settings  as per DSM-5. The cause of BPD is not known, but it is suggested that BPD is the product of an interaction between genetic, neurobiological, and psycho-social influences that affect the brain development. Life experiences are also known to be associated with the development of BPD, with Childhood trauma being the most significant (but not mandatory) risk factor for development of BPD.

“You smile, but you wanna cry

You talk, but you wanna be quiet

You pretend like you are happy, 

but inside you are not”

Don’t worry. It’s time to talk. Treatment is not without hope. But it requires not just the right therapeutic techniques, but a strong therapeutic alliance to unlock the potential of treatment.