Borderline for Beginners
What to expect after the diagnosis.
Any information given is based upon my experience and is not to replace medical or psychiatric care.
Borderline personality disorder is a complex mental illness that is often misunderstood. Often, a diagnosis does not come without a lot of misdiagnoses and frustration. The stigma surrounding this particular mental illness is one of the most severe. People with borderline personality disorder are often treated unfairly by doctors and those in the mental health system because of the lack of education surrounding the subject.
To understand borderline personality disorder, we must first understand what the criteria is. According to the DSM-5 (the Diagnostic Manual for mental illness), a person must meet 5 of 9 criteria. Criteria for this diagnosis includes: struggling with interpersonal relationships, engaging in risky and impulsive behavior, extreme fluctuations in mood, fear of abandonment, struggling with identity, chronic feelings of emptiness and more. It is common for people not to be diagnosed until the age of 18, when they are considered an adult. Borderline personality disorder is most known for self harm and suicidal behavior, which is also a criteria to meet this diagnosis. Another prominent behavior for this illness is a strong feeling of uncontrollable anger and angry outbursts. It is these two behaviors which unfortunately and unfairly give BPD a bad name.
The tricky part about diagnosing this illness is that there are many factors that can cause it and there are many shapes it may take. For example, a common borderline trait is the extreme anger, but that strong emotion is not always visible to other people. This form of BPD is known as "quiet borderline." If a person doesn't outwardly show their emotions, sometimes BPD is not considered. This doesn't mean it is not there. Causes of this illness are usually related to childhood or past trauma. Other disorders may also be occurring at the same time, making it hard to specify the problem. Often, people with BPD have also struggled with depression, anxiety, eating disorders and sometimes even PTSD.
A controversial point recently surrounding borderline personality disorder is its title of a disorder. Many mental health professional believe in changing its name to childhood trauma because that is the most common cause of the illness. The word "disorder" is meant to sound like there is something wrong with someone or that they are broken. This is not a fair word for the experiences of someone with BPD.
Because of the stigma surrounding BPD, a diagnosis can make it difficult to receive help. People with BPD are often stigmatized as dangerous and scary, which is not usually the case. People with BPD are rarely a danger to anyone else, and the people they pose the most danger to is often themselves. It can be difficult to receive treatment if the professional is not trained or doesn't have experience in working with BPD. This can make communicating with a professional such as a doctor or therapist very difficult. It is the experience of many people with BPD that they are often passed around from therapist to therapist because of the complexity of their diagnosis.
Now, all this is not to say that there is not help out there. BPD is certainly manageable with therapy and time. Although there is not a medication designed specifically for BPD, there is a therapy called DBT, or Dialectical Behavioral Therapy. DBT was designed for BPD specifically by a psychiatrist who has dealt with it personally; her name is Dr. Marsha Linehan. The model of DBT is designed to work on five main parts of the disorder: Mindfulness, Emotion Regulation, Interpersonal Effectiveness, Distress Tolerance and Walking the Middle Path. Each section is used to help conquer the everyday struggles the disorder brings up. Combined, the five focuses of DBT are used to help manage extreme moods, feelings of anger, and extreme amount of distress and impulsive behavior. The key to DBT being so effective is its focus on Dialectics, or the Middle Path. People in this therapy are taught to accept where they are at the moment and be willing to change. Dialectics is the idea that two opposites can both be true, like it can be sunny and raining. Another important aspect of DBT is group therapy. Being in a group helps the loneliness and emptiness the disorder can bring on. Talking with people who have similar experiences creates a great support system while working through the illness.
Finding supports and resources is really important when recovering from any illness, especially mental illness. Some resources that have helped me are The DBT Skills Training Guide by Marsha M. Linehan, The Buddha and The Borderline by Kiera Van Gelder (a novel), I Hate You, Don't Lave Me by Jerold J. Kreisman & Hal Straus (a novel), @safespacebpd on Instagram and Back From The Edge- Borderline Personality Disorder (a documentary). Finding supports within the community is also a great place to start recovery. Perhaps the most important support will be from family and friends.
In closing, BPD is a very hard thing to deal with for people diagnosed and those around them. Healing and recovery is possible, and happiness is absolutely attainable. When working on oneself, whether in therapy or not, remember that everyone is doing the best they can at any moment. I am writing this six months into recovery from BPD and I am much better off than when I started. My impulsivity and seemingly uncontrollable moods are becoming more manageable, and I am learning how to build meaningful relationships again. Remember that even if you slip up every once in a while, you are always doing the best you can. Happy and hopeful recovery!