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What is BPD?
Borderline personality disorder (BPD) is a mental disorder characterized by disturbed and unstable interpersonal relationships and self-image, along with impulsive, reckless, and often self-destructive behavior.
How does BPD present itself?
Individuals with BPD have a history of unstable interpersonal relationships. They have difficulty interpreting reality and view significant people in their lives as either completely flawless or extremely unfair and uncaring. These alternating feelings of idealization and devaluation are the hallmark feature of borderline personality disorder. Because borderline patients set up such excessive and unrealistic expectations for others, they are inevitably disappointed when their expectations aren’t realised.
What causes BPD?
Adults with borderline personalities often have a history of significant childhood traumas such as emotional, physical, and/or sexual abuse and parental neglect or loss. Feelings of inadequacy and self-loathing that arise from these situations may be key in developing the borderline personality. It has also been theorised that these patients try to compensate for the care they were denied in childhood through the idealised demands they now make on themselves and on others as adults.
What are the symptoms?
The DSM-IV-TR requires that at least five of the following criteria (or symptoms) be present in an individual for a diagnosis of borderline disorder:
- frantic efforts to avoid real or perceived abandonment
- pattern of unstable and intense interpersonal relationships, characterized by alternating between idealization and devaluation (“love-hate” relationships)
- extreme, persistently unstable self-image and sense of self
- impulsive behavior in at least two areas (such as spending, sex, substance abuse, reckless driving, binge eating)
- recurrent suicidal behavior, gestures, or threats, or recurring acts of self-mutilation (such as cutting or burning oneself)
- unstable mood caused by brief but intense episodes of depression, irritability, or anxiety
- chronic feelings of emptiness
- inappropriate and intense anger, or difficulty controlling anger displayed through temper outbursts, physical fights, and/or sarcasm
- stress-related paranoia that passes fairly quickly and/or severe dissociative symptoms— feeling disconnected from one’s self, as if one is an observer of one’s own actions
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