3 Shocking Things to Know About Borderline Personality Disorder

Borderline personality disorder (BPD) is a mental disorder characterized by a pervasive pattern of instability in interpersonal relationships, self-image, emotions, and behavior. Clinicians often connect self-harm, unstable relationships, and intense emotions to the disorder. Even with these descriptions, it’s still hard to grasp what this disorder is all about.

This article dives into the symptoms, history, and the flaws of this mental diagnosis. My intention is to provide you the insight that many mental health professionals fail to inform their clients. This would allow you to make an informed decision on how to address these challenges.

Let’s dive deeper into what borderline personality disorder is. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), the manual that many mental health clinicians use, describes BPD as “a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity.” To receive the diagnosis, a person must show at least five of these nine signs:

1. Desperate attempts to avoid abandonment, real or imagined
2. Rocky relationships, swinging between worship and hatred
3. Shaky sense of self, not knowing who you really are
4. Risky behavior in areas like spending, sex, or substance use
5. Repeated suicidal actions or self-harm
6. Mood swings, with intense periods of distress, irritation, or worry
7. Ongoing feelings of emptiness
8. Explosive anger or trouble controlling temper
9. Brief periods of paranoia or feeling disconnected from reality when stressed

I delved into the significance of each of these symptoms in another article. Click here to read more. Prior to forming any conclusions about yourself, it’s important to grasp their intended message. In my experience, the majority of people tend to only pay attention to one or two terms that catch their eye, without considering the complete context.

If you are struggling with number 5, please reach out to a crisis hotline. Just remember, you aren’t alone on this journey. I used to work as a volunteer for the Crisis Text Line. The organization is top-notch with fantastic training. People work there free-of-charge, so people do care!

Before I get into the nitty-gritty of the disorder, it’s important to know what it means to receive one. Brace yourself for this shocking review.

Getting a diagnosis from the DSM-V doesn’t mean a whole lot.

No, you didn’t misread what I just said. This is from a counselor who specializes in BPD and eating disorders. Most counselors—if they are up-to-date with the research—reading this will agree with me.

The DSM-V is notorious for lacking predictive validity. That may sound like a foreign term, but it’s a crucial element when it comes to diagnosis and assessments. It ensures that the diagnosis accurately forecasts future outcomes, leading to informed decision-making and effective interventions.

For example, when the doctor discloses to you that you’re positive for strep throats, it could be a sense of relief for many people. It means that they will take certain medications for a specified duration, and they will be cured.

That cannot be said the same for the mental health industry. When someone gives you a diagnosis for borderline personality disorder, it causes more uncomfortable feelings. You can try 5 different medications and several psychotherapists and still not find the treatment that works for you. A common recurring situation I observe throughout my years as a clinician.

There’s no specified duration or fixed treatment plan. It’s forever changing. The accuracy of a standard treatment plan is nearly 0%. It’s one of the most pointless things that many therapists are required to complete.

Would you go to a doctor that gives you a treatment plan for a disease and switches your medication 3 to 5 times? Well, that’s what’s going on in the mental health field. It’s so common that it’s extraordinary.

Then, you factor in the lack of diagnostic consistency among clinicians. Clinicians can interpret the same symptoms differently, resulting in unique diagnoses. Overlapping mood symptoms can lead clinicians to initially misdiagnose around 40% of individuals with BPD as having bipolar disorder, according to studies. The numbers didn’t lie. 4 out of 10 people got the incorrect diagnosis. That’s just with bipolar disorder. I can include plenty of statistics that prove the claim I made.

On the first episode of my podcast with the wonderful co-host, Sheree Morgan, we dove deep into the problems with the DSM-V. Check out the article or listen to the podcast by clicking here. It’s the primary motivation for me to start this blog and podcast to inform the public of its danger. Although it has its use for the clinicians, it doesn’t have much for the clients.

The Historical Context of BPD

It’s worth noting that BPD has a controversial history. The term “borderline” was first used in the 1930s to describe patients who were on the border between neurotic and psychotic disorders. Over time, the understanding of BPD has evolved, but the stigma associated with the diagnosis persists.

In the 1970s, psychoanalyst Otto Kernberg coined the term “borderline personality organization” to describe a consistent pattern of functioning and behavior characterized by instability and reflecting a disturbed psychological self-organization. However, it wasn’t until 1980 that the DSM-III officially recognized BPD as a diagnosis.

This historical context is crucial because it highlights how our understanding of mental health conditions can change over time. As our knowledge expands, our understanding of mental health conditions might lead us to view what we consider a distinct disorder today differently in the future.

The Impact of BPD Diagnosis on Treatment

Receiving a BPD diagnosis can significantly affect the type of treatment a person receives. While this can be beneficial sometimes, it can also lead to a one-size-fits-all approach that doesn’t account for individual differences.

Common treatments for BPD include:

1. Dialectical Behavior Therapy (DBT)
2. Acceptance & Commitment Therapy (ACT)
3. Process-based Cognitive-Behavioral Therapy (PCBT)

If you want to learn more about these therapeutic approaches and understand how they can serve you, click here to read more.

While these therapies have shown effectiveness for some individuals with BPD, it’s important to remember that everyone’s experience with mental health is unique. What works for one person may not work for another, regardless of sharing the same diagnosis.

I recently wrote an article on mindfulness, one of the most effective therapeutic approaches for Borderline Personality Disorder. Click here to learn more about it.

What do you do if you receive this diagnosis?

I would say do what your clinicians recommend you to and nothing more. Overwhelming yourself with the diagnosis doesn’t contribute to your overall wellbeing. From experience, many people begin to identify themselves with that label. It becomes their identity.

Rather than putting energy towards learning about these nonfunctional labels, I would put efforts towards doing the homework and exercises that the mental health clinician assigns you. There’s this yearning for coherence within us all. As soon as I assign a diagnosis, especially something as ambiguous as Borderline Personality Disorder, the clients would make their life revolve around this label. That effort could be spent on mindfulness exercises and engage in actions that take them towards things that truly matter in their lives.

The Importance of Holistic Approach

While it’s crucial to address the symptoms associated with Borderline Personality Disorder, it’s equally important to look at the person as a whole. Factors such as lifestyle, social support, physical health, and personal goals all play a role in mental wellbeing.

Instead of fixating on the BPD label, focus on developing healthy coping mechanisms, building strong relationships, and pursuing activities that bring you joy and fulfillment. Remember, you are more than your diagnosis.

Conclusion

Understanding BPD is like trying to catch smoke with your bare hands – it’s elusive and constantly shifting. While the diagnosis can provide a framework for understanding certain behaviors and emotions, it’s crucial not to let it define you entirely.

If you received a diagnosis of Borderline Personality Disorder, remember that this is just one part of your story. Focus on the strategies and tools that help you navigate life’s challenges, rather than getting caught up in the label. Your journey is unique, and with the right support and self-awareness, you can lead a fulfilling life beyond the confines of any diagnosis.