What is BPD?

Borderline Personality Disorder is classified by Psychiatrists as one of the severe psychiatric illnesses. I know this to be true, because I have the diagnosis. Unlike some other well-known psychiatric disorders, BPD pervades almost all aspects of a person’s mind: for the diagnosed, BPD affects how we function, and means a whole list of seemingly simple practical interactions can become highly complex.

 

The crux of having this diagnosis is that most people with BPD, have low self-esteem, and they can have a way of thinking that is sometimes so skewed that it can lead to self-harm, risk-taking, or suicide. Barrel of laughs eh......  However, BPD sufferers can form long-lasting and constructive relationships which endure and are positive, especially if the other person is understanding and has knowledge of the diagnosis.

 

We can be the life and soul of a party. But we can also hide under a blanket while the world enjoys itself, just because someone said something about our dress that quickly spiralled from a cheap shot by someone who should have known better, to a bout of self-hatred which could end in an overdose. During times of stress, sometimes we can have psychotic episodes where we might see or hear things that are both freaky and, ultimately, not actually there in the real world. This can also manifest, for some, in less overt episodes of paranoia and intense introspection. My winter evenings can whizz by…sometimes in deluded terror that Bigfoot might be in the back garden. He isn't, obviously, but at the time it all makes perfect sense.

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But…we are also capable of being really empathetic. Some can cry a lot, some overthink, some pick up on the slightest bit of body language from another person. And some are passionate, to the point of being great people to start a relationship with, or a new project; when we are into something, we’re really into it. See….there are positives from the diagnosis, too, despite how it can feel.

 

There is a debate as to where/how exactly (scientists always like to know exactly, don’t they) BPD is caused and how it affects physical brain structure – and I won’t go into that here, mainly because I can’t stand looking at brain photos – but the general consensus is that the disorder is a mix of Nature/Nurture and has a basis in our formative years.

 

BPD is treatable (hooray for that!). The symptoms are usually controlled by medication, but the Blue-Ribbon treatment is the snappily titled Dialectical Behavioural Therapy (DBT) – developed in the USA. DBT is intensive and for many can be life-changing. It focuses on controlling the symptoms and behaviour. Ideally, once completing DBT treatment, it's important to have further therapy to explore the deeper roots of what causes the symptoms and behaviour. Other treatments recommended for BPD include mentalisation-based therapy (MBT), Therapeutic communities (TCs) and Arts therapies. You can read more about all these therapies on the NHS website here. 

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Obviously, symptomatic control can be hit and miss and depends on outside factors and the general pervasiveness of everyone’s own experience of their diagnosis. So, in truth, there is no panacea or nirvana for BPD sufferers. The old adage of ‘What works for you’, is perhaps the best rule of thumb. Each one of us can feel better.

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So….the prognosis? Well, it’s good. I suppose as long as you can get help, don’t goof off in therapy, and try really hard to enable some positive change in your life, things can look up – they are for me, for example. My future lies in things infinitely more positive than the drudging horror of the last couple of decades. Hope….that’s the key, folks. And it really does exist.

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