What’s Borderline Personality Disorder?

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Borderline Personality Disorder (BPD) is a serious mental condition defined by extreme behaviors. The name itself comes from the supposed boundary between neurosis and psychosis, although modern psychologists have moved away from that definition. In essence, a patient with this disorder is always caught between manageable anxiety and uncontrollable psychotic behavior. A patient may cut himself with a knife, for example, but only to the extent of self-mutilation, not necessarily suicide.

Although borderline personality disorder can occur in males or females, the majority of diagnosed cases tend to be young females just entering adulthood. Childhood trauma or sexual abuse is believed to be directly linked to the later formation of this condition. Sufferers often enter into risky sexual relationships or develop intense but unstable friendships. Those with true BPD can become so emotionally dependent on others that stable relationships become impossible to maintain.

An important aspect of borderline personality disorder is the “black or white” worldview. Those with BPD tend to view their friends, colleagues, and family members with a hypercritical eye. A sibling may be seen as an idealized role model one day, only to be treated as unreliable or worthless the next. The only person a BPD sufferer hates more than an unfaithful friend is themselves. Self-mutilation and extremely low self-esteem are classic symptoms of the disorder.

There are some critics who suggest that borderline personality disorder is more of a generic diagnosis used to classify those who don’t quite fit other definitions of mental disorder. BPD may be similar to the muscle condition of fibromyalgia, more of a generic diagnosis for a host of unrelated symptoms. Indeed, many young women in the 1960s and 1970s were routinely diagnosed with this disorder, leading to a controversial confinement in psychiatric hospitals. Winona Ryder’s character in the film Girl, Interrupted is diagnosed, although she does not experience the more extreme symptoms.

Treatment for this disorder is typically long-term psychotherapy and the use of mood-stabilizing medications. Psychotherapy is not always an easy process, because sufferers often treat their doctors with the same contempt and animosity they show to others. The main goal of psychotherapy is to overcome the patient’s defense mechanisms and uncover the initial trauma that triggered the condition. Borderline personality disorder can be equally devastating to close friends and family members, who feel the need to “clean up” the sufferer and can become enablers.

Borderline personality disorder can accompany other mental conditions, which often makes a correct diagnosis difficult. While someone with bipolar disorder can be depressed for weeks, a BPD sufferer can be depressed for a few hours and then become almost manic for a short time. Binge eating, promiscuity, gambling and excessive shopping are also indicators of an active disorder.

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