On the surface, people with borderline personality disorder (BPD) may seem manipulative and needy drama makers.
Their off-putting behaviour prevents others to see the enormous emotional pain and suffering that stands behind it. Even specialists are sometimes tricked. As Sandra Sulzer of the University of North Carolina at Chapel Hill discovered in her study with 22 psychiatrists and psychologists: “Clinicians frequently view borderline personality disorder symptoms as signs of badness, not sickness.”
But sickness it is and one of the most painful types. Here is the confession of a sufferer of BPD:
”As a borderline personality disorder sufferer myself I want you to know that we are not manipulative. We are desperate.
We don’t know how to live with others, how to have friends and get our needs met the normal way. We simply are ignorant in this respect…
Our uncontrollable and horrible emotions deprive us of ability to think and control our behaviour. Our behaviours are not meant to harm. Rather they are an expression of desperation. ”
Living with BPD may feel like living in hell.
Some of the daily struggles this debilitating state may induce are:
Feelings of Emptiness
Borderline sufferers are closely acquainted with depression. The feeling of emptiness may become overwhelming to the point of making suicide look like a seducing option. As Kristalyn Salters-Pedneault at Eastern Connecticut State University writes:
”Suicidal behaviors and completed suicides are very common in people with borderline personality disorder (BPD). Research has shown that up to 80 percent of people with BPD will make at least one suicide attempt in their lifetime, and many will make multiple suicide attempts. People with BPD are also more likely to complete suicide than individuals with any other psychiatric disorders. ”
The confessions of the sufferer are explicit enough:
‘’Please believe me, the depression and dysphoria of BPD is the most horrible feeling. Sometimes I prefer I had cancer instead. At least then the whole world would not blame me for desperate efforts to blunt the pain brought about by my biological vulnerability and abuse I suffered as a child.’’
Unstable Interpersonal Relationships
For people with BPD the world of relationships is scary and full of polarities. One day their partner is all good and wonderful, the next day he’s the worst scum of the universe. This black and white thinking is quite exhausting for both parties and may ruin the relationship altogether. Michael J. Formica explains the changing dynamics between extreme idealization and the inevitable disappointment which follows:
”Depending on the rapidity of the cycle, within weeks, months or sometimes years, this idealized image is replaced, bit by bit, with, for lack of a more clinical term, its evil twin. The other is split black, and once one is taken there, the perception on the part of the borderline character, while it may flip-flop for a time, is not likely to be reversed.”
Impulsivity is the tendency to act without thinking about the consequences of your actions. Apart from being a suicide risk factor, impulsivity in BPD may take the form of all kinds of dangerous behaviours ranging from substance abuse and reckless driving to binge eating and casual sex. It may be the way sufferers cope with stress or feelings of anger and emptiness. Kristalyn Salters-Pedneault points that there is a way out of it:
”While impulsive behaviors can be serious and pervasive, this symptom can be successfully managed with therapy. Many treatments for BPD have components that target impulsivity. For example, dialectical behavior therapy (DBT) focuses on building skills that reduce your impulsive behaviors and increase your ability to reflect before acting. By using healthy coping mechanisms to handle intense emotions, a person with BPD is better equipped to handle different situations.”
Many people with BPD experience extreme fluctuations in moods. Seemingly minor events may trigger disproportionate reactions. They find it difficult to regulate emotional responses and are often at risk to be overwhelmed by them. This feature is probably responsible for labelling them drama queens. But this label misses the point. They are not making it in order to hurt or annoy those around them. It’s their distorted interpretation of reality which triggers the tantrums.
Inconsistent Sense of Self
In order to function in the world you need a strong sense of identity. That means knowing what your core values and attitudes are, what you believe in and who you are in your different roles. For people with BPD this whole identity thing may be quite confusing and inconsistent. Kristalyn Salters-Pedneault explains it this way:
‘’Identity problems in BPD are sometimes called identity diffusion. This refers to difficulties determining who you are in relation to other people. Some people with BPD may describe this as having difficulties understanding where you end and the other person begins. As a result, many people with BPD struggle to set up and maintain healthy personal boundaries and have difficulties in their interpersonal relationships.’’
The emotional pain associated with BPD is very intense but treatment can make a huge difference.
Here is a quick test you can take to check if you have borderline tendencies in your character (and don’t worry, we all do): psychcentral.com
If you think you’re at risk of committing suicide, however, you need to get help now. You can call the National Suicide Prevention Lifeline suicidepreventionlifeline.org at 1-800-273-8255. It’s open 24/7, 365 days a week, and it’s free and confidential.