Borderline Personality Disorder: Understanding The Complexities

Borderline Personality Disorder is one of the most commonly misunderstood and misdiagnosed mental illnesses. Because symptoms of Borderline Personality Disorder vary on a broad scale, it is easy to misdiagnose. Millions of men and women who are struggling with Borderline Personality Disorder are not receiving proper clinical diagnoses, treatment plans, or interventions designed to meet their needs.  

Problematically, it is the very nature of borderline which contributes to the confusion in diagnosing the disorder. Many people living with Borderline Personality Disorder often experience a deep-seated and ultimately controlling fear of abandonment. So intense is their fear of rejection and abandonment, they may do whatever it is they feel it takes to cover up or avoid a sense of abandonment. Anger, manipulation, explosive rage, self-harm, and other concerning behaviors are common with Borderline Personality Disorder.  

Someone who is living with borderline is on a mission to protect the inner parts of themselves which they feel cannot or should not be seen – which can mean leading therapists and clinicians down a complicated winding road until arriving at the proper tools for recovery.  

Trauma and Borderline Personality Disorder 

For years, there was no answer to Borderline Personality Disorder and its many different reactions, responses, and symptoms. Thorough amounts of shame and stigma were placed upon these individuals who were clearly struggling to make sense of their internal world. Finally, clinicians sought to ask and determine what was going on in that internal world, rather than generalize “emotional difficulty” as the answer.  

Fears of abandonment do not manifest on their own. In order to experience abandonment, one has to experience abandonment. Meaning, there is often a real or perceived traumatic experience that caused feelings of abandonment, rejection, or neglect, in the story of someone who is living with Borderline Personality Disorder.  

Trauma is experienced differently by everyone and cannot be determined by any one single person. The inability to cope with the fear of abandonment or rejection is deep and intensely complicated in borderline personality disorder, leading to an array of reactions and behaviors. Until recent years, the behaviors of Borderline Personality Disorder have been designated as “attention-seeking” placing too much blame, shame, and guilt on those who are struggling. Today, we have greater understandings of borderline and know that these individuals are in desperate need of comfort and assurance, healing, and growing, as well as the development of healthy tools to cope.  

What Are The Signs and Symptoms of Borderline? 

• deep fears of abandonment  
• manipulation 
• extreme emotional reactions 
• rage or anger management issues 
• taking extreme measures to force or avoid abandonment 
• unstable relationships 
• idolizing/hating 
• distorted or empty sense of self 
• impulsive behaviors 
• self-harming behaviors 
• suicidal behaviors and threats 
• feeling empty 
• anger management issues 
• paranoia or suspicion 
• dissociation and realization 
• depression 
• anxiety 
• substance use 
• compulsive sexual behavior
   

Borderline Personality Disorder and Substance Use 

The core features of Borderline Personality Disorder include impulsivity, emotion dysregulation, and interpersonal dysfunction. Of all the personality disorders, Borderline Personality Disorder is typically the second most prevalent to have patients with substance abuse. About 78% of adults with Borderline Personality Disorder develop a substance use disorder or addiction at some time in their lives. This means that both disorders must be treated at the same time, by the same team, in order to achieve lasting recovery results. Thankfully, many of the interventions with which work for Borderline Personality Disorder symptoms also show effectiveness in the treatment of substance use and visa versa. As clinicians, this means that a clear treatment plan can successfully address symptoms of both issues and help the affected person move toward change. 

Early Death Rates and Borderline 

Approximately 70-75% of patients with Borderline Personality Disorder have a history of at least one deliberate act of self-harm. A study published online in January of 2019 in the Journal of Clinical Psychiatry found evidence that individuals with Borderline Personality Disorder may be at a higher risk for premature death, specifically from suicide. Three hundred patients with Borderline Personality Disorder were followed in the study for 24 years in addition to 72 other patients who did not have Borderline Personality Disorder. Every other year during the 24-year span, the patients were evaluated for their state of mental health. The intensity of borderline symptoms often causes suicidal attempts and threats, which can, unfortunately, come to completion.  

If you are struggling with thoughts of suicide, please reach out to the National Suicide Prevention Lifeline for support at 1-800-273-8255.  

Recovery Is Possible 

There are answers for recovering from borderline and learning to live a balanced, regulated, fulfilling life which includes healthy, functional, reciprocal relationships, and research has shown that outcomes can be quite good for people with Borderline Personality Disorder, particularly if they are engaged in treatment. With specialized treatment interventions, such as Dialectical Behavioral Therapy (DBT) or Eye Movement Desensitization and Reprocessing (EMDR), most people with Borderline Personality Disorder find their symptoms are reduced and their lives are improved. Through evidence-based approaches, difficult symptoms can be navigated more readily, giving individuals with borderline the freedom they seek, as well as deserve.  

Origins Behavioral Healthcare is a well-known care provider offering a range of treatment programs targeting the recovery from substance abuse, mental health issues, and beyond. Our primary mission is to provide a clear path to a life of healing and restoration. We offer renowned clinical care for addiction and have the compassion and professional expertise to guide you toward lasting sobriety. For information on our programs, call us today: 561-841-1296