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Why Is Borderline Personality Disorder Misunderstood?


Borderline personality disorder (BPD) is often cast as one of the most difficult mental illnesses to diagnose and to treat. Characterized more often by external behaviors rather than internal causes, getting to the root of BPD can be a therapeutic challenge as a complicated web of coping behaviors that have been formulated to protect against an intense fear of abandonment, very often caused by an episode of trauma in early childhood.

BPD Comes With Many Symptoms

The term “borderline” can be interpreted as meaning there is no border between one area of this personality disorder to the next, whereas other mental health conditions draw a relatively distinct line between what they are and what they are not. For BPD, there are five common areas where mood and personality dysregulation, according to Perry D. Hoffman, President of the National Education Alliance for Borderline Personality Disorder.

      1. Emotional Dysregulation: An inability to regulate emotional thoughts, states, and experiences, often projection and placing blame for their emotions on others.
      2. Behavioral Dysregulation: An inability to regulate behaviors, maintain control over behaviors, and often placing blame for behaviors onto others out of fear of abandonment for accepting responsibility for the self.
      3. Cognitive Dysregulation: Changing thoughts, disturbing thoughts, and overwhelming thought processes.
      4. Interpersonal Dysregulation: Unstable and volatile relationships with others, often abusive, manipulative, and intense relationships.
      5. Self Dysregulation: A deep lack of understanding of the self, feeling like there is a missing identity of the self, etc.

Through each area of dysregulation, there comes a number of other symptoms that contribute to the oftentimes chaotic internal experience of living with borderline personality disorder. Problematically, there are hundreds of ways that BPD symptoms can present themselves, often leading to misdiagnosis and mistreatment of the disorder.

        • Intense and inconsolable fears of abandonment
        • Severe and sudden mood shifts
        • Impulsivity and otherwise highly unpredictable behavior
        • Anger management issues
        • Self-harm or self-injurious behaviors
        • Suicidal thoughts, ideations, behaviors, and attempts
        • Often using suicide as a threat or form of manipulation towards others
        • Difficulty managing or maintaining relationships
        • Substance abuse
        • Eating disorders
        • Co-occurring mood and personality disorder diagnoses or symptoms

As Hoffman explains, “Those afflicted with borderline symptoms very often experience sudden shifts in emotion that frequently leave both the individual with BPD and those close to them in their environment in a state of intense disruption… Needless to say, experiencing even a few of the behaviors can create a life of pain and suffering.” Treatment for BPD is possible and many who have lived with untreated symptoms eventually come to call themselves “recovered” from the unmanageability of life before treatment.



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