learn about borderline personality disorder info sheets 2014 www.heretohelp.bc.ca In the past, people thought that someone with borderline personality disorder (BPD) was “on the borderline” between psychosis and neurosis (anxiety/depression). Today, we know much more about BPD, and there is more research on BDP than any other personality disorder. But there is a lot of stigma around personality disorders. People living with borderline personality disorder may be given hurtful "Just having the labels. But no one is ever just their diagnosis, whether they’re ability to protect living with a personality disorder or any other mental illness. myself from the There is hope and there is help. belief that I’m not What is it? good enough makes What is a personality disorder? you have a pattern of feelings, thoughts A personality disorder is a pattern of and emotions for a long time that cause my life so much feelings, thoughts and behaviours that problems. may have been with you for a long easier. It frees me up time. Personality disorders affect the What is borderline to focus on the good way you understand yourself, the way personality disorder? you react to the world around you, the Borderline personality disorder is a things in my life, and way you cope with emotions and the mental illness that affects the way to there are many good way you navigate relationships. Having relate to other people and the way a personality disorder does not mean you relate to yourself. If you’re living things now!" that there is something wrong with with borderline personality disorder, your personality—it simply means that you might feel like there’s something borderline personality disorder fundamentally wrong with who you are—you might feel ‘flawed’ or could I have borderline worthless, or you might not even have a good sense of who you are as a personality disorder? person. Your moods might be extreme and change all the time, and you might have a hard time controlling impulses or urges. You may have a hard time trusting others and you may be very scared of being abandoned or alone. I can’t control my anger. I often lose my temper or get into fights BPD is made up of five groups of symptoms: unstable behaviour, unstable I feel empty inside most of the time emotions, unstable relationships, unstable sense of identity and awareness I experience intense anxiety, problems. depression or irritability, and it usually goes away in a few hours or a few days • Unstable behaviour means that you often act on impulses or urges, I do whatever I can to avoid being even when they hurt you or other people. Some examples of impulse abandoned control problems are: I can’t stop spending money, having • Thinking about or attempting suicide risky sex, using drugs or other things • Hurting yourself on purpose, such as cutting or burning your skin that can hurt me (self-harm) I think about ending my life • Risky behaviours like spending a lot of money, binge eating or I harm myself problematic substance use I have a hard time maintaining personal • Unstable emotions mean that your moods can be extreme and change relationships; I fall ‘in and out of love’ very quickly. Some examples of unstable emotions are: quickly • Extreme depression, anxiety or irritability that might last for only My sense of self changes all the time; I don’t know who I really am a few hours or days, usually in response to a stressful event If you have several of these symptoms and • Intense anger or difficulty controlling anger you’ve noticed them for a long time, the • Intense boredom best person to talk to is a doctor or mental • Unstable relationships mean that you have a hard time maintaining health professional. BPD can look like relationships with other people. Some example of relationship problems many other illnesses, so you should never are: try to diagnose yourself (or other people). • Doing anything you can to avoid being abandoned or alone • Feeling like you don’t know yourself or having very unstable sense of who you are and how you feel about yourself • Intense relationships where you often impulsively shift between seeing the other person as ‘all good’ or ‘all bad’ • Unstable sense of identity means that you don’t have a good sense of who you are as a person. Some examples of an unstable sense of identity include: • Feeling like you don’t know yourself • Having a very unstable sense of who you are and how you feel about yourself • Feeling “empty” much of the time • Awareness problems mean that, from time to time only and often in response to a stressful event, you experience sensations or feelings that aren’t based in reality. Some examples of awareness problems are: • Psychosis (delusions or hallucinations) • Feeling like you’re separated from your mind or body (dissociative symptoms) 2 info sheets 2014 www.heretohelp.bc.ca borderline personality disorder There are many different combinations • Other mental illnesses—Many therapy focuses on identifying of symptoms, so BPD can look very people living with BPD have other unhelpful way of thinking, feeling different among people with the mental illnesses. This can make it and behaving. illness. To diagnose BPD, mental hard to diagnose BPD properly. The • Other types of counselling may health clinicians look for patterns of illnesses most often associated with also help. Supportive therapy helps behaviour that last for a long time and BPD are mood disorders, anxiety to improve day-to-day life skills, have caused distress or problems with disorders, substance use disorders, increase self-esteem and helps relationships or other areas of life, such attention-deficit/hyperactivity you understand your feelings. as work. disorder, eating disorders, Interpersonal group therapy lets dissociative disorders and other you share your problems and Who does it affect? personality disorders. successes with others, and it teaches About 1% to 2% of the general relationship skills. Family therapy population has BPD. It’s usually What can I do about it? helps family members understand diagnosed in teens and young adults, Treatment for BPD can be very effective. the illness and teaches them coping though it may also be diagnosed later It may include a combination of skills. in life. It seems to affect more women therapy (counselling), medication and than men. self-help. Medication • Family members—You are five Medications won’t resolve BPD, but times more likely to develop BPD Therapies they can help manage some troubling if a close family member like a Several different therapies may help: symptoms. Atypical antipsychotics, parent or sibling has BPD. You also • Dialectical behaviour therapy mood stabilizers and certain have a higher risk of BPD if a close (DBT) is often a treatment of choice. antidepressants may help. family member has an impulse It’s based on cognitive-behavioural control disorder like a substance use therapy and mindfulness. Self-help disorder or antisocial personality Cognitive-behavioural therapy There are many things you can do to disorder. teaches you how your thoughts and help manage BPD. Learning about the • Childhood trauma—Abuse, neglect, behaviours affect your emotions, illness can help you understand what’s loss and other hurtful events that while mindfulness teaches you to going on. It’s always a good idea to occurred in your childhood increases focus on the present moment. DBT get enough sleep, eat well and exercise your risk of developing BPD. teaches you to replace extreme and regularly. Finding help for other issues • Age—BPD is more likely to be rigid ways of thinking with more like a substance use problem or another diagnosed in your 20s. This is also open and flexible ways of thinking, mental illness can also help you cope the time with the highest suicide and teaches skills like acceptance, with BPD. risk. Many people find that their problem-solving and tolerance. symptoms become more manageable • Several newer therapies also show BPD can take some time to treat. It’s as they get older, and many people a lot of promise in the treatment important to build a trusting and recover by the age of 50. Researchers of BPD. Mentalization-based open relationship with a counsellor or aren’t completely sure why people therapy helps you understand doctor and keep a consistent, long-term often feel better as they get older. your behaviour and other people’s treatment plan. One theory is that people become behaviour, and the thoughts less impulsive as they get older. and feelings associated with the Another theory is that certain brain behaviours. Transference-focused structures related to emotion change therapy helps you understand as we age. how you see yourself in your relationships. Schema-focused info sheets 2014 www.heretohelp.bc.ca 3 borderline personality disorder where do I go from here? In addition to talking to your family Canadian Mental Health Association, Alcohol & Drug Information and BC Division Referral Service doctor, check out the resources below Visit www.cmha.bc.ca or call 1-800-555- If you’re concerned about your alcohol for more information about borderline 8222 (toll-free in BC) or 604-688-3234 (in or drug use or concerned about some personality disorder. Greater Vancouver) for information and else’s use, call the Alcohol and Drug BC Partners for Mental Health community resources. Information and Referral Service at and Addictions Information 1-800-663-1441 (toll-free in BC) or 604- Visit www.heretohelp.bc.ca for the Resources available in many languages: 660-9382 (in Greater Vancouver). This Managing Mental Illnesses series, *For each service below, if English is service is available seven days a week, more info sheets and personal stories not your first language, say the name 24 hours a day.