Please fight my ignorance: "Borderline Personality Disorder"

Factual Questions
1

I am legitimately a bit flummoxed by what this disorder is supposed to be. That is perhaps because it’s terribly named: “Borderline Personality Disorder” doesn’t really tell you a lot about what the disorder is.

Anyway, I only heard of this ailment within the last ten years or so and, as it happens, many people on Facebook now either say they have it or post links to articles about it. The thing is, I cannot for the life of me figure out what this disease is. And I’m not JAQing off here, or being a dink; I am sure someone with clinical insight can lead me to some sort of “aha!” moment.

My confusion stems, aside from the generic name, in that BPD appears to be basically everything; according to the sources I have looked up, BPD manifests as extreme mood swings, paranoia, depression, anxiety, impulsive behaviour, and psychosis, and that’s a short list; basically, it’s almost every kind of psychological problem a person can have.

Like, is this a thing? Or is it a way to describe people who may suffer from more than one disease?

2

“The essential features of a personality disorder are impairments in
personality (self and interpersonal) functioning and the presence of
pathological personality traits. To diagnose borderline personality
disorder, the following criteria must be met:
A. Significant impairments in …”
Basically, as I understand it, and am not a doctor, psychologist, or psychiatrist, is that such a person is incapable of having feelings towards other, to the extent that he is liable to maim or kill others, but not himself.

3

Much easier to understand using the DSM-V criteria. It’s:

“a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning in early adulthood and present in a variety of contexts.”

http://theravive.com/therapedia/Borderline-Personality-Disorder-DSM--5-301.83-(F60.3)

4

That is not at all consistent with any source I’ve read. In fact, that sounds like a description of a psychopath, which is a reasonably well defined concept.

5

BPD is kind of a catch all for pathological maladaptive behaviors (those that interfere with normal social functioning and result in overly dramatic or projective behavior) but don’t fit into one of the other Cluster B category disorders (narcissistic, histrionic, or anti-social) and is often comorbid with or misdiagnosed as post-traumatic stress disorder since many of the basic symptoms (depression, substance abuse, difficulty with emotional regulation, unstable relationships and avoidant behavior) are the same, and effective treatments (cognitive behavioral therapy, group empathy, psychopharmacological management with SSRIs and Bupropion) are essentially identical.

Realize that the categories of personality disorders are just general spectrums, and the causes in and treatment of individuals suffering disorders in these spectrums are unique, or at least, tailored to the individual. Therapy for emotional and personality disorders is really more art than science and is highly dependent upon both the skill and experience of the therapist and the willing participation of the patient.

Stranger

6

From what I’ve read of the acting out of people with claimed BPD it seems like garden variety, short tempered, self absorbed angry asshole behavior applied in a situations where the BPD person thinks they can get away with it. Basically an emotionally unstable super jerk.

This is kind of an interesting take on it which says that unlike many physiologically based mental disorders BPD is* learned *disorder.

7

If you search the SDMB you’ll find several very informative threads where members relate their experience with people who have it. I’d link to some of the better ones if I wasn’t posting from a mobile device.

8

The difference between “asshole behavior” and a pathological disorder is that the former is a deliberate choice (more or less) and the latter is uncontrollable behavior that is self-destructive or obstructive to leading a productive and happy life with desired social connections.

I once dated a woman who was (in my non-professional opinion) suffering from Borderline Personality Disorder. She seemed to enjoy our time together and responded to courtesy and affection, but then would become emotionally unstable, to the point of being unhinged, cancel out on dates for manufactured or no credible reason, accuse me of imagined misdeeds when talking to mutual friends, and otherwise presented emotional dysfunction. She then apologized once I confronted her about it and promised it wouldn’t happen again only to repeat the behaviors with no provocation whatsoever. This clearly wasn’t helpful for her or what she wanted, but she had a compulsion toward avoidant, self-destructive behavior that severly affected her conscious decisions.

BPD is treatable to an extent dependent upon the patient’s willingness to recognized and take responsibility for their behavior and consciously adopt strategies to self-correct poor decisions and develop new patterns of behavior, which is often hard even for emotionally stable people (witness the failures of pledges to modify diet or follow an exercise program). Effectively treating BPD requires a lot of external reinforcement by people around the patient to not facilitate or accept poor behavioral patterns as well as having a process to modify emotional responses, hence why peer sharing and cognitive behavior therapy are part of the recommended treatment regimen.

Stranger

9

My father has been diagnosed with it (but doesn’t believe it to be true). Some more memorable examples of the associated behavior from my childhood:

  1. Once passed 17 cars on a 2 lane highway without returning to his own lane

  2. waterskies with the rope wrapped behind his head - he knows it makes everyone super nervous

  3. climbed Mt. Kilimanjaro in 1 day because the guides said he couldn’t- he demanded the national park (of a third world country) refund or prorate his pass as he only used 1 of the 5? days.

  4. has never paid for his own ticket to Disneyland or Disneyworld and just talks his way by anyone trying to stop him

  5. Snow skiing involves him buying a child’s or learners ticket
    Much of these relate to the superman and superasshole component- but they take white male privilege and amp it up to 11 across the board.

  6. He once went ballistic when I told him that one of my high school teachers (who was in his “friend” circle) said to me that my dad had called him already that morning to remind him that he was one year closer to death as it was his birthday. My dad could not comprehend that this teacher was joking or rewording for comedic effect.

  7. Everyone is taught defensive driving- my dad truly drives offensively, both literally and figuratively.

  8. He has had an anonymized/blocked phone number since forever including on his phone- and he gets them for free because he just harrasses the phone company until they give in- because it is his right to not be identified. (His anger at his beloved GOP and Trump-deswamper selling his internet privacy is highly amusing!)

  9. But the real kicker is his fear of “The Man” being out to get him, he really believes that the government and a seemingly literal man are trying to keep him down and repressed and miserable. I know people and my dad use the phrase all the time, but he really means it.

My dad is the greatest asshole that I’ve ever met to companies, to beauracracy, to laws, etc. but he is ridiculously generous and will have anyone’s back if they need him and they express their appreciation to him. He just wants to be liked but never ever be told what to do.

10

I have a relative by marriage who I’m pretty convinced has BPD. He’s convinced that everyone is out to get him, blames people who try to help him for not doing enough, has a hair trigger temper that leads to days of rage followed by remorse, abuses alcohol, and has a sense of entitlement that is out of this world (he’s living in a house provided by a relative for him rent-free, but he’s furious that they didn’t give him the house outright). A couple days ago he had a conversation with his grandfather which set off a multi-day rage, during which he sent me 91 text messages raging about how badly life is treating him. Oh, and he can’t understand why none of his family ever wants to visit him.

11

My exwife was diagnosed as severe BPD, they sent me to a few sessions and a seminar for those living with a BBD and I read one book on the subject.

The most noticeable symptoms I noticed was a complete lack of identity, She would assume the identity of who ever her current idle happened to be. She would take on their speech, walk, style, mannerisms etc. as close to everything she could. The first time a conflict would come up with that person she would feel betrayed and either go into a verbal attack or sink into depression. She was also capable of being extremely violent. She tried to kill me numerous times. No sense of boundaries with people. There is a small easy to read book called " I hate you don’t leave me" I think it gives a good overview of the disorder.

12

As I understand it, one of the most notable charactaristics is extreme black and white thinking…someone is their favorite person in the world, up on the highest pedestal, then when they (inevitably) let the person with BPD down in some tiny way (such as setting a boundary), that same person becomes Satan personified who can do no right.

13

Well, since I’m not on a mobile device, I was able to do a little searching.

Someone I know has borderline personality disorder

How bad is Borderline Personality really? Examples?

Borderline Personality Disorder – Real disease or lazy, catch-all diagnosis?

Please describe Borderline Personality Disorder

Ask a “high-functioning” borderline your questions!

14

Thx! The whole process of cutting and pasting links using a touchscreen usually results in a profanity laced tirade from me, and I was sitting in the waiting room of one of my kid’s school principals when I made that post.

15

My gf has bpd and her symptoms sound like textbook examples: 1. intensely felt emotions, both positive and negative. 2. Fear of abandonment. 3. Wild mood swings over minuscule matters (this ties in with #1). 4. Difficulty with self-identity (I see this as having too much empathy). 5. Facts are heavily colored by emotion, as in if something is felt strongly enough, it’s the truth. 6. Very black and white thinking. And more which are currentlyescaping my memory.

It IS treatable but the right combination of therapy/therapist and a patient who will commit to the therapy is needed in order to be successful. DBT-dialectical behavioral therapy-is currently the therapy holding the most promise.

People unfamiliar with bpd will see someone seemingly just being melodramatic or bratty or whatever. Its actually because the person with bpd is experiencing the same emotions as normal people but the degree to which they feel them is off the charts compared to those with no bpd.

16

I’ve heard therapists complain that BPDs are the hardest to treat.

Go one minute over the scheduled time, and the patient thinks the Dr is the greatest person ever, and probably in love with her.

Go one minute under the time, and the patient thinks the Dr hates her completely and is not doing enough and just does not UNDERSTAND!

17

They can actually do very well socially and in the workplace until they start getting close to someone. having more than one friend is seen as betrayal.

18

I find that the single greatest challenge to understanding all psychological disorders, is the fact that so far, there is absolutely no OBJECTIVE way to arrive at a decision of what label to use on someone.

Most disorders have more of a SPECTRUM of POSSIBLE symptoms, than they have any firm requirements. BPD certainly fits that. And because no two people with the same diagnosis/label are ever alike in all ways, a lot of people still refuse to admit that there even IS such a thing as a mental “disease.”

I am of the opinion that I have been heavily involved with at least one, and possibly two BPD people, after doing a lot of reading (and first hand observation). If nothing else, the term Borderline Personality fits them, because they can only barely be said to have a DEFINITE, even intermittently stable personality. Instead, they appear to be purely reactive to where ever they are, and whoever they are with.

The worst of the two, was not the violent one, ironically. The worst one would better be described as “always acting out her life, as though it were a scripted film.” It meant that her own life story would change, the moment something new happened, that required her response. This meant that I eventually realized that I actually knew almost nothing about her for sure, and since she seemed to be unaware of the process she used to get by in the world, I don’t even know if SHE could tell the difference between what had actually happened to her, and what she had made up out of fantasy to fill the gaps, or to make whatever was going on in the moment, more fun.

I notice that most of the symptom lists that people gave above, weren’t what I would recommend using for the purposes of a thread question like this. They were more lists of “what goes wrong for the victims of the disorder” than they were lists of WHY THE DISORDER WAS THEORIZED. I think it’s actually more difficult to figure out what something like BPD means, based on what goes wrong for everyone.

It’s also, I think, a little bit of an oversimplification to say that the difference between someone with an official disorder and someone who is “just a royal jerk” is that the one with the “illness” can’t help themselves. Some people with real disorders, actually have the problem that they CAN help themselves. The woman I described above, was all about “helping herself” get along, in fact, most of her worst behaviors were the direct result of her helping herself. She just didn’t have a stable inner starting point (i.e. a true independent personality) from which to pivot.

19

Just as a bit of a data point, the relationship I have with my gf is by a large degree the best relationship of my life. Its definitely also the most difficult. But she is highly intelligent and is completely committed to her therapy. Also, after a bit of research and education on the disorder, I was able to understand her behavior better. This allows me to empathize and de-escalate the situation, knowing it will be a short-lived episode. Prior to understanding the disorder, my reactions would escalate the episode dramatically.

20

I was married to my wife for 20 years, for the most part it was the happiest 20 years of my life, we have been divorced 27 years now and have remained very close in spite of our divorce. I wish I would have understood more about the disorder while we were still married. I feel we could have salvaged a mostly very good relationship