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If you deal with emotions in a way that can be harmful to yourself and have difficulties in close relationships, you may have a personality disorder. Here we explain what borderline is and how to get help.
What is borderline personality disorder?
Borderline personality disorder (BPD) is also known as emotionally unstable personality disorder (EIPS). It is a mental illness and personality disorder characterized by significant emotional instability, intense relationships with others and a strong fear of abandonment. People with BPD may experience rapid and extreme mood swings, and their self-image may also be unstable.
This is a severe condition that often involves self-harm, suicidal thoughts and substance abuse. If you have these problems, you should primarily seek help through your health care centre to get a referral to a specialist psychiatrist. In case of severe suicidal thoughts, you can call emergency services on 000 or Lifeline Australia on 13 11 14 (24 hour service).
According to the Mental Health Commission (Australia) 50% of all adult mental health issues emerge before the age of 14.
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What is a personality disorder?
Personality disorders, or personality syndromes, are psychological conditions that affect an individual’s thoughts, feelings and behaviours in a way that often differs significantly from society’s norms and expectations.
Why do people get borderline?
The causes of borderline personality disorder are not entirely clear, but may be a combination of genetic, biological and environmental factors, including early trauma such as sexual abuse.
There doesn’t have to be trauma, but there are also theories that the way people are treated growing up, if parents have had a lack of empathy and mirroring the child emotionally so that they feel seen and heard, can contribute to the problem.
In adolescence, there may be symptoms similar to borderline as this period involves an exploration of identity, but these symptoms usually resolve themselves. With borderline, however, the symptoms are more persistent but they also tend to improve as you get older.
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How common is borderline personality disorder?
Approximately 1-2% of the population is diagnosed with borderline personality disorder.
Symptoms of borderline personality disorder
There are several symptoms of borderline personality disorder. It is important to note that the severity and prevalence of symptoms can vary greatly between individuals. In addition, there may be co-morbidity with other mental health conditions, such as ADHD, autism, depression, eating disorders and PTSD, which can affect the expression of the profile. Diagnosis and treatment should be done by a licensed psychologist or psychiatrist. Here are some of the main symptoms and characteristics of borderline personality disorder:
- Fear of abandonment: An intense fear of real or imagined abandonment. This can lead to desperate attempts to avoid being abandoned, even through self-harming behaviour.
- Unstable relationships: Relationships can be intense and stormy, with periods of idealization followed by devaluation. These swings are often due to black-and-white thinking, with the person with borderline either idealizing others as “perfect” or dismissing them as “terrible”.
- Unstable self-image: A deeply disturbed or changing perception of oneself. People with borderline may have problems with their identity and self-esteem.
- Impulsivity: This can include risky behaviours such as substance abuse, eating disorders, reckless driving, or excessive spending.
- Self-harm: Includes behaviours such as self-harm and suicidal thoughts or attempts.
- Emotional instability: Rapid and intense mood swings that can be difficult to control.
- Feelings of emptiness: A chronic sense of emptiness or meaninglessness.
- Intense anger: Difficulty managing anger, which can lead to temper tantrums or constant irritation.
- Stress-related paranoia or dissociation: During periods of extreme stress, people with borderline personality disorder may experience paranoia or dissociation from reality.
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Assessment of personality disorders
Personality disorders are often diagnosed by specialist psychiatrists through a personality assessment. This involves taking an initial medical history to review the background to the symptoms and completing assessment forms. A structured diagnostic interview and an interview with family members are then carried out to see how the symptoms manifest themselves in different areas. You will often see both a doctor and a psychologist, and the assessment may include a blood test to rule out an underlying medical cause.
Treatment for borderline personality disorder
Treatment for BPD usually involves a combination of psychotherapy, medication (to manage co-occurring conditions such as depression or anxiety) and self-help strategies. Dialectical behavioural therapy (DBT) is a form of therapy specifically developed to treat borderline personality disorder and has been shown to be particularly effective. MBT, which is short for mentalization-based therapy, is also helpful for borderline personality disorder.
An important part of the treatment is mindfulness to manage emotions, but other strategies and tools are also used to increase self-understanding and improve the ability to manage emotions.
Advice for those who know someone with personality disorder
Be careful with boundaries: It is important to set clear boundaries to protect yourself and your own psychological well-being.
Seek professional help: It is not your job to diagnose or treat someone. Let this be handled by qualified health care providers.
Try not to judge: A personality disorder is a medical diagnosis and not a character flaw. It does not always excuse a person’s behaviour, but it can explain it. Try to have an empathetic attitude.
Be aware of your own needs: take care of yourself and seek support, either from friends, family or a professional therapist or psychologist.
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Approaching the topic of borderline personality disorder can feel overwhelming, but we are here to make the hard part easier. When you feel it’s time to talk to a psychologist or therapist, you can easily book a session with us. No matter when you take the step, our experienced team is always ready to help you or your loved ones.
12 frequently asked questions about borderline personality disorder
What is a personality disorder?
A personality disorder is an enduring pattern of behaviour, worldview and inner experience that is markedly different from what is expected of those around you. This is because personality disorders can affect one’s ability to relate to others and function effectively in everyday life.
Is borderline a type of personality disorder?
Yes, borderline personality disorder is one of several types. It is a mental illness characterized by significant emotional instability, intense interpersonal relationships and a strong fear of abandonment.
How is borderline diagnosed?
Diagnosis of narcissism is usually carried out by a psychiatrist or psychologist and involves a detailed diagnostic interview and family interview.
What treatment options are available for borderline personality disorder?
Treatment usually involves a combination of psychotherapy and medication. Recommended psychotherapy is Dialectical Behavioural Therapy (DBT) and Mentalization Based Therapy (MBT).
Does DBT help with trauma?
If you have experienced trauma and have symptoms of post-traumatic stress disorder (PTSD), it is important to get a thorough assessment and treatment for your PTSD symptoms. It is possible to get help with trauma as part of the treatment.
Is there any way to prevent personality disorders?
Personality disorders are largely caused by environmental influences during childhood, so there are things you can do to prevent unhealthy personality development if you have children. Personality disorders mainly manifest themselves in adulthood, so consult a child psychologist if necessary or adult psychiatry if you think you may have a personality disorder as a parent.
What is the difference between DBT and cognitive behavioural therapy (CBT)?
DBT is a later development of CBT but they are based on the same foundation of learning theory and thoughts, feelings and behaviours. DBT also includes more mindfulness-based elements that have been inspired by Zen Buddhism.
Are women more likely to attend DBT than men?
It is equally common for men and women to be diagnosed with EIPS, with about 1-2% of the population having it. However, it is much more common for women to seek care and receive DBT, about 75% of patients are women.
Is it called EIPS instead of borderline personality disorder?
Emotionally unstable personality syndrome is also known as borderline personality disorder, but EIPS is often used in healthcare as borderline personality disorder can be a stigmatized term. EIPS is used in the ICD diagnostic manual while borderline personality disorder is described in the DSM-5 diagnostic manual.
What can I do as a family member?
The most important step is to encourage the person to seek professional help. You can also offer emotional support, but remember that you are not a substitute for qualified care.
Can you force someone to go to therapy?
No, you can’t force someone to undergo therapeutic treatment. It is rarely a good idea to force someone into therapy. A person needs to understand that they need to work on themselves. However, in cases of severe self-harm and suicidality, compulsory treatment can be given, but this is decided by a doctor in inpatient care.
Where can I get help?
If you think you may be in need of treatment, you can seek care through your health centre and get a referral to psychiatry. We also have licensed psychologists at Lavendla who can help you with an initial assessment and make further referrals. If you have acute suicidal thoughts call emergency services on 000 or Lifeline Australia on 13 11 14 (24 hour service).
