This piece is the first in our series examining the stigma toward mental illness.
Borderline personality disorder, otherwise known as BPD, is a mental illness that is estimated to affect 1.6 percent of U.S. adults, though that number may be as high at 5.9 percent. While all mental illness carries the weight of stigma, BPD is one of the most misunderstood and least accepted, both by the general public and by mental health professionals. There are many myths that surround this illness that further contribute to suffering — myths that often keep those who identify with this disorder from seeking treatment. I know this because I am one of them.
For a long time, I resisted my diagnosis because I thought it confirmed what I already believed to be true: that I was difficult and unlovable. However, I now understand that this is not the case. While living with BPD is not easy, it is possible. And beyond that, you can have borderline personality disorder and still live a happy and fulfilling life. Personally, I manage my symptoms through therapy and hard work.
Living with any mental illness is a little easier when those close to us understand our disorders a bit more. As such, here are nine things those with borderline personality disorder want loved ones to understand.
1. We are not untreatable.
Those with BPD are often considered “high risk” clients to mental health professionals because of self-harming and suicidal behavior. Some even refuse to work with those who have been diagnosed because of the high incidence of these tendencies. However, believing we are untreatable is simply not true. “There are decades of research that disprove this [idea]. In actuality, BPD has one of the most thorough and successful treatments in mental health, Dialectical Behavioral Therapy (DBT), developed by Dr. Marsha Linehan,” explains licensed master social worker Stephanie Brubaker, who specializes in DBT.
Through therapy, we can learn healthy coping strategies to deal with
our intense emotional arousal.
DBT is a highly structured therapy program. It teaches skills to help those with BPD cope with life more effectively. Using a foundation of mindfulness and living in the moment, the skills taught by DBT include emotion regulation (management of negative and overwhelming emotions), interpersonal effectiveness (effective and healthy communication tactics), and distress tolerance (strategies to help even out intense emotional or physical pain). Other possible treatments for BPD include Mentalization-Based Therapy, Schema-Focused Therapy, and Transference-Focused Therapy.
2. We can have stable, loving relationships — romantic and otherwise.
Those with BPD are often thought to be unable to have healthy relationships with the people in their lives, but this is not the case. “Regardless of whether someone has a personality disorder diagnosis, human beings crave belonging and validation, or just wanting to be understood and to feel they are accepted,” says Brubaker.
3. BPD is an emotional regulation disorder.
This does not mean we cannot work or have loving relationships. “One thing I always tell my folks with BPD is that this is an emotion regulation disorder. This doesn't mean you’re not smart enough to work, to have relationships. It means you can’t regulate your emotions to be effective in those situations,” says Gollick. Through therapy, we can learn healthy coping strategies to deal with our intense emotional arousal.
To further explain what it’s like to live with BPD, Brubaker gives the analogy of sending a text and waiting for a response: “If you’ve ever experienced anxiety after sending a text message and waiting for a response, you have some idea of how uncomfortable it can be to sit with an emotion without having relief. If you imagine that feeling multiplied in intensity and happening frequently throughout the day, it gives a small glimpse into how painful it can be to have BPD.”
4. We don’t self-harm for attention.
Up to 70 percent of those diagnosed with BPD self-harm. When we self-harm, it’s often because we don’t have the coping mechanisms to deal with our pain in a healthy and productive way. We are in intense emotional pain and don’t know how to express it.
Because of the stigma associated with our disorder, we can often feel
very alone in our struggle.
“A lot of people don’t understand the high emotional pain that comes with BPD,” explains licensed professional counselor Mallory Gollick, who also specializes in DBT. “It’s not attention-seeking behavior, it’s the inability to handle high emotional arousal. But that emotional pain can be treated.”
5. We are not manipulative, and we don't purposefully try to hurt others.
We are not trying to make you feel bad, and people with BPD aren’t manipulative by nature. Sometimes, we simply lack the skills or coping mechanisms to explain what it is we need. “Folks with borderline personality disorder aren’t intentionally going into situations trying to split or trying to confuse people. What’s happening is they have a need and they don’t know how to get that need met,” explains Gollick. “They often don’t realize how they’re affecting the environment.”
6. We’re doing our best (and we know you are too).
Living with borderline personality disorder is not easy, and we understand that it can be difficult for those who suffer, as well as for those who love someone who has BPD. We know you are doing the best you can, and we really appreciate your support.
7. Having BPD can be very isolating.
Because of the stigma associated with our disorder, we can often feel very alone in our struggle. It can be difficult for us to speak up when we’re experiencing an intense emotion because we are afraid someone will think we are being irrational or “over the top,” no matter how close we are to that person or how much we trust them. This can lead to isolating behavior. If we’re distant with you or push you away, it’s not because we don’t care or don’t love you; it’s because we are trying to cope in the best way we can.
8. BPD looks different on everyone.
“BPD, like any other mental health diagnosis, is pretty individualized in how it presents. There are nine DSM criteria for BPD, and you don’t need all nine. It looks very different,” explains Gollick. What you’ve seen in the media might accurately portray some symptoms of BPD, but it isn’t a one-size-fits-all diagnosis. We all experience it differently.
9. We are so much more than our diagnosis.
“There are a lot of strengths in people with BPD," says Gollick. "They tend to be very kind, very caring, very loving. They love other humans, they love animals. They are brilliant listeners usually."
If you have BPD, understand that you are so much more than a diagnosis; I am so much more than a diagnosis. And, if you have a loved one with BPD, do not be afraid to ask how you can help and to learn more about what it is we go through. It is through speaking up about our experiences and being willing to share our stories that will ultimately uproot stigmas and bring more understanding and compassion to this world.
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