Borderline Personality Awareness Month is dedicated to raising awareness, understanding, and support for individuals living with borderline personality disorder (BPD). This blog aims to shed light on this often-misunderstood condition, provide insight into the experiences of those affected, and offer guidance on how to support loved ones with BPD. 

Understanding Borderline Personality Disorder

BPD is a complex mental health condition characterized by pervasive instability in moods, behavior, self-image, and functioning (Mendez-Miller & Naccarato, 2022). People with BPD often experience intense episodes of anger, depression, and anxiety that can last from a few hours to days. Mendez-Miller and Naccarato (2022) outline hallmark symptoms of BPD, including: 

1. Emotional Instability: Rapid and intense mood swings that can be triggered by seemingly minor events. 
2. Interpersonal Difficulties: Unstable relationships marked by idealization and devaluation, often referred to as “black-and-white” thinking (Cechak et al., 2021). 
3. Impulsive Behaviors: Engaging in risky activities such as substance abuse, binge eating, or reckless driving. 
4. Self-Image Issues: An unstable sense of self and chronic feelings of emptiness. 
5. Fear of Abandonment: An intense fear of being left alone or abandoned, whether real or perceived.
6. Self-Harming Behaviors: Engaging in self-injury or having suicidal thoughts or behaviors as a coping mechanism. 

Comorbidity of Borderline Personality Disorder 

BPD often coexists with other mental health conditions, a phenomenon known as comorbidity (Shen et al., 2017). Understanding these comorbidities is crucial for comprehensive treatment. Common comorbid conditions include: 

1. Mood Disorders: Depression and bipolar disorder frequently occur alongside BPD, complicating the emotional landscape for individuals (Bayes et al., 2022). 
2. Anxiety Disorders: Generalized anxiety disorder, social anxiety (Qadeer et al., 2023) and PTSD (Jowett et al., 2019) are often seen in individuals with BPD. 
3. Substance Use Disorders: There is a high prevalence of substance abuse as individuals may use drugs or alcohol to manage intense emotions (Howe et al., 2021). 
4. Eating Disorders: Disorders such as anorexia, bulimia, and binge eating disorder are also commonly comorbid with BPD (Khosravi, 2020). 
5. Other Personality Disorders: Narcissistic, histrionic, and antisocial personality disorders may co-occur with BPD, affecting the overall treatment approach (Giroux & Smith, 2024). 

The Challenges of Living with BPD 

Living with BPD can be incredibly challenging, both for those diagnosed and for their loved ones. The emotional rollercoaster can lead to strained relationships, difficulties at work or school, and an overall reduced quality of life. Many individuals with BPD report feeling misunderstood and stigmatized, which can exacerbate feelings of isolation and hopelessness (Ikhtabi et al., 2022). 

The Importance of Awareness and Education

Awareness and education are crucial in combating the stigma associated with BPD. Understanding that BPD is a legitimate mental health concern, rather than a character flaw or a sign of weakness, is the first step towards empathy and support. By spreading awareness, society can become more inclusive and compassionate. 

Treatment and Support for BPD. 

Despite its challenges, BPD is a treatable condition. Evidence-based treatments such as Dialectical Behavior Therapy (DBT), has shown to be effective in helping individuals manage their symptoms and leading full lives (Mehlum, 2021). DBT focuses on teaching skills in mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. 

In addition to professional treatment, support from family and friends plays a vital role in recovery process. Mind (n.d.) offers some ways to support a loved one with BPD: 

1. Educate Yourself: Learn about BPD to better understand what your loved one is experiencing. 
2. Communicate Openly and Honestly: Create a safe space for open dialogue, where your loved one feels heard and validated.
3. Set Boundaries: Establish clear and consistent boundaries to help manage expectations and reduce conflicts. 
4. Encourage Treatment: Support your loved one in seeking and continuing with professional treatment.
5. Practice Self-Care: Taking care of your own mental health is crucial when supporting someone with BPD. 

Moving Forward

As Borderline Personality Awareness Month is observed, there is a commitment to breaking the stigma and fostering a deeper understanding of BPD. By supporting those affected and advocating for greater awareness, a world can be created where individuals with BPD feel accepted, understood, and empowered to seek the help they need. 

For more information on BPD and available resources, please visit our website to contact our office or to book an appointment to speak with one of our therapists. Together, a difference can be made. 

_References 

_{Bayes, A., Spolema, M., & Parker (2022). Comorbid bipolar disorder and borderline personality disorder: Diagnosis using machine learning. Journal of Psychiatric Research, 152, 1-6. https://doi.org/10.1016/j.jpsychires.2022.05.032} 

_{Bleidorn, W., Hopwood, C. J., Back, M. D., Denissen, J. J., Hennecke, M., Hill, P. L., Jokela, M., Kandler, C., Lucas, R. E., Luhmann, M., Orth, U., Roberts, B. W., Wagner, J., Wrzus, C., & Zimmermann, J. (2021). Personality trait stability and change. Personality Science, 2. https://doi.org/10.5964/ps.6009} 

_{Cechak, P. S., Henriques, G., Gritchfield, K., & Savina, E. (2021). Borderline personality disorder: A review and analysis through the lens of the unified theory (dissertation). James Madison University, Harrisonburg, VA.} 

_{Giroux, C., & Smith, W. E. (2024). Personality Disorders. In Geriatric Psychiatry: A Case-Based Textbook (pp.649-674). Cham: Springer International Publishing.} 

_{Howe, L. K., Fisher, L. R., Atkinson, E. A., & Finn, P. R. (2021). Symptoms of anxiety, depression, and borderline personality in alcohol use disorder with and without comorbid substance use disorder. Alcohol, 90, 19-25. https://doi.org/10.1016/jalcohol.2020.11.002} 

_{Ikhtabi, S., Pitman, A., Toh, G., Birken, M., Pearce, E., & Johnson, S. (2022). The experience of loneliness among people with a “personality disorder” diagnosis or traits: A qualitative meta-synthesis. BMC Psychiatry, 22 (1). https://doi.org/10.1186/s12888-022-03767-9} 

_{Jowett, S., Karatzias, T., & Albert, I. (2019). Multiple and interpersonal trauma are risk factors for both post-traumatic stress disorder and borderline personality disorder: A systematic review on the traumatic backgrounds and clinical characteristics of comorbid post-traumatic stress disorder/ borderline personality disorder groups versus single-disorder groups. Psychology and Psychotherapy: Theory Research and Practice, 93(3), 621-638. https://doi.org/10.1111/papt.12248} 

_{Khosravi, M. (2020). Eating disorders among patients with borderline personality disorder: Understanding the prevalence and psychopathology. Journal of Eating Disorders, 8(1). https://doi.org/10.1186/s40337-020-00314-3} 

_{Mehlum, L. (2021). Mechanisms of change in dialectical behavior therapy for people with borderline personality disorder. Current Opinion in Psychology, 37, 89-93. https://doi.org/10.1016/j.copsyc.2020.08.017} 

_{Mendez-Miller, M., Naccarato, J., & Radico, J. A. (2022). Borderline personality disorder. American family physician, 105(2), 156-161.} 

_{Mind. (2022, September). How to help someone with borderline personality disorder (BPD). Mind. https://www.mind.org.uk/information-support/types-of-mental-health-problems/borderline-personality-disorder-bpd/for-friends-and-family/} 

_{Shen, C. -C., Hu, L. -Y., & Hu, Y. -H. (2017). Comorbidity study of personality disorder: Applying association rule mining to the Taiwan National Health Insurance Research Database. BMC Medical Informatics and Decision Making, 17(1). https://doi.org/10.1186/s12911-016-0405-1} 

_{Qadeer Shah, A., Prasad, D., Caropreso, L., Frey, B. N., & de Azevedo Cardoso, T. (2023). The comorbidity between personality disorder (BPD) and generalized anxiety disorder (GAD): A systematic review and meta-analysis. Journal of Psychiatric Research, 164, 304-314. https://doi.org/10.1016/j.jpsychires.2023.06.009}