Borderline Personality Disorder or BPD (similar to bipolar disorder) is a severe mental health disorder impacting an estimated 1.6% of all U.S. adults. This disorder is characterized by mood swings, difficulty regulating emotion, and intense emotional responses to stress and triggers. For many, that means depression, impulsive behavior, poor self-esteem, difficult relationships, and an inability to maintain interpersonal relationships and friends. All of this functions as a self-defeating cycle, with people who lose friends to emotional outbursts often having emotional outbursts at the thought of losing other friends the same way – thereby pushing them away. Communicating that can be the first step to working to maintain a healthy relationship – because getting the people in your life to understand what’s going on in your head can help them to make better decisions about your behavior and your mental health.
Start with Diagnostic Criteria
Most people have a very vague understanding of mental health and mental health problems in general. Starting from a place of medical research, especially from a brochure or flyer from your doctor, is always a good place to ground what you are saying and to show that your experiences are rooted in research and others experience them too. For that reason, if your loved one doesn’t understand your borderline personality disorder, information from a trusted source is a great place to start. Here, you’ll almost always find that printed information handed out by your doctor will have more weight than something you find online, however, you can always use articles to show what you’re trying to say as well. Here, you should discuss borderline personality disorder as a diagnosis, the diagnostic criteria, and how common BPD is. For example, 1-1.4% of all Americans have BPD, 70% of those are women.
The disorder is described as having a pervasive pattern of emotional instability resulting in instable interpersonal relationships, self-image, and impulsivity – and these symptoms almost always start in late adolescence or early adulthood. In addition, there are nine diagnostic criteria for the disorder under the DSM 5. To be diagnosed, an individual must show at least 5.
These include:
- Frantic / unreasonable efforts to avoid abandonment, real or imagined
- Extreme and instable relationships
- Persistent instable sense of self or self-image such as self-esteem goes from extremely low to extremely high with no real outwardly identifiable cause
- Self-damaging impulsivity such as around sex, driving, eating, spending, etc.
- Gestures, threats, or self-harm related to suicidal ideation
- Mood swings and instability of mood
- Intense and inappropriate anger
- Paranoia or severe disassociation
Those symptoms are extreme, are often dangerous for the people experiencing them, and can require significant treatment and medication. Taking someone over them, reading articles together, or even reading a book about the disorder together can help them to understand that they are that serious and they do affect many people.
Go Over Your Own Symptoms
Once you’ve discussed diagnostic criteria for BPD, you can start to add your own experiences. For example, it’s highly unlikely that you’d experience all nine symptoms of BPD, exactly as listed. Instead, you’re more likely to have some of them but not all. You might experience symptoms that aren’t’ on the list. You might experience them in ways that feel different to you.
E.g., if you feel something in a specific way, you might be able to share how it feels different to you, how it specifically impacts you, etc. For example:
- I really struggle with feeling like I’m going to lose you, I know it’s not rational but sometimes I overreact because I can’t get through my head that you will not.
- Sometimes I don’t know who I am because my emotions can be very up and down – if I’m feeling very little other than intense anger, I don’t associate myself with being the same person I am when I’m safe and comfortable.
- I feel inadequate because I can’t control my emotions like everyone else and I know that I shouldn’t, but I feel like everyone else can regulate emotions and I’m here being controlled by my emotions. That’s not fair to the people in my life and it makes me feel like a terrible partner and friend. I want help with that.
That discussion can help to relate your actual symptoms to what’s on paper, but chances are, you should go further.
Share Your Experiences
If you want someone to understand your disorder, you have to share how you feel and why. That can be intensely difficult, especially if you don’t necessarily understand that yourself. Here, some people prefer to keep a mood or emotional journal. Others prefer to sit down and talk about what prompted an episode or a trigger because that’s more personal and interpersonal. What is important is that you be able to understand and therefore to share your own experiences. Writing things down can help a great deal.
For example.
- What moods do you experience throughout the day? How much does that change over time?
- Do similar things normally prompt anger? What?
- Do similar things normally prompt feelings of low-self-esteem?
- What events or statements often underly feelings of inadequacy or low self-esteem?
For most of us, there are patterns around emotional reactions. Identifying those and communicating them can help you to better share what’s going on in your head, can help you to understand them yourself, and can help everyone involved to mitigate the negative response. Of course, it’s no one’s responsibility to walk on eggshells around you or to specifically manage your disorder for you, but people usually want to help if they can – and if it’s something simple like taking time to reassure you that they’re still here, or stepping out of the room when you react with anger, etc., it can be immensely helpful in helping you to maintain interpersonal relationships and to build self-esteem.
Eventually, communicating about borderline personality disorder is always going to be difficult. People who haven’t experienced a disorder and haven’t lived it won’t ever really know what it’s like. Instead, they’ll have to relate it to things they do understand and emotions they have been able to control. That makes communication difficult especially if your loved one isn’t willing to try to step outside of that. At the same time, most people do want to help, communicating about your experiences, sharing how you feel, and trying to work together to find compromise and mitigation measures can be healthy for everyone involved. And, if they’re willing, you can take them to therapy with you – with family therapy and relationship therapy both heavily involved in treating the symptoms and in managing borderline personality disorder.
If you or you loved one need help with mental health treatment, drug rehab, or alcohol rehab Compassion Recovery Center is here to help. Contact us to ask about our mental health programs and how we can support your specific requirements as you move into treatment.
