What is BPD?

BPD is one of the most misunderstood and stigmatised mental health conditions out there. Most people either haven’t heard of it, or have misconceptions about what it is.

I have been diagnosed with three mental health conditions, Depression, Anxiety, and BPD.

When I say that to people, usually they will fixate on either the Depression or the Anxiety because they know a bit about these conditions. They may know someone who is suffers from Depression or Anxiety, or they may even have direct experience of going through these conditions themselves.

But often, when I tell people my diagnoses, the one that is the most difficult for me, that has a huge impact on my daily life-  is completely overlooked because people don’t know what it is. People don’t understand what it means, so they just skip past it as if I haven’t said it.

The few people that don’t skip past it usually think that BPD stands for Bipolar Disorder. It doesn’t. BPD and Bipolar are two totally different conditions.

BPD stands for Borderline Personality Disorder.

The name ‘Borderline Personality Disorder’ is confusing in itself if you don’t know much about it. It makes it sound like you are on the borderline of having some sort of disorder, but you don’t quite meet all the criteria. That’s not the case at all.

The name ‘Borderline Personality Disorder’ was originally created to describe people that were ‘on the borderline between Psychosis and Neurosis’.

It has taken me a long time to write this blog post. It is difficult to put into words something that is so big, and has such a huge impact on my life, every hour of every day.  One of the worst things for me is that I can’t get away from it. I can understand what it is in an intellectual way, I can recognise when it is impacting me, but I can’t stop it. I can’t distance myself from it or take a break from it because it is trapped inside my head. It is always there, and it is so deeply intertwined in my brain with who I am that I can’t get away from it. 

At times it is a bit like being stuck in a lift with someone really irritating that won’t shut the hell up for even a second so you can hear yourself think clearly.

I can’t choose when it interrupts me, and I can’t take a break from it when I’m tired of putting up with it. It will always be there in my brain, right up close next to me. My only choice is to accept that it is there, accept that it is part of me, and do my best to live with it the best way I can.

The best case scenario is learning to manage the condition to the extent that it doesn’t really bother you any more- through years of therapy and hard work every single day.

Needless to say, having BPD can be exhausting.

But I can’t really imagine not having it. That’s not to say that I wouldn’t get rid of it if there was a magical way to do so- I very much would, in a second- but I just can’t comprehend what my brain would do if it wasn’t constantly fighting with BPD. There would be so much… space… inside my head. I could think about and do whatever I wanted. It would be weird. And freeing. But I can’t even really imagine it.

Anyway, let’s cover the basics before I go any further. I want this post to have a quick explanation of all the basic stuff- like what the characteristics of BPD are and why people end up with BPD.

 


CHARACTERISTICS OF BPD

According to DSM-IV-TR Diagnostic Criteria:

  • Frantic efforts to avoid real or imagined abandonment
  • A pattern of unstable and intense interpersonal relationships/ characterised by alternating between extremes of idealisation and devaluation/ ‘splitting’
  • Identity disturbance- Markedly and persistently unstable self-image/ sense of self
  • Impulsivity in at least two areas that are self-damaging, eg: spending money, sex, substance abuse, reckless driving, binge eating
  • Recurrent suicidal behaviour/ self harm/ self-mutilating behaviour
  • Intense and highly changeable moods, with each episode lasting between a few hours and a few days
  • Instability due to a marked reactivity of mood. Intense episodic dysphoria/ irritability/ anxiety
  • Chronic feelings of emptiness
  • Inappropriate, intense anger/ difficulty controlling anger
  • Transient, stress-related paranoid ideation/ Psychotic-like perpetual distortions/ lapses in reality/ severe dissociation

To summarise, living with BPD is not fun. Every day is a struggle. It affects me at least once every hour. And whilst it is affecting me, I am also attempting to seem ‘normal’ to other people. I will be trying to sit still at my desk at work like everyone else, without doing weird vocal or motor tics because I haven’t slept properly in weeks, or I’ll be in a social situation, panicking because I have completely forgotten what I am trying to say mid sentence and everyone is looking at me like I’m a weirdo.

The thing is, because no one ever knows what BPD is, they can’t recognise the symptoms of it when they come up, so I just seem like I’m being strange, rude, or weird. It’s also not the kind of thing I can just pop into conversation in a few words and the other person will understand. It would require a full on, lengthy conversation about BPD, what it is, why I have it, and how it affects me. And that stuff isn’t easy to sum up in one easy to digest sentence. Hence this post.


These are actual pictures of my actual brain. How freakish is that?!
I had some brain scans done a few years ago in London.


Brain scans have shown differences between ‘normal’ brains and the brains of people with BPD. The following areas of the brain differ in people with BPD:

The amygdala; the hippocampus; & the orbitofrontal cortex.


CAUSES OF BPD

Research shows that BPD is caused by a combination of three different types of factors: Genetic Factors/ Family History; Structural/ Functional Brain Factors; and Environmental Factors.

Common contributing factors include:

  • Childhood Trauma/ Traumatic Life Events: 70% of BPD sufferers have been through childhood trauma.
  • Physical Abuse/ Sexual Abuse/ Emotional Abuse
  • Childhood Neglect/ Invalidation
  • Early Parental Loss: 30% of BPD sufferers have experienced early parental loss.

Every person with BPD is different and has different life experiences- but in my experience, meeting other people with BPD in therapy, we tend to be people who have had difficult lives. 

So to finish this post, here’s a quick shout out to anyone with BPD.  You are not on your own in quietly having to deal with this every day.

It sucks, but keep going. You can do it x

 

 


FURTHER READING

A BPD Brief: An Introduction to Borderline Personality Disorder Diagnosis, Origins, Course, And Treatment– John G. Gunderson, MD

Borderline Personality Disorder and the Brain– K Redmayne


x Lucy x

The Capsulist


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