Recognising borderline personality disorder

Mental Health
Jannah Walshe

Many famous people have been diagnosed with borderline personality disorder (BPD). Most notably for us here in Ireland is the comedian Tommy Tiernan, who following his diagnosis said, “I got diagnosed recently with borderline personality disorder. It means I’m no good on my own … or with people.” But what is it really, and how does it affect you?
BPD is a mental health condition that was originally seen as falling on the border between neurosis and psychosis, hence its name. (Neurosis is where a person is in distress, but can still tell the difference between reality and what they are experiencing; psychosis is where a person cannot tell this difference and can experience delusions and/or hallucinations.)
However, that definition has become outdated, however, and BPD is currently thought of as a mood disorder. It is also sometimes referred to as Emotional Dysregulation or Emotionally Unstable Personality Disorder (EUPD).
Personality disorders can range anywhere from mild to severe. They typically emerge during the late teenage years and persist into adulthood. The wide range of symptoms associated with BPD includes feelings that are overwhelming in nature and hard to manage without resorting to self-harming behaviours, difficulty in maintaining relationships and some periods of disconnect with reality.
BPD sufferers are sensitive, and what might seem like small things to others can trigger intense reactions for them. It is hard to control or bring down these reactions once they happen, and it is extremely difficult to think straight. Self-harm and impulsive behaviours are common as a result. A negative cycle is established and coming out of this cycle is tough – but not impossible, as was previously thought.
BPD is typically diagnosed by a psychiatrist, and a person must experience at least five of the following symptoms before being diagnosed with the disorder:

• Fear of being alone for long periods of time or of abandonment
• Unstable or changing relationships (for example, can change easily between loving and hating someone)
• Low self-image and unclear about identity or sense of self
• Impulsive or harming behaviours (for example, excessive spending, unsafe sex, substance abuse, dangerous driving, binge eating)
• Suicidal behaviour or self-harm
• Constantly changing and random mood swings
• Pervasive feelings of worthlessness, emptiness or sadness
• Sudden and/or intense anger which is difficult to control
• Stress-related paranoia or loss of contact with reality

Furthermore, a large percentage of BPD sufferers develop suicidal behaviour, meaning this illness is a serious issue.
The label of Borderline Personality Disorder also has a history of misuse and prejudice. BPD is a clinical diagnosis and not a judgment. In the past people, labelled as borderline were often seen as attention-seeking and always in crisis. As a result, many people felt ashamed and did not seek or want such a diagnosis, regardless of whether it explained their symptoms or not.
This situation is slowly changing, and now many people have spoken out about receiving their BDP diagnosis with a sense of relief to know what is happening to them and how to get appropriate treatment.
If you’re experiencing some of the symptoms of BPD and are struggling to cope, talk to a mental health professional. It can be difficult to manage on your own, and it is important to seek appropriate help.
Marsha Linehan is an American psychologist, famous for developing Dialectical Behaviour Therapy (DBT), who has also spoken out about her own history with BPD. Her DBT therapy is now quite a successful treatment option for people with BDP.
DBT can help you learn how to manage emotions and ways to correctly respond to people and situations. DBT combines techniques from a number of different areas of psychology, including mindfulness, cognitive-behavioural therapy, and relaxation and breathing exercises. Support from family, friends and community groups is a key element in recovery. Medication may be helpful but seek advice from your GP and mental health professional about this.
Don’t lose hope: Even though there is no specific ‘cure’, sufferers can greatly improve over time with the right support and treatment.

Some useful websites for information about Borderline Personality Disorder: helpguide.org, hse.ie, mind.org.uk, reachout.com.

Jannah Walshe is a counsellor and psychotherapist based in Castlebar and Westport. A fully accredited member of The Irish Association for Counselling and Psychotherapy, she can be contacted via www.jannahwalshe.ie, or at info@jannahwalshe.ie or 085 1372528.