“Please don’t go", yelled Annie with tears streaming down her face. Annie’s boyfriend, Mark, is going out of town for one night on a business trip, which he does frequently. Annie tells him that if he really loved her, he wouldn’t go. She tells him this every time. And every time Mark comes back home. Annie is experiencing fear of abandonment. She logically knows that Mark is coming back, but the fear is overwhelming. Annie decides that she will call Mark’s boss, Jennifer, and inform her that she is sick with the flu, and her boyfriend needs to stay home with her. When Mark gets to the airport, he is told that his plane tickets have been cancelled. Mark, in a very confused state, returns home. He doesn’t yet know that Annie called his boss. Annie secretly feels guilty because of her desperate behavior but the pain of feeling like Mark was leaving forever was unbearable. She had to do something.
After another argument with Mark, Annie reaches under her mattress and finds the razor blades she has been trying not to touch for weeks now. She takes the razor and begins cutting the tops of her thighs, trying to hide all evidence. She’s able to dull her excruciating emotional pain with physical pain. Even though she initially tries to hide the wounds, she knows that she will show Mark what she has done tomorrow.
Annie met a new friend while eating lunch at work one day. Her friend, Donna, really enjoys sky-diving. Annie, who is scared of heights, tells Donna that she has gone sky-diving multiple times. She makes plans with Donna to go sky-diving the next weekend. Annie, in an effort to feel connected with someone and heal the void in her life, becomes whoever she needs to be in an attempt to have a sense of belonging.
Annie knows that something is not right in her life. She’s unable to maintain relationships, her moods are very volatile, and she may even consider wanting to kill herself. She schedules an assessment with a mental health professional and is told that her symptoms indicate a diagnosis of Borderline Personality Disorder. She is told not to tell anyone she’s been given this diagnosis because if she does, she may be turned away from treatment.
The stories above are a fictional depiction of some symptoms of Borderline Personality Disorder (BPD). I first became interested in BPD while I was working at a Dialectical Behavior Therapy (DBT) clinic in Wilmington, NC. While there, I met fascinating and intelligent people of all ages. People who were struggling to make sense of the world. I taught daily skills groups, met with clients privately, and witnessed the hope of DBT. Clients shared with me the reasons they had come to treatment, telling stories like those above. As I began to really connect with the clients, as well as other adults and teens that I met later in my career, I realized that I wanted to focus on supporting people with symptoms of BPD.
In order to truly empathize with someone dealing with BPD and make a difference in their life, I revisited some of my tumultuous teen moments to notice the similarities between my experiences and the symptoms experienced by a person with BPD. If you are an identified man or woman, or teen, experiencing what you think might be BPD, then you are likely experiencing an emptiness that is hard to explain. Teenagers also often feel like there is “something missing”, but they aren’t quite sure how to fill the hole. Teens also often desperately want to have a sense of belonging so they may dress like or pretended to like the same hobbies as other people. Some teens think having friends will fill the void in their life. All teens are searching for their identity and often look for guidance outside of themselves. In healthy development a teen evolves so that there is no longer a void to fill and the teen becomes more sure about who they are as a person. Mimicking behavior and asking, “Who am I?”, is developmentally appropriate for a teen. If you are experiencing BPD, the emptiness lingers and you might not be sure of how to behave, what hobbies to pursue, or how to dress in ways that represent yourself. Many symptoms of BPD are similar to the experience of being an adolescent, only magnified by 1000. Symptoms of BPD are also frustratingly long lasting and do not gradually dissipate as a person develops.
A common symptom of BPD is feeling misunderstood and believing that you are a burden to other people. I know the pain of being told “just get over it”, “it’s not that big of a deal”, and “do we have to talk about this again?”. As a teen, I saw the eye rolls that my family would make when I tried to talk about something I found important. I was told that no one wanted to “walk on eggshells” around me. Your family members may also express this same thing from time-to-time.
Experiences of rapid mood swings and anger outbursts are common in both adolescence and BPD. However, the mood swings and anger outbursts associated with BPD are more intense than what I experienced as a teen. If you think you might be experiencing BPD, evaluate whether or not tiny annoyances ignite rage. Has someone expressed their concern because you are yelling at strangers in the grocery store and having vicious fights with your spouse or significant other? Rapid mood swings often follow the pattern of feeling content on some days and being able to complete tasks, but on other days being unable to even get out of bed. From adolescence I remember how confusing the mood swings could be, albeit I never stayed in bed the whole day, and how I sometimes became engulfed in anger. Unfortunately, because of biopsychosocial reasons, someone with symptoms of BPD continues to struggle with mixed-up emotions and angry out-of-proportion reactions.
If you are experiencing BPD symptoms, you probably have a strong desire to connect with people and feel supported. However, instead of growing closer in your relationships, you are often so eager that people back away from the friendship. To you, other people just don’t seem as interested in the relationship, which is very disappointing. Sometimes relationships end abruptly after an argument or other chaotic event. Waking up one day and deciding that you don’t like the person anymore, even though you were in love with them the day before, can occur frequently. Teens similarly have a strong desire for companionship, they are also fickle, and they learn that friendships can be one-sided. A person without symptoms of BPD gradually learns to manage their emotions on their own and no longer needs to heavily lean on others. However, no matter their age, a person with BPD symptoms constantly seeks support from other people and depends upon them to help with emotional regulation.
Other mental health issues often accompany BPD. Depression, anxiety, and panic attacks are not uncommon. There may be many consecutive days in which a person with BPD cannot leave their house. You may have regular panic attacks or emotional outbursts that prevent participation in everyday activities. When under a great deal of stress, experiencing paranoia is possible. Feelings of extreme self-consciousness may keep you from even trying to attend social events. Likewise, being self-conscious is the hallmark of adolescence. I remember feeling like I wasn’t comfortable in my own skin. However, the severe mood and anxiety issues that are present in someone who is dealing with BPD symptoms, are not a typical adolescent experience. If you are having recurrent crying spells, feel hopeless, and have little to no energy, please make an appointment for an evaluation with a mental health professional.
A person who experiences BPD may try to communicate with friends and family but don’t hear what they need to hear and so shut down completely. They may isolate themselves and feel like the only choice they have to help calm the strong emotions is to engage in self-harm. If you have engaged in self-harming behaviors before, maybe you fight the urge to go to the drugstore and buy razor blades. But one day the emotional pain becomes too much for you to bear and so you do go to the store, purchase the blades, and cut yourself. Here is where the parallel between having regular teenage experiences and having symptoms of DBT ends. Self-harming behaviors and/or suicidal behaviors seen in teens are warnings that what they are experiencing (or have experienced in the past) is not due to the developmental stage of adolescence. Most adults who engage in self-harm started the desperate coping mechanism as a teen. If you, or someone you love, is engaging in self-harm or having thoughts of suicide, please seek help from a qualified professional immediately.
Even though I no longer deal with the same issues I dealt with as an adolescent, I have found a way to draw upon those feelings and use them to help people with symptoms of BPD. I know what I experienced is not as intense, or as dangerous, or as long-lasting, as the feelings that invade the mind and heart of a woman suffering with BPD. Thankfully, I also know that there are steps a person with BPD can take to improve how they regulate their emotions and interact with others. Therapy is the only way to make a positive impact on the symptoms of BPD. Unlike depression and anxiety, the symptoms will not respond to pharmacology. I treat women and teens with symptoms of BPD using Dialectical Behavior Therapy (DBT), an evidenced based clinical intervention specifically designed to treat BPD. If you’re the parent of a teen or a teen yourself, determining whether or not behaviors need professional attention can be confusing. Click below and schedule a free consultation with me. We can figure it out together. If you’re an adult who realizes that what you have been experiencing has an actual name, or if you have been diagnosed with BPD previously, I would love to help you build a more peaceful and enjoyable life.