As human beings, there is a certain level of emotionality we are willing to accept in others and even in ourselves. However, there seems to be a subset of individuals we encounter as we go about life that often exceed our tolerance for emotional expression. If you have run across these individuals, they may simply be your extra sensitive next-door neighbor or may possibly be one of the 2 to 5 % of the population that lives with a serious psychiatric condition called Borderline Personality Disorder.
We are all born with a certain temperament. Everyone experiences emotions to a larger or lesser degree based on this temperament. Studies have been done in nurseries where babies are tickled with feathers to elicit an emotional response. Some babies appeared to have no reactions to the stimuli, some began to squirm slightly, and some became almost inconsolable. It is noteworthy that this is from birth, before any environmental influence has taken place. (Manning, 2011.)
The individuals that were identified as “inconsolable” did not all grow up to be people at the mercy of their emotions- some of them learned skills to manage their “race car” emotional systems. But there was that subset we talked about earlier, those who had intense emotional systems, but then went on to develop a mental health disorder. Their particular difficulty was not always apparent to those around them, often not allowing those that loved them to teach them the necessary skills to manage the twists and turns of race car driving. And who of us is born with a manual at birth, anyway?
Individuals living with BPD, and those that love them, live with a great deal of suffering. Unfortunately, this suffering is often not accurately diagnosed and therefore appropriate treatment is not identified. Just like with any other illness, a proper diagnosis and recognition of the condition affords the ability to find help and move past it.
The Diagnostic and Statistical Manual of Mental Disorder identifies Borderline Personality Disorder as “A pervasive pattern of instability of interpersonal relationships, self-image, and affects and marked impulsivity beginning by early adulthood and present in a variety of contexts” as indicated by 5 or more of the following:
- Frantic efforts to avoid real or imagined abandonment,
- A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation,
- Identity disturbance: markedly and persistently unstable self-image or sense of self,
- Impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating,
- Recurrent suicidal behavior, gestures or threats, or self-mutilating behavior,
- Affective instability due to a marked reactivity of mood,
- Chronic feelings of emptiness,
- Inappropriate, intense anger or difficulty controlling anger,
- Transient, stress-related paranoid ideation or severe dissociative symptoms.
In essence, what we are really looking at is a disorder of emotion dysregulation. In the DBT world, we identify 5 areas of dysregulation that basically encapsulate the criteria identified above: Behavioral Dysregulation, Cognitive Dysregulation, Self-Dysregulation, Interpersonal Dysregulation and Emotion Dysregulation. The Emotion Dysregulation primarily drives the other types of dysregulation.
The green ribbon is worn during the month of May to signify Mental Health Awareness. May is also Borderline Personality Disorder Awareness month and a grey ribbon is worn to bring attention to its significance. Bringing awareness to this condition increases the likelihood that individual’s will receive an accurate diagnosis and, along with their families, receive the treatment they need to live fulfilling and meaningful lives.
DBT Center of Silicon Valley encourages you to wear your grey ribbon in support of BPD Awareness month and share the knowledge that this is a highly treatable disorder. Our Linehan Board Certified Program offers comprehensive DBT treatment to individuals suffering from Borderline Personality Disorder, as well as a 9 week “Friends and Family” class to loved ones to provide knowledge in self-care and the skills needed to create more effective relationships with their family member. This month is a celebration of hope. DBT provides hope. DBT doesn’t make things easy…. but it makes them possible.
Accurate information can be hard to find when it comes to this disorder. Here are some resources that you can trust…..
“Loving Someone with Borderline Personality Disorder” by Shari Manning
“Borderline Personality Disorder in Adolescents” by Blaise Aguirre
“Building a Life Worth Living: A Memoir” by Marsha M. Linehan
NEA-BPD (National Education Alliance for Borderline Personality Disorder)
BehavioralTech (Video “What the Heck is DBT?” and other resources)
DBT-Linehan Board of Certification (Looking to find a certified clinician or program?)
“If Only We Had Known” 5-part video series about BPD
- Understanding BPD
- Causes of BPD
- Diagnosing BPD
- Treating BPD
- Coping with BPD
“Back from the Edge” (Runs approximately 45 min.)
In the Media
“Crazy Ex-Girlfriend” (A compassionate depiction of an individual living with BPD)
Brandon Marshall (NFL Football player who has openly disclosed diagnosis of BPD)
Pete Davidson (SNL comedian who has openly disclosed diagnosis of BPD)