Borderline Personality Disorder (BPD) is a complex mental health condition characterized by pervasive patterns of instability in mood, emotional regulation, self-image, behavior, and interpersonal relationships. People with BPD often experience intense emotions that fluctuate rapidly between extreme highs and lows within a matter of hours or days. They also struggle with chronic feelings of emptiness, fears of abandonment, and difficulties regulating their impulses.

Specifically, people with BPD may feel intense insecurity and fear that their loved ones will leave them. This fear of abandonment can manifest in clingy behavior, push-pull dynamics in relationships, and an overall difficulty in trusting others. It is often a pervasive and overwhelming sense of anxiety that stems from unconsciously rooted fears relating to experiences from childhood abandonment or neglect. This causes many people struggling with BPD to engage in love-hate relationships. They may idealize people, seeing them as perfect, and become intensely attached to them. They may also put specific people on a pedestal, expecting them to meet all their emotional needs, which is impossible for any one person to achieve. This creates an unhealthy dynamic that leads to disappointment, resentment, and feelings of inadequacy. 

In addition, people with BPD also commonly have dysfunctional relationships because they are prone to feelings of anger and jealousy, leading to conflict and frequent fighting with others. There is often a pattern of forming intense relationships that are unstable and turbulent. It’s important to recognize that individuals struggling with BPD are not doing this on purpose, but rather they are struggling to regulate emotions and they are struggling to feel loved, connected, and secure.

Emotional dysregulation is defined as an inability to effectively modulate one’s emotional responses to different situations, often resulting in intense and unpredictable mood swings. People with BPD experience the spectrum of emotions more intensively than others and struggle to regulate feelings effectively. As a result, they may have intense feelings of sadness, anger, shame, or guilt that are out of proportion to the situation or trigger. For instance, a person with BPD may have an explosive outburst over a minor inconvenience or perceive a well-intended comment as intense criticism or rejection. These extreme emotions can be overwhelming for family members and friends of people with BPD, leading them to feel scared, exhausted, and overwhelmed.

People with BPD also typically struggle with identity issues. Lacking a strong sense of who they are. People struggling with BPD often experience a shifting sense of identity and purpose, which can be frustrating and emotionally draining. They may feel disconnected from themselves and struggle to understand who they truly are in relation to the rest of the world. This constant struggle for self-understanding often leads to feelings of emptiness and confusion. When combined with the instability inherent in BPD, a history of traumatic experiences can also have a profound impact on an individual’s sense of self, leading to feelings of alienation and disconnection from normal experiences. This can result in individuals feeling lost, alone, and unsure of their place in the world.

Impulsive behavior in BPD can also manifest in a variety of ways. For example, someone with BPD might engage in impulsive spending sprees, eat compulsively, engage in risky sexual behavior, or even engage in self-harm. These behaviors are often unplanned and occur without any forethought or consideration of consequences. They may provide a temporary relief from the intense emotions that the individual is experiencing, but they can also lead to negative outcomes such as financial problems, physical harm, or strained relationships.

A combination of environmental, neurobiological, and genetic factors may contribute to the development of BPD. Studies have shown that individuals with BPD are more likely to have experienced neglect or abuse during their childhood. These traumatic, chaotic experiences can cause significant emotional stress, especially if they occur during critical periods of development, and can hinder the development of a stable sense of self. Beyond affecting one’s sense of self, an unstable environment can cause someone to develop erratic behaviors out of attempts to gain a sense of control over the environment. Trauma can also lead to difficulties in regulating emotions and inability to trust others. In terms of neurobiological factors, individuals with BPD have been found to have abnormalities in brain structure and function. This can include reduced prefrontal cortex volume and abnormalities in the amygdala and hippocampus, areas of the brain that are associated with emotional regulation and memory. Plus, research has indicated that individuals with a family history of mental health conditions may be more at risk of developing borderline personality disorder.

Most importantly, it’s critical to understand that BPD is a valid condition – NOT a character weakness or personal choice. Unfortunately, there is some social stigma regarding borderline personality disorder. Some people misunderstand the diagnosis and label people with BPD as “attention-seeking” or “irrational,” which only perpetrates harmful myths about mental illness, leading to discrimination and barriers to treatment for people with BPD. At River Oaks Psychology, we actively fight against stigma and promote education on the seriousness of BPD in order to bring light to the very real struggles that people with this disorder experience. With the right guidance and support, individuals living with BPD can learn to manage their symptoms effectively, build healthy relationships, improve their sense of self-worth, and ultimately lead fulfilling lives.