Borderline personality disorder (BPD) is often misunderstood. Even today, this disorder is shrouded in myths and misinformation, and people living with it face a great deal of stigma. Living with BPD can be challenging. Yet, despite these challenges, people with BPD can live meaningful, happy, productive lives with support and effective treatment. It is time to dispel the myths and dismantle the stigma surrounding BPD.
What Is Borderline Personality Disorder?
Borderline personality disorder is a psychological disorder characterized by a pervasive pattern of instability in affect regulation, impulse control, interpersonal relationships, and self-image. The term borderline personality disorder was coined in 1938 by Adolph Stern. It described patients who did not fit neatly into groups of psychotic or neurotic patients. These patients’ symptoms bordered on other conditions.
There is disagreement among mental health providers regarding the age of onset of BPD. Some experts believe it cannot and should not be diagnosed in people under 18 since the personality is still forming. However, BPD can still be diagnosed in adolescents using similar criteria to diagnose adults but with additional caveats. Borderline symptoms and traits can be seen even in early adolescence. In recent years, more attention has been focused on the early manifestations of BPD in adolescents.
Misconceptions Surrounding Borderline Personality Disorder
As mentioned earlier, BPD has long been shrouded in myths, misconceptions, and stigma. These myths include:
- BPD is untreatable. BPD can be effectively treated using talk therapy. Dialectical behavioral therapy (DBT) can be effective for BPD. Mentalization-based therapy (MBT) has also been effective in treating BPD. Although no medications have a specific indication for BPD, they can be used to treat the symptoms associated with BPD.
- Behaviors associated with BPD are just attention-seeking behaviors and should be ignored. When people with BPD self-harm or act out impulsively, it is not just to get attention or manipulate those around them. These behaviors signal that the person is in distress and needs help. Taking time to listen and show empathy to someone with BPD who is in distress can save a life.
- People choose to have BPD. The negative feelings and thoughts associated with BPD are intense and sometimes terrifying. However, no one decides to have this disorder!
- People with BPD do not commit suicide. However, BPD is strongly associated with self-harm behaviors and suicide attempts. Up to 10% of people with BPD will die by suicide.
- Those who have BPD do not help themselves. Many people with BPD do not have the tools to manage their well-being. However, with support and treatment, people with this disorder can learn to manage their well-being and help themselves effectively.
- A person with BPD cannot live independent and fulfilling lives. Living with borderline personality disorder is challenging, but that does not equate to a life of misery and dependence. On the contrary, people with BPD who receive treatment and support are perfectly capable of living independent, whole, happy lives.
- BPD only affects women. BPD was once thought only to affect women. We now know that men can develop BPD as well.
- All people with BPD experienced childhood abuse. Many people with BPD have experienced trauma and abuse during childhood. However, like most mental health disorders, BPD can be caused by multiple factors.
Appropriate Levels of Care for Treating Borderline Personality Disorder
Hospitalization is not especially useful for people with BPD, except for a short hold during a crisis. Repeated hospitalization may even be counterproductive as it interferes with outpatient treatment and interrupts the day-to-day lives of patients.
Once a person with BPD is no longer in imminent danger of harming themselves, partial hospitalization programs (PHP) can offer an effective alternative to inpatient hospitalization. Research demonstrated that psychoanalytically oriented PHP was superior to standard psychiatric care for people with BPD. Although replication is needed with larger groups, this study does suggest that PHP can be used as an alternative to inpatient treatment. This would allow people with BPD to receive intensive treatment without the life disruption caused by an inpatient hospitalization. PHP can also cost significantly less than inpatient treatment.
The intensive outpatient program (IOP) level of care is another option for people with BPD. It is less intensive than PHP but still more intensive than typical therapy. This level of care can be used as a step down from PHP. Although research on the effectiveness of IOP for BPD is limited, the available studies demonstrate that people with BPD received significant benefits from treatment at this level of care. This level of care is becoming even easier to fit into a busy lifestyle now that more facilities and providers offer the option of virtual IOP.
Outpatient therapy is also effective for treating people with BPD who might need a less intensive level of care. Some providers even offer virtual therapy sessions, making seeking treatment more flexible and convenient. Health plans may not even require prior authorization for therapy if the provider is an in-network provider.
The Importance of Treatment and Support
For people with BPD, seeking treatment early is essential. Early intervention may prevent self-harm and suicide attempts, as well as repeated hospitalizations. Learning to effectively manage the disorder can lead to a happier, more productive, and more fulfilling life.
People with BPD do not need to be shamed or stigmatized. Rather than viewing their behaviors as “attention-seeking,” try looking at them as “support-seeking.” People with BPD need and deserve empathy, kindness, support, and effective treatment.
The Significance of Understanding CBT and DBT Differences
When seeking treatment for Borderline Personality Disorder (BPD), understanding the differences between Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) becomes paramount. Both therapeutic approaches are widely recognized and utilized in the management of BPD, but they offer distinct methodologies. CBT focuses on identifying and changing negative thought patterns and behaviors, addressing the cognitive distortions often associated with BPD. On the other hand, DBT integrates mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation, providing a comprehensive skill set for individuals dealing with the intense emotional fluctuations characteristic of BPD. Recognizing these differences enables individuals and mental health professionals to tailor treatment plans to the specific needs of those with Borderline Personality Disorder, promoting more effective and personalized therapeutic interventions.
Receiving a diagnosis of borderline personality disorder (BPD) can be frightening because of the stigma and myths associated with the disorder. However, there is hope, and effective treatment is available at Sober Life. Our empathetic and highly-trained staff can help. Our PHP and IOP programs will allow you to get the treatment you need with the flexibility of not having to stay in an inpatient or residential unit. We understand that mental illness and substance use disorders do not occur in a vacuum. They affect families, friends, and patients, which is why we offer family therapy. To learn more about what Sober Life can do for you, call us at (619) 542-9542.