Borderline Personality Disorder, or BPD, is one of the most misunderstood mental illnesses out there. Film and television portrayals of BPD — think Fatal Attraction or Girl, Interrupted — have either used the illness as an edgy plot device or glossed over the reality of the disorder entirely.
The National Institute of Mental Health's rather vague definition of BPD as a mental illness marked by "unstable moods, behavior, and relationships" illustrates just how greatly BPD can vary from case to case. Qualifying traits of BPD can include a difficulty establishing a sense of self, chronic feelings of emptiness, and a fear of abandonment, as well as a general difficulty in regulating one's emotions. Those who suffer from BPD are more inclined to have suicidal thoughts, which is often wrongly assumed to be an act of manipulation rather than a way to stop the seemingly relentless mental torment. The rate of actual suicide completion among those diagnosed with BPD is tragically high, with estimates between 4 and 9 percent.
The reality of BPD is rather different than the stereotypes. Many who suffer from BPD can — with treatments like Dialectical Behavioral Therapy, which aims to stop harmful behavioral patterns before they start — lead happy lives, and be compassionate and loving spouses, parents, and friends. BPD is also much more prevalent than some might realize; A 2008 study reported BPD can be found among 6.2 percent of women and 5.6 percent of men.
We talked with three women in recovery from BPD to learn what having BPD is actually like for them.
BPD Activist, Filmmaker, Founder of The Fight Within Us
Broadly: What was it like to learn you had BPD?
Amanda Wang: A lot of people might not feel like they had a good relationship with their diagnosis, like they were in denial of it, but for me I felt a lot of relief. I got treatment for it that was specific for my diagnosis, and I was like, "Wow, how come I didn't figure this out ten years earlier?"
How have your relationships been affected by having BPD?
I think one of the common symptoms of BPD is volatile relationships, but for me — well, I will try to put it into context, there's 256 or so ways to have BPD — but I think mine is a little more unique, because I don't really have problems in my relationships. That's what helped make it so much more easy for me to come out with it.
Which misconception about BPD bothers you the most?
I think it's that we're manipulative. I think if anyone has personally gone through what we go through on an hour-by-hour, day-by-day basis, they would understand why our behaviors are the way they are. Sometimes they seem manipulative, but it's more out of desperation to genuinely connect with someone, and have someone understand what it's like to be in our shoes. Sometimes that gets lost when we're interacting with other people, but I think [impulsivity] genuinely is how we try to communicate with other people. Instead, people perceive it as manipulative.
If anyone has personally gone through what we go through on an hour-by-hour, day-by-day basis, they would understand why our behaviors are the way they are.
Do you think there are any fictional portrayals of BPD out there that you think get it right?
I don't know. I don't think there is a good fictional portrayal out there yet unfortunately.
What's one thing you would want to tell others with BPD?
I wish often that I saw the symptoms earlier than I did. I think I was diagnosed in 2007, so I was about 27 years old at that time, and I have been struggling with it since I was a teenager. I've seen doctors and therapists since I was a teenager, and none of them actually said anything about BPD. It wasn't until I had a crisis that I finally found myself in the hospital [and] got the correct diagnosis. I wonder if there's a way that you can identify the diagnosis before going into crisis, because it's a scary place to be.
Author, Blogger, Peer Educator, and Founder of DBT Path
Broadly: What was one of your most prevalent symptoms?
Debbie Corso: The issue that brought it to the forefront was I had really bad identity disturbance. I didn't know who I was and acted differently from one person to the next. Like extremely, not like, you are different with your boss than you are with your boyfriend — that's normal. But it was extreme, and that's ultimately the criteria that led to my diagnosis.
What did a bad day feel like for you back then?
If you want to pick one scenario out of a myriad of different triggers that could trigger a myriad different versions of a bad day — my biggest one was when my significant other would have to leave me for any length of time, like, going to work even, but more so if he had to travel for business or visit his family. I was unable to keep it together. I couldn't function, and what that looked like was not being able to eat, getting sick to my stomach with anxiety, feeling out of control, crying spells, grieving, not being able to work or focus on anything, being irritable with other people, and just feeling really helpless and in need.
Why do you think suicide attempts are so high among those suffering from BPD?
For me — and this is not true for everyone, and you have to take suicide threats very seriously because a lot of people actually do follow through with attempting. I think it's 10 percent of BPDs actually do complete suicide, it's really high — but it was my desperate cry for help, and it wasn't a manipulation thing, "I'm going to say I'm going to kill myself so people will listen." I didn't have that kind of conscious awareness of what I was doing.
I think a lot of times you just feel like the level of intensity is so severe that you don't know any other way to express it. So, you think you want to die because you think that's the only way out. But what you really want is for someone to completely be with you and sit with you and understand and know that this episode is going to pass, and you're going to feel okay again.
You have no idea how severe my episodes are and how badly I feel.
What do you think about BPD's primary treatment, Dialectical Behavioral Therapy (DBT)?
For the first few months, to be honest with you, I was thinking this is bullcrap. There is no way that sitting down and smelling some lavender essential oils is going to calm me down. They were like, "Touch a furry animal," and I'm like, "No, you have no idea how severe my episodes are and how badly I feel. This is too simple." This was at the three-month mark.
Well, it started working. I started noticing changes in my life, not monumental changes yet because I was still six months into it. But I had much more awareness of when I had emotion coming up inside of me. The mindfulness component helped me to slow down. My rate of sabotage began to decline. It rarely happens anymore, which is awesome.
Life Coach, BPD Activist, Founder of Love Bugs Blog
Broadly: Are people ever surprised to find out that you have BPD?
Tami Green: Most average people have never heard of it before. People close to me didn't know what to do with it. They didn't know what to say, but I overwhelmingly got a lot of people that said, "Thank God there's someone else out there like me." There were also some [people that I met] that had a really stigmatized [view of BPD], so they were taken aback that I had it. They didn't really understand because of the stereotypes.
What is one of the biggest misconceptions about people with BPD?
That they're mean or manipulative. I know the behavior comes across as that, but the intent couldn't be farther from the truth in the vast majority of cases. Borderlines are the most sensitive, kind-hearted, caring people, [who] really want to love and be loved. Manipulation is thinking out a strategy on how to get what you want. When you suffer from Borderline, there's not a lot of thought in it — you just act. I think that people think, "Oh, you're just trying to guilt me," and that's what they think is the manipulation. But you're really not thinking out your actions. As a matter of fact, you deeply regret a lot of what you do and say and you wish you could control it.
Borderlines are the most sensitive, kind-hearted, caring people, [who] really want to love and be loved.
How did you end up finding out you had BPD?
I was [misdiagnosed for a long time] when I was suicidal. I became suicidal ten-ish years ago, and that flagged my therapist to look at Borderline, because a lot of therapists associate Borderline with suicidal tendencies, for good reason. So, that's how I finally got diagnosed with it.
And before that what were some other theories of what you were suffering from?
Post-traumatic stress disorder, depression. Those are my main two ones.
How is your relationship with your children now versus back then?
I was estranged from my children for many years. They were just sick of dealing with me, and I needed to work on myself, as much as the abandonment was painful on both sides. I made a decision that I was going to do everything I could to get better and be a better mother. I worked really hard. My goal was when I [got] back to my relationship with my children they could tell me absolutely anything and I wouldn't react and would remain calm. It's really hard. It wasn't about me and my feelings. It was about loving them.