Borderline Personality Disorder Awareness Month: Facts And Fictions About BPD
Borderline personality disorder (BPD) is a mental health condition that may be one of the most misunderstood mental health disorders, as it tends to be surrounded by a host of misconceptions. These inaccurate ideas may contribute to a persistent stigma that can make life difficult for individuals with this condition and decrease their odds of receiving the treatment they deserve. In May 2008, the U.S. House of Representatives declared May Borderline Personality Disorder Awareness Month, which is primarily an effort to raise awareness of the condition, helping people educate themselves about the realities of this often-challenging mental illness.
Research shows that people with BPD may have physical or functional differences in the brain, especially the regions that control impulses. BPD is typically characterized by a combination of emotional dysregulation, intense feelings of fear of abandonment, and impulsive, potentially self-destructive tendencies.
Although negative stereotypes and pessimistic beliefs about this disorder are relatively common, there’s growing evidence that effective treatments can provide support to those with BPD. A better understanding of what BPD looks like in everyday life can make it easier to offer effective support.
For help in treating BPD or other mental health disorders, reach out to a therapist in person or online. A licensed professional can help individuals build healthy coping skills to evade or combat unhelpful symptoms.
What is borderline personality disorder?
BPD is generally categorized as one of 10 distinct personality disorders currently recognized by clinicians. Unlike many other mental health conditions, personality disorders typically represent lifelong patterns of maladaptive thinking and behavior.
A diagnosis of borderline personality disorder usually requires at least five of the following symptoms to have been present throughout the person’s adult life.
Intense fear and avoidance of abandonment
Individuals with BPD are often very insecure in their interpersonal relationships and may go to extreme lengths to try to persuade, manipulate, or compel others to continue to give them attention or care. This fear of isolation may also prompt behaviors that seem calculated to push others away, either to avoid vulnerability or to “test” the commitment of friends or loved ones.
Difficulty sustaining stable relationships
A person with BPD may have a history marked by intense, tumultuous, and short-lived relationships. Individuals with this condition tend to shift rapidly between idealizing others and feeling resentment or hatred toward them. This can lead to passionate, whirlwind romances followed by bitter breakups or intense friendships that quickly fall apart.
An unstable sense of self
Some people with BPD may struggle with self-image. They might quickly pick up and abandon interests, beliefs, goals, or identity signifiers. Sometimes, this can involve taking on and then discarding characteristics they see in other people.
Reckless behavior
Intense episodes of impulsive, risky behaviors can be another common symptom of this disorder. Examples may include excessive spending, gambling, reckless driving, substance misuse (the term “substance abuse” is no longer used), high-risk sexual choices, and binge eating.
Suicidal or self-harming impulses and behaviors
Those with borderline personality disorder often attempt suicide or make suicidal gestures or threats. They may also engage in self-mutilation or self-harm (e.g., cutting). On average, individuals with BPD die by suicide more often than patients with other personality disorders (5.9% versus 1.4%). Warning signs of potential suicide risk include a sense of emptiness and a lack of hope, expressions of thoughts of death, and alterations in behavior.
If you are experiencing suicidal thoughts or urges, contact the National Suicide Prevention Lifeline at 988. Support is available 24/7.
Emotional instability
BPD tends to involve difficulties with controlling emotions, and people with this condition often react with unusual intensity to external events. As a result, they may experience dramatic and short-lived mood swings.
Persistent feelings of emptiness
Many people with BPD report a nagging perception that something is missing in their lives or themselves. They may experience a sense of disconnection or numbness. This can be commonly linked to feelings of unfulfillment, depression, or hopelessness.
Extreme, inappropriate anger
Along with overall challenges managing emotions, those with BPD often have difficulty controlling their anger. They may experience disproportionate rage over minor slights or setbacks, lose their tempers frequently, and stay angry longer than others.
Bouts of paranoid thinking
Although BPD doesn’t usually involve the kind of persistent delusions sometimes found in conditions like schizophrenia, people with this condition may experience short-term paranoid distortions. During times of major stress, they may become temporarily convinced that others are conspiring against them or believe the world around them is unreal or illusory.
How severe and widespread is borderline personality disorder?
Current estimates suggest that BPD affects around 1.6% of the population at any given time, and about 5.9% of people may meet the criteria for diagnosis at some point in their lives. People with BPD appear to be overrepresented among those receiving mental health care, comprising up to 11% of outpatient psychiatric patients and 20% of those in inpatient care.
BPD can be a serious mental illness associated with a wide range of negative life outcomes. People with this condition may be less likely to maintain stable careers and functional relationships, and they typically report a lower quality of life than others. They may also have a significantly lower life expectancy, with a mortality risk that is 8.3 times that of the general population.
In addition, BPD very often co-occurs with other mental health disorders. Mood disorders like depression can be particularly common, as can anxiety disorders, substance use disorders, and eating disorders.
Common misconceptions about borderline personality disorder
Popular culture and pop psychology often circulate many mistaken and potentially damaging ideas related to BPD. Here are a few of the most common misunderstandings about this condition.
There’s no treatment for BPD
People with BPD are manipulative and attention-seeking
Many people believe that individuals with BPD act out behaviorally in a cynical ploy for attention or sympathy from others. While some people with this disorder may, at times, engage in manipulative behavior, it's typically an impulsive reaction to their severe fears of rejection and abandonment rather than a calculated attempt to control others.
People with BPD are dangerous
Studies suggest that borderline personality disorder alone does not contribute to an increased risk of violent behavior. However, some people with this condition may have additional mental health conditions, such as antisocial personality disorder or substance use disorders, that may make dangerous behavior more likely. Specific BPD symptoms, such as explosive anger, may increase the risk of intimate partner violence, but not everyone with this condition has those symptoms.
Watching out for red flags like extreme anger, impulsivity, and controlling behavior can give you a better sense of someone’s propensity toward violence than their diagnosis alone. If you or a loved one is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7.
BPD is the same as bipolar disorder or schizophrenia
Borderline personality disorder is often confused with other mental illnesses, most commonly schizophrenia and bipolar disorder. Though they may have a few similar symptoms, such as emotional instability, mental health professionals usually consider them substantially different disorders.
Research generally supports this view. For instance, while some people believe that BPD can be an “early sign” of psychosis, studies indicate that the overlap between these conditions may actually be quite rare.
In addition, while about 20% of those with borderline personality disorder may also have bipolar disorder, the majority of people with these conditions don’t overlap.
BPD mostly affects women
Early studies of borderline personality disorder suggested that, in the adult population, it was around three times as common in women as in men. More recent research disputes these findings, though. It appears that women may be more likely to receive treatment for BPD, but men may be just as likely to have this condition.
Researchers have found evidence that BPD tends to manifest differently based on gender. Men with BPD appear to be more likely to display “externalizing” symptoms, such as aggression, impulsivity, and harmful substance use. Women with BPD may be more likely to experience emotional instability and relationship dysfunction, and they may be more prone to self-harm.
How you can observe BPD Awareness Month
A more widespread and nuanced understanding of borderline personality disorder may make it easier for people with this condition to find the help they deserve and lead happy, fulfilling lives. Here are a few ideas for how you can help during this Borderline Personality Disorder Awareness Month.
Get educated about mental health disorders
The better you understand BPD, the more you may be able to offer support, encouragement, and allyship to those affected. You can educate yourself by seeking out informational resources like those provided by the National Education Alliance for Borderline Personality Disorder (NEABPD).
Amplify the voices of others
Many people with BPD have offered thoughtful reflections on what it’s like to live with this condition. Reading and discussing these personal stories can give those affected the opportunity to speak for themselves, and it may dispel some of the stigma around mental illness.
Speak up against misinformation and bigotry
If you encounter people in everyday life repeating misconceptions or hateful ideas about people with borderline personality disorder, taking a moment to offer a different view may have a substantial positive impact. Impartinv what you’ve learned about the realities of BPD can clear away confusion and foster understanding.
Donate to advocacy and join organizations
There are many nonprofit organizations dedicated to offering informational facts that educate legislators and other individuals about BPD, expanding to mental health care, and providing support to those impacted. If you’re looking for a tangible way to contribute to BPD Awareness Month, you might consider donating money or time to the following groups:
Benefits of online therapy
Online therapy may be a convenient option for those with BPD or who suffer from trauma and are interested in seeking professional help with their mental health. The ability to attend talk therapy from home at a time that fits their schedule may make it easier to keep appointments, even when experiencing challenging symptoms like emotional instability and feelings of emptiness. According to some of the latest research, mentalization-based therapy, in particular, has been found to be an effective treatment for reducing BPD symptoms, but more research is needed to confirm findings.
Effectiveness of online therapy for mental health conditions
According to a 2021 study, online dialectical behavior therapy “may provide [an] … alternative to treatment for individuals with borderline personality disorder without sacrificing the quality of care.” This joins a growing body of peer support that suggests that online and in-person therapy tend to produce the same client outcomes.
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