welcome to the bpd carrd -- a very simple carrd about bpd by someone with bpd. the person who made the carrd wants you to use this carrd for some personal education (and to break down some stigma), but not for you to make a self-diagnosis.
What is BPD?
Borderline Personality Disorder, sometimes called Emotional Dysregulation Disorder, is a mental illness where a person’s relationships with people, self-image, and emotions are impaired. It is often described as having "no emotional skin," or "emotional third-degree burns" because of how intensely people with BPD feel their emotions. It is usually environmentally induced. It is also often misdiagnosed.
Those with BPD are often labelled as toxic because of their behavior. BPD is very heavily stigmatized, even in a professional environment. There are many clinicians with reservations about both the legitimacy of the disorder and taking on patients with BPD. Other diagnoses with symptoms of suicidality or anger are not considered stigmatizing in the same way, which is why many patients won’t disclose that they have BPD in fear of being turned away.
By not disclosing diagnoses, patients can receive inadequate and misguided treatment. And while BPD is often accompanied by some other mental illness (i.e. depression) that can be managed with medication, BPD cannot usually be treated with medication alone.
“There is perhaps no serious mental illness more maligned and misconstrued than borderline personality disorder.” - Joyce Burland, Ph.D
Some BPD Facts
• 65-70% of persons with BPD make at least 1 suicide attempt
• 10% of patients with BPD complete suicide
• Self-injury (cutting, burning, bruising, head-banging, biting) is seen in 75% of patients
• Clinicians have the right to turn away BPD patients
DSM Criteria
do not by any means use this to self-diagnose
1. Frantic efforts to avoid real or imagined abandonment.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
3. Identity disturbance: persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
5. Recurrent suicidal behavior, gestures, or threats, of self- mutilating behavior.
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.
Note that 7 out of 9 of the criteria affect OTHER relationships which is why it’s considered the “disorder of relationships.”
BPD Criteria Reorganized
Interpersonal Dysregulation:
-Abandonment fears
- Unstable relationships (ideal/devalued)
-Emptiness
Affective/Emotion Dysregulation:
- Affective instability (no elations)
- Inappropriate, intense anger
Behavioral Dysregulation:
- Recurrent suicidality, threats, self-harm
- Impulsivity (sex, driving, bingeing)
Self Dysregulation:
- Unstable/distorted self-image
- Depersonalization / paranoid ideation under stress
“Borderline individuals are the psychological equivalent of third-degree burn patients. They simply have, so to speak, no emotional skin. Even the slightest touch or movement can create immense suffering.”
- Marsha Linehan
BPD Resources
What is DBT?
Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, is a type of psychotherapy ("talk therapy") primarily used to treat borderline personality disorder (BPD). DBT is a form of cognitive behavioral therapy (CBT), meaning it's a type of therapy that focuses on the role of cognition, which refers to thoughts & beliefs, behavior, or actions, in the development and treatment of BPD.
DBT has also proven to be helpful with other mental illnesses, such as ADHD, PTSD, and various eating disorders.
The core DBT strategies:
Mindfulness
Helps you focus on the present or “live in the moment.” It helps you pay attention to what is happening inside: your thoughts, feelings, sensations, and impulses. It also encourages you to tune in to what's happening around you (what you see, hear, smell, and touch) in nonjudgmental ways. Mindfulness skills help you slow down and focus on using healthy coping skills when you are in the midst of emotional pain.
Distress Tolerance
These techniques help prepare you for intense emotions and empower you to cope with them with a more positive long-term outlook.
It includes distraction, improving the moment, self-soothing, and thinking of the pros/cons of not tolerating distress.
Interpersonal Effectiveness
Helps you to become more assertive in a relationship (for example, expressing your needs and be able to say "no") while still keeping a relationship positive and healthy. It also helps you to learn, to listen, and to communicate more effectively, as well as deal with challenging people, respect yourself, and respect others.
Emotion regulation
These skills help you learn to identify, name, and change your emotions. When you are able to recognize and cope with intense negative emotions (for example, anger), it reduces your emotional vulnerability and helps you have more positive emotional experiences.
What is "Switching?"
"Switching," also known as "splitting," is very common with BPD.
"When a baby enters the world, they experience the things within it as either good or bad, or as all or nothing. As the baby develops psychologically, they begin to understand that the world isn’t just good or bad. They become able to integrate the idea that good and bad can be held in the same object."
People with borderline personality disorder often experience overwhelming emotions. This causes them to struggle with the concept that good and bad can co-exist.
Switching or splitting is a psychological mechanism which allows the person to tolerate difficult and overwhelming emotions by seeing someone as either good or bad, idealized or devalued. It makes it (seemingly) easier to manage emotions.
This is a type of black and white thinking. You may be completely repulsed by someone one day or one week or one hour, then think they are perfect the next. This way of thinking often jumps back and forth, and can be hard for the receiving end to follow. It's important to keep in mind that this has a name and is a real thing people experience -- it does not make someone evil. It just may take some communication and work toward a healthier relationship.
A note to my fellow borderlines (or whatever you prefer to be called)
If you're reading this and having a hard time, I hope you know all your feelings are valid and real and I know how deeply you feel them. I also hope you know that you're not a bad person, no matter what evidence you use against yourself. Frankly, if you're paranoid about being a bad person, that's a huge sign that you aren't -- you wouldn't really be worried about being a bad person if you were one, no?
I really struggle with personalizing everything I see online. I know how hard it can be to read things online about "toxic" traits and feeling ashamed when you can cross off everything, especially when people say things like "drop people like this," because it's othering and dehumanizing. I'm just going to say it plainly: those people are so, so ignorant. And, you know what? Sometimes, they simply lack compassion. That's on them and not entirely on you. Of course, you should try to combat your behavior you know can potentially cause pain. But you deserve to be surrounded by people who see and recognize your struggle.
There's nothing someone, especially me who is literally sitting here making a carrd with her laptop on her stomach with four chins, can say that can make you feel better when you're struggling because your brain can seemingly just keep going unless you utilize the skills to stop it (and that's a muscle, and sometimes, it doesn't work the way you need it to). But something that helps me is remembering this: feelings aren't facts -- they move. They come and go like waves. I know each time can feel significantly worse than the last, but you can make it and I hope you're able to get the help and support that you need.
I've written two things about BPD on Medium. One of them is called "Down the Rabbit Hole," which goes more in-depth into how it feels to have BPD and how fucking left out you can feel on days like World Mental Health day, when you feel like everyone has depression and anxiety but will never understand the depth of what you feel or the way you behave. And the other is called "I'm Borderline -- Not Broken," which is just a thank you to Rebecca Bunch from The CW's Crazy Ex-Girlfriend, who has BPD (and, to me, is the best representation of BPD that I've ever seen on TV). And if you want to read them and they help you feel less alone or seen in any way, they were worth writing!
What is the DSM?
The government and many insurance carriers require a specific diagnosis in order to approve payment for treatment.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a book published by the American Psychiatric Association that is widely used by clinicians and psychiatrists in the United States to diagnose psychiatric illnesses. It covers all categories of mental health disorders for both adults and children, and contains descriptions, symptoms, and other criteria necessary for diagnosing mental health disorders.
It also contains statistics regarding the demographics of each illness, the effects of treatment, and common treatment approaches.
