Q: How are we supposed to handle it when my loved one is acting out?

When your loved one with BPD is acting out, it’s essential to remain calm and non-judgmental. Validate their emotions while setting boundaries to protect yourself and others from harm. Encourage them to engage in coping strategies they’ve learned in therapy. It’s also crucial to prioritize your own well-being and seek support from friends, family, or mental health professionals when needed.

Question 1

What is borderline personality disorder?

Accepted Answer

Borderline personality disorder (BPD) is a mental health disorder characterized by pervasive patterns of instability in interpersonal relationships, self-image, emotions, and behavior. Individuals with BPD often experience intense and unstable emotions, have difficulty regulating their emotions and impulses, and struggle with a strong fear of abandonment. BPD typically emerges in early adulthood and can have a significant impact on various areas of life, including relationships, work, and self-esteem.

Question 2

How is BPD different from bipolar disorder?

Accepted Answer

Many people get borderline personality disorder and bipolar disorder confused with one another. In fact, one study in 2017 showed that 40% of people with BPD were misdiagnosed with bipolar disorder type 2.

These two disorders do have a lot in common, but there are also marked differences. Both conditions cause severe mood changes, but the moods will look different with each disorder. Bipolar produces mania and depression, while BPD will produce intense feelings of emotional pain, loneliness, and desperation.

Also, mood changes with BPD are usually very brief and last for a few hours, whereas bipolar mood swings can last days or even weeks.

Question 3

What causes borderline personality disorder?

Accepted Answer

The exact cause of borderline personality disorder (BPD) is not fully understood, but it is believed to result from a combination of genetic, neurobiological, and environmental factors. Here are some factors that may contribute to the development of BPD:

Genetic factors: There is evidence to suggest that genetics play a role in the development of BPD, as the disorder tends to run in families. Individuals with a family history of BPD or other mental health disorders may be at increased risk of developing the disorder themselves. However, specific genetic markers or genes associated with BPD have not been identified.
Neurobiological factors: Abnormalities in brain structure and function, particularly in areas involved in emotion regulation, impulse control, and interpersonal processing, have been observed in individuals with BPD. Imbalances in neurotransmitters such as serotonin, dopamine, and noradrenaline may also contribute to the symptoms of BPD.
Early life experiences: Adverse experiences during childhood, such as abuse, neglect, trauma, or unstable family environments, are commonly associated with the development of BPD. These early life experiences can disrupt the development of healthy attachment relationships, emotional regulation skills, and self-identity, contributing to the emergence of BPD symptoms later in life.
Biological vulnerability: Some individuals may have an inherent biological vulnerability or predisposition to developing BPD, which can be influenced by genetic factors, temperament, and early brain development. This vulnerability may interact with environmental stressors or trauma to increase the risk of developing BPD.
Environmental stressors: Environmental stressors such as chronic interpersonal conflicts, loss or abandonment, invalidating or dysfunctional family dynamics, or other life transitions or disruptions can trigger or exacerbate symptoms of BPD in vulnerable individuals. Stressful life events may further disrupt emotional regulation and coping mechanisms, leading to the onset or worsening of BPD symptoms.

Invalidating environments: Growing up in environments where emotions are dismissed, invalidated, or punished can contribute to the development of BPD. Individuals raised in invalidating environments may internalize a sense of shame, self-doubt, and invalidation, leading to difficulties in emotion regulation, self-esteem, and interpersonal relationships characteristic of BPD.

Question 4

What are the signs and symptoms of borderline personality disorder?

Accepted Answer

Intense and unstable relationships: Individuals with BPD often have tumultuous and unstable relationships characterized by alternating extremes of idealization and devaluation. They may form intense, intimate bonds with others quickly, only to become intensely fearful of rejection or abandonment and push others away. Identity disturbance: People with BPD may have an unstable sense of self and may struggle with chronic feelings of emptiness, identity confusion, or a lack of clear goals, values, or direction in life. They may have difficulty forming a stable and coherent sense of identity. Emotional dysregulation: Individuals with BPD may experience intense and rapidly shifting emotions that are difficult to regulate. They may have episodes of intense anger, anxiety, depression, or irritability that are disproportionate to the situation and may have difficulty calming down once upset. Impulsivity: People with BPD may engage in impulsive behaviors that have the potential for harm or consequences, such as reckless driving, substance abuse, binge eating, reckless spending, or unsafe sexual practices. These behaviors are often driven by a need to alleviate distress or avoid feelings of emptiness. Fear of abandonment: Individuals with BPD often have an intense fear of abandonment or rejection and may go to great lengths to avoid real or perceived abandonment. They may become overly dependent on others for validation and support or engage in desperate or manipulative behaviors to maintain relationships. Chronic feelings of emptiness: People with BPD may experience persistent feelings of emptiness, boredom, or inner turmoil, even in the presence of others or when engaged in activities they once found pleasurable. They may seek to fill this void through relationships, activities, or substance use but may find temporary relief at best. Dysfunctional patterns of behavior: Individuals with BPD may engage in recurrent patterns of behavior that undermine their goals, relationships, or well-being. These behaviors may include self-harm, suicidal gestures, unstable career or educational choices, and frequent job changes or relational conflicts. Paranoia or dissociation: Some individuals with BPD may experience transient episodes of paranoia, dissociation, or depersonalization, where they feel detached from reality, experience distorted perceptions of themselves or their surroundings, or have periods of amnesia.

Question 5

What medications have been useful in treating borderline personality disorder?

Accepted Answer

There are no proven medications yet that help specifically with borderline personality disorder, however, some options exist that can treat various symptoms related to BPD. Some medicines can alleviate symptoms of depression and anxiety, but they are not considered a cure for BPD.

Medication should not be considered the only treatment for borderline personality disorder, but rather one tool among many.

Question 6

Why does my loved one act like this?

Accepted Answer

Understanding why someone with borderline personality disorder (BPD) behaves in a certain way can be complex. BPD often involves difficulties with emotion regulation, self-image, and interpersonal relationships. Past traumas or adverse experiences may contribute to their behaviors. At Alter, we work to help the family members learn as much as possible about BPD so they can better relate to their loved ones.

Question 7

How are we supposed to handle it when my loved one is acting out?

Accepted Answer

When your loved one with BPD is acting out, it&#8217;s essential to remain calm and non-judgmental. Validate their emotions while setting boundaries to protect yourself and others from harm. Encourage them to engage in coping strategies they&#8217;ve learned in therapy. It&#8217;s also crucial to prioritize your own well-being and seek support from friends, family, or mental health professionals when needed.

Question 8

How do we set boundaries with our loved one who has BPD?

Accepted Answer

Setting boundaries with a loved one with BPD requires clear communication and consistency. Start by identifying your limits and expressing them assertively but compassionately. Use &#8220;I&#8221; statements to convey your needs and expectations. Enforce consequences if boundaries are violated, but remain supportive and empathetic. Seek guidance from a therapist experienced in working with BPD to develop effective boundary-setting strategies tailored to your situation.