Warning: This article contains discussion of suicide and self-harm which some readers may find distressing.
A doctor has explained the key traits to look out for that could mean you’re suffering with borderline personality disorder (BPD).
Dr Ramani Durvasula sat down with MedCircle to discuss the ‘highly misunderstood mental health condition’ in a YouTube video.
The NHS defines BPD as a disorder of mood and how a person interacts with others, explaining those with the disorder will significantly differ to those without in terms of how they think, perceive, feel or relate to others.
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American clinical psychologist Durvasula shared the nine traits to help people understand the disorder.
Fear of abandonment
She said this can be real or ‘perceived’.
“They’re always preparing for this abandonment,” the doctor explains. “And in trying to prepare for it all the time, they almost make it happen.”
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In doing this, it can ‘grind the other person into the ground’, explaining it could be in romantic relationships, friendships or with family.
Unstable and really intense interpersonal relationships
Again, Durvasula says this can be with any ‘close relationship’.
Typically, it will start ‘passionately and closely’ but quickly leads to ‘very loud arguments, that ramp up’.
“The relationships will always have a rollercoaster feel,” she adds.
Identity disturbance
By this, the doctor means the person ‘almost literally doesn’t know who they are’.
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And she says this can cause a ‘chronic inside battle’ because if you don’t know who you are, you don’t know how ‘to navigate the world’.
There might also be chronic changes in the person’s appearance, from hairstyle to fashion sense or even changing their name.
Impulsivity
“Impulsivity is the idea of acting out or behaving in a way without thinking about it,” Durvasula says. “So that could be manifested by often dangerous or problematic behaviours.”
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In this, she includes: binge eating, binge spending, gambling and impulsive sexual behaviour
Suicidal behaviour or suicidal thoughts
The doctor says this is seen often and it can often be a way of people dealing with that fear of abandonment.
This might also include self-harming, and can be seen as a ‘cry for help’.
Affective instability
Durvasula says this is ‘a fancy way of saying their moods are sort of all over the place’.
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This is essentially when mood shifts can happen within a couple of hours.
“It’s this affective instability where moods can shift and fluctuate in a very short period of time.” She adds this can be why BPD can be a ‘very difficult disorder to manage’ and is often why people confuse it with disorders like bipolar.
Chronically feeling empty
Durvasula says those with BPD often report they feel like there’s ‘nothing inside’ and describe feeling like a ‘drum’ or a ‘hollow shell’.
And they might regulate it or fill it in by looking to the ‘outside world’, with ‘shopping, spending, eating’.
Interpersonal difficulty
The expert moved onto the penultimate point, highlighting that this is shown by 'inappropriate and intense shows of anger', to the point where 'anything' frustrates them, no matter how small or insignificant.
It's not just verbally but physically, as they can 'throw things', 'scream and yell', though it ends as quickly as it begins.
As a result, people end up walking on eggshells around them as they are scared of angering them.
Transient stress
Saying that this last one is 'relatively severe', she explains that it's a fancy way of describing a significant stress experienced by someone with BPD, and that they may face 'frankly paranoid symptoms' as a result.
They believe that 'other people are out to get them or harm them', similar to a conspiracy, as negative voices in their head impact their behaviour.
"They're scared of them so they literally look psychotic," she revealed, adding that a mental health practitioner may diagnose them in that moment of time as a psychotic person.
Additional words by Joshua Nair
If you're experiencing distressing thoughts and feelings, the Campaign Against Living Miserably (CALM) is there to support you. They're open from 5pm–midnight, 365 days a year. Their national number is 0800 58 58 58 and they also have a webchat service if you're not comfortable talking on the phone.
Topics: Mental Health, Health, Community
Jess Battison