Being given a diagnosis of a personality disorder can be a shock if you weren’t expecting it, but it can be a relief too. You may have long felt that there was something wrong with you that wasn’t being recognised. Now you have the diagnosis you are in a position to plan and look after yourself better.
What does it mean? What is it?
Borderline Personality Disorder (BPD) is also referred to as Emotionally Unstable Personality Disorder (EUPD).
Symptoms of BPD / EUPD
- Emotional instability, particularly involving negative emotions: rage, sorrow, shame, panic, loneliness
- Disturbed patterns of thinking or perception
- Intense and unstable relationships with others
- The terms BPD / EUPD cover a long-term pattern of abnormal behaviour, frequently indicated by unstable relationships to other people.
- Sometimes this will involve destructive risk taking behaviour, often it will involve self-harming,
- Addiction based issues are often part of the picture.
Fear of Abandonment
Often people with BPD or EUPD will have heightened anxieties involving a fear of abandonment. It is the anxiety about abandonment that links BPD or EUPD to our early histories of attachment, to the way we did not feel we were adequately cared for by our parents and carers.
For this reason, BPD or EUPD is considered as being a disorder that relates to your early experiences.
It is not about something that is wrong with you, it is more the case that it reflects something that has happened to you, particularly in terms of your early relationships.
Frequently there will have been experiences of trauma, sometimes involving sexual abuse. Often both the attachment issues and the traumatic experiences that were experienced will have been overlooked.
People who have gone through these kind of early relationship problems and experiences are frequently the children of parents who themselves went through something similar and may have the disorder themselves. These conditions are often handed down from one generation to the next. So what can you do to manage it?
Is BPD / EUPD Treatable?
Yes. Often treatment will involve medication and a talking therapy. If you are experiencing depression and or anxiety then you may want to consider medication to help you with those symptoms, perhaps just in the short term. But in the longer term BPD or EUPD is something that can be treated with psychotherapy. Dialectic Behavioural Therapy, a version of cognitive behavioural therapy is often suggested.
You should find a therapist who has some experience of working with these conditions. Psychotherapists who have been trained in analytic and psychoanalytic models tend to have gone through a longer and more rigorous training.
It may be helpful to prepare a bit before the initial meeting with your therapist. You might find it helpful to write some notes about your experience.
It will be helpful to think of this as a longer term project
In advance of meeting a therapist write up some brief notes on your understanding of ;
- what you have been through – the history of your mental health
- what the changes in mood have been / are like
- what you have found helpful and unhelpful in the psychiatrists and psychotherapists you have met
- any diagnoses, and what you have made of them
- what you are looking for in psychotherapy now
- what you can afford to pay
- when you are available for a weekly session
Writing some notes, preparing, will help you feel you are addressing this proactively, and not that you are suddenly being thrown into a reactive and stressful state of mind.
Therapy should help you to develop a therapeutic relationship in which you will start to gain some confidence. This should allow you to explore your early attachments and to consider the traumatic experiences you may have been exposed to.
Planning for longer term management of BPD / EUPD
A feature of the diagnoses refers to unstable emotions which tend to cause sufferers to become highly reactive. We need to try to find a way of bringing stability into our lives, routines and relationships. Be prepared that this will take some work.
- Start with small acts of measured self care.
- Try to introduce a better routine into your daily life.
- Start with small steps.
Becoming able to plan your routines is the start of developing a proactive attitude to yourself and the people around you. It may help to break the cycle of reactive behaviour. It is very difficult to be stable when you are continually having to react to things.
Introducing stability, starting to plan for yourself, will help to take the panic out of things and may help you bring your BPD / EUPD under better control.