Borderline personality disorder (BPD) is one of the most misunderstood and stigmatized disorders. There is a big difference between what BPD looks like to others and how BPD feels. Given my experience living with BPD and years of studying the disorder, I will attempt to acknowledge most of its aspects in the hopes that you can learn and relate.
In this article, we'll talk about how BPD develops, how BPD affects the brain, what BPD looks like to others, how BPD feels, how BPD affects behavior, and if BPD will ever go away.
How BPD is developed
There's a strong genetic component that can explain around 37 to 65 percent of people with BPD. Besides heritability, BPD can also develop in a family's upbringing due to an invalidating environment. And lastly, a large portion of a child's BPD development can be attributed to a parent having BPD.
It's known that there's a high correlation between trauma and BPD. My favorite theory is from Marshall Linehan, who is the creator of dialectical behavioral therapy. She believes that in order to develop BPD, we need a brain that is sensitive to negative emotions as well as an invalidating environment. When you have a brain that's sensitive to negative emotions, but if you grow up in the right environment where you get enough emotional reassurance, you can develop security and feel good about yourself even though you experience negative emotions. If your brain isn't sensitive to negative emotions, then even if your environment is somewhat invalidating, it's not that big of a deal because your brain can regulate the emotions internally. On the other hand, when you are sensitive to negative emotions and are in an invalidating environment, the negative emotions that arise will get amplified and not toned down by your environment, which then develops into BPD.
However, there are always exceptions. Like some people with BPD don't grow up in necessarily traumatic households. Or, only one of three children in a family where the mother is invalidating may develop BPD. Even though they all lived in the same invaliding environment, the other two kids have brains that are not sensitive to negative emotions.
How BPD affects the brain
People with BPD have increased emotional responsiveness, which can be seen in their brain activity. When something bad happens to someone who does not have BPD, it may take 10 to 15 seconds to get angry, whereas someone with BPD will get angry within one second. This is because the amygdalas of people with BPD are a bit smaller. The amygdala is the fear center of the brain and works as our survival mechanism. You might wonder if a smaller amygdala means less fear, but no, a smaller amygdala means more fear because the brain is less capable to regulate it. Additionally, with a smaller amygdala, people will feel negative emotions more intensely, longer, and faster. That means someone without BPD gets upset in 30 seconds and stays upset for about an hour, whereas someone with BPD will get upset within one second and stays upset for eight hours.
BPD reading facial expressions
A very interesting study on BPD is one where they looked at facial expressions. The researchers recorded a person's face as they transitioned from a happy smile to an angry face. Then they turned this recording into 100 pictures, which represents 100%. At the halfway point (50%), the majority of people can't tell if the person is happy or angry. The research revealed that for a typical brain to detect anger, a person must reach a level of 70% anger. And people with BPD can detect anger at only 30% anger. So, even when someone is still 70% smiling and happy, the brain of the person with BPD detects anger in that situation.
Imagine what it would be like to go through life seeing those around you, even if they're 70% happy, being angry with you. Imagine how hard it is to go through life when you're doing 70% right, but all you can see is the 30% unhappiness.
BPD sense of self
When we go through life, we have a sense of self, and that sense of self is something that we carry with us and can respond to the things around us. For example, if I'm confident in myself and things don't go my way, let's say I get fired from a job, I won't let that determine my value as a human being. If I've done good work and I believe that I'm a good person, parent, friend, husband, etc., even if I get fired from a job, that one incident doesn't determine who I am.
In my opinion, the core issue of BPD is that the sense of self is distorted or not formed very well. I don't know who I am, which results in feelings of emptiness and loneliness. What most often happened with BPD patients is that they're raised in traumatic situations where their sense of self cannot form healthily. Because a confident sense of self comes from a nurturing and caring environment.
How I feel about myself is determined by how people treat me. So if people treat me with lots of love and care, I, in turn, love, and care for myself. If people treat me with hostility, anger, and resentment, then I will feel like a really terrible person. So who I am is determined by how I'm treated. That, in my opinion, is the core feature of BPD and explains all kinds of other things. Because this explains why I need people to love me all the time because when someone stops giving me that daily reassurance of their love, I'm not able to love myself. I will start to feel empty and abandoned. Even though I logically know that this person still cares about me, I require that kind of input from the outside to determine my worth.
What that results in is becoming a chameleon. It creates a lot of problems in relationships because if I want this person to like me, I'm going to pretend to be into the stuff they're into. This way, I don't have my own joys, preferences, desires, or personality. I adapt and absorb the desires of other people. I create this false contract with the people around me, in which I pretend to be into something that I'm not. Eventually, it starts to become hard to maintain the facade. Other people may then notice my facade and stop inviting me. And if they stop inviting me, it triggers the fear of abandonment.
This issue can go even as far as someone with BPD being in a relationship with someone who wants to be in an open relationship, and because the person with BPD does not want their partner to leave them, they agree to an open relationship even though it's not what they want. Then once they enter into an open relationship and their partner is being intimate with other people, that exacerbates the fear of abandonment and causes all sorts of behaviors to explode.
People with BPD are also very empathic, which, once again, fits in with the idea of having no sense of self. Because my sense of self is going to be determined by how other people treat me. And for that to work, I have to be very empathic. The problem is that the kind of empathy that I have is biased. It's biased toward the negative. What I tend to see is dissatisfaction, fear, disappointment, and anger in all of my relationships. As explained earlier, I start to react out of fear when people are still 70% happy because all I can see is them being upset with me.
What does BPD look like to others?
1. Unstable relationships The first symptom that other people tend to see in people who have BPD, like me, is a pattern of unstable relationships. Due to the fact that I can quickly form romantic relationships and really close friendships with others. I'm quickly thinking about moving in together when we've just met a week ago. The problem is that these kinds of relationships tend to become unstable. At first, everything appears to be perfect, but then all kinds of interpersonal conflicts arise, begin to fight all the time, and push-and-pull behavior is shown, which causes the relationships to collapse rather quickly.
2. Strong emotional reactions The second thing that others often see from me is strong emotional reactions, which can be very frustrating from a relationship standpoint. I may explode over something that seems minor. Small things can evoke strong negative reactions. For example, when you forget to do something for me, I may get upset and start to show weird behavior. And if you ask me what's wrong, I often say: ''Nothing's wrong''. However, from the outside, you can see that something's wrong with me, but I won't communicate it to you. What you see is a strong emotional reaction over practically nothing, and if you start to pull away or don't talk to me as much, I may engage in what feels like manipulative behavior, guilt-tripping, or gaslighting to try to get you to re-engage.
3. Distorted sense of self The last thing other people tend to see from the outside of someone with BPD is that I do not entirely understand who I am as a person. I get excited about stuff, but I don't seem to have a consistent trajectory in life. I may get excited by particular things very easily, but if you ask me: ''Who are you? What do you want from life?'' I will often struggle with the question more than the typical person. Sometimes I will be able to give you an answer, but that would be something like: ''The only thing I want from life is you. I just want you.'' but that's not who I am as a person. I have a distorted sense of self-image, which can be noticed from the outside by the people who know me.
How BPD feels from the inside
1. Fear of abandonment I fear abandonment, which means that I'm afraid of screwing up relationships. I'm constantly afraid of saying or doing something wrong that will drive my loved ones away. I'm more concerned with when people are going to leave me than if they will. I believe people are looking for any excuse to leave me at any point. I could be dating for five years, but ever since the second month, I have been plotting an excuse to be abandoned. Relationships are incredibly stressful because I have to walk a fine line between appearing too clingy and appearing too careless, which both carry the fear of losing someone else's affection.
2. Emotional pain The subject of experience of people with BPD is something that I think we lack compassion for. Because, for people with BPD, the experience of life can be incredibly painful. The average person can rip an (emotional) band-aid off while it hurts for a few seconds with a 6 out of 10 pain. But if you've got BPD, the pain signals of life, especially emotional pain, are actually amplified. Things like breakups will (in a subjective way when taking two people, one person with BPD and one without BPD) hurt the person with BPD way more. It's almost like my nerves are on fire when it comes to emotional pain. It's often times confusing for me because I notice that I struggle more with life than my friends. My friends might be able to bounce back after like two to six months after a breakup, but I still feel very hurt after a year. This complicates relationships because what ends up happening is that normally two months after a break-up, other people still give me a lot of emotional support, but after four months, six months, or a year they get tired, and then these people stop supporting me emotionally, which makes me feel even more abandoned.
3. Feelings of emptiness The other common experience in BPD is subjective feelings of emptiness. This is where I feel empty on the inside while not knowing who I am as a person and what I want from life. Most of the time, the life goal I set is to get rid of pain without moving toward something. So, I'm actually moving away from something. For example, to get rid of these feelings of loneliness, I'm even willing to get back to my abusive partner. Because without this relationship, I feel disconnected from life, and empty on the inside while not knowing who I am. Because, with BPD, who I am is determined by other people.
4. Dissociation Last but not least, I occasionally dissociate or disconnect from life, which is probably a neurologic coping mechanism for people with BPD. Since I experience so much emotional pain, I detach or dissociate from that pain to be able to survive. This relates to the feeling of emptiness because the more I disconnect from myself, the harder it is to discover who I am.
How BPD affects Behavior
Because I have BPD, I'm going through life with a fear of abandonment, feelings of emptiness, and a lot of emotional intensity. To cope with that, I will engage in certain behaviors. The problematic aspects of BPD are visible in these behaviors because the more frequently these behaviors occur, the worse the consequences become.
1. Impulsivity The first conduct that people with BPD tend to engage in is impulsive behavior. For example, falling deeply in love with someone due to the emotional high they get when hanging out with them. This person is idealized and seen as the best individual they've ever met in their lives. Even though their last 10 relationships have been trainwrecks, this person feels different, and they want to move in with them. Impulsive behaviors can be expressed in many ways, such as oversharing, overspending, or quitting a job suddenly.
2. Self-harm Self-injurious behavior and suicidal ideation are not always the same thing. Suicidal ideation is the desire to end your life, which people with BPD are at high risk of. However, self-injurious behavior doesn't necessarily correlate with that. When you ask someone with BPD why they cut, burn, or engage in self-injurious behavior, they'll typically say it's a meditative practice for them. That sounds like something good, but I'm not advocating for doing this, but if you ask them when they cut, they say when the internal emotional pain becomes unbearable and when they feel unloved. Once they start cutting, that sensation of physical pain eliminates the emotional pain and their fears of loneliness and abandonment.
3. Substance use Substance use disorders are commonly comorbid with BPD. When they're feeling so much pain inside which they want to forget, they may get high or drunk to make all that pain go away.
4. Manipulative behavior The last kind of behavior we see from BPD sufferers is what looks like manipulative behavior. There are different ways to deal with feeling empty or bad on the inside, and one of the ways for them to feel better is to feel loved by someone else. If they feel abandoned and do something that evokes love and caring from other people, then they will feel better about themselves.
Will BPD ever go away?