What is Borderline Personality Disorder ?
Borderline Personality Disorder (BPD) is a complex and serious mental health condition. It is a condition that affects approximately 2% of Australians, however, this number is underrepresented due to poor diagnosis and understanding of the condition. According to the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM 5), BPD is characterised as “a pervasive pattern of instability of interpersonal relationships, self-image and affect, and marked impulsivity beginning by early adulthood and present in a variety of contexts” (American Psychiatric Association, 2013, p.663). More specifically, some of these symptoms include an inability to understand oneself and the world around them, unstable and intense relationships and impulsivity and self-harming behaviours.
There is no one pathway to a diagnosis of BPD. In fact, there is a complex interplay between factors such as one’s environment (trauma, abuse, neglect, marginalisation, invalidation), temperament (high sensitivity and reactivity to emotional stimuli) and genetic predisposition.
However, there is a strong correlation between a history of trauma, domestic violence and neglect. According to women experiencing BPD and my own lived experience, these symptoms can create difficulties in looking after oneself, managing one’s fluctuating mood, making decisions, defining oneself, building healthy relationships, maintaining daily routines and managing stressful situations (Larivière et al., 2015).
The Effect on one’s Life
These symptoms have a significant impact on one’s quality of life including living a life worth living. People with BPD can experience frequent hospitalisations due to self-harm, mood instability and suicidality. These can cause a profound disruption on one’s daily routines and occupational roles including working, caring for self and others, socialising and looking after one’s own home (Birken & Harper, 2017).
Diagnostic Criteria
People with BPD typically experience some, but not necessarily all, of these symptoms.
- Frantic efforts to avoid real or imagined abandonment
- Unstable and intense interpersonal relationships.
- Identity disturbances. Unstable sense of self and self-image.
- Impulsivity and risk behaviours e.g. binge eating, spending money, sex, substance misuse, reckless driving.
- Recurrent suicidal behaviours
- Intense changes in mood
- Chronic feelings of emptiness
- Intense anger
- Paranoia and emotional detachment
Click HERE to a video of my lived experience with BPD.
References:
- Birken, M., & Harper, S. (2017). Experiences of people with a personality disorder or mood disorder regarding carrying out daily activities following discharge from hospital. The British Journal of Occupational Therapy, 80(7), 409-416. doi:10.1177/0308022617697995
- Larivière, N., Couture, É., Blackburn, C., Carbonneau, M., Lacombe, C., Schinck, S.-A., . . . St-Cyr-Tribble, D. (2015). Recovery, as Experienced by Women with Borderline Personality Disorder. Psychiatric Quarterly, 86(4), 555-568. doi:10.1007/s11126-015-9350-x
OT for BPD 