Alana Barlia, LMHC

Borderline Personality Disorder is a mental health condition characterized by unstable moods affecting one’s thoughts and feelings about themselves, others, and the world. For a number of reasons, BPD has gotten a bad rep over the years. People with BPD can be difficult to have relationships with due to their unstable moods, emotional attachment, and impulsive behaviors. However, many of the ‘truths’ we know about BPD are myths passed down by therapists and psychiatrists spooked by this diagnosis. In order to effectively treat BPD as a community, we must first debunk some of these harmful myths. Here are 5 I have noticed in the community: 

1) BPD has no scientific foundation 

That’s not true! Although it is not caused by a chemical imbalance in the brain, such as what happens during a depressive episode, BPD does have biological foundations. BPD develops partly from having a highly sensitive nervous system. The nervous system is responsible for carrying messages to and from the brain and spinal cord to nerves that connect to other organs in the body. It has been suggested that people can have highly sensitive nervous systems. This means the person has a lower threshold for releasing stress hormones that are activated more intensely than the average person’s and in such result in chronically elevated stress hormones causing a host of intense emotional responses from the individual. The person essentially lives in fight flight or freeze mode all of the time. This paired with an invalidating environment or traumatic incident can lead to BPD.  

2) BPD is not a real diagnosis

Historically, BPD has been difficult to diagnose because it is characterized by emotional dysregulation, which can be vague in presentation. However, the characterization of emotional dysregulation as it affects people’s relationships, job stability, family life, and friendships is a very real process for the individual. Some clinicians have proposed that BPD is simply a trauma response and would be better treated in that regard. I disagree – BPD has both biological and social underpinnings, so when the client does experience a distressing event or a trauma, they are likely to react in a heightened way due to their highly sensitive nervous system. Thus, BPD should be treated slightly different to the average person’s trauma response.  

3) BPD only affects women 

Although BPD is seen more often in women, and unfortunately is more often diagnosed in women, it actually occurs on a quite equal standard among genders. This harmful stereotype is linked to the way society views emotional responses from women – heightened, impulsive, overly emotional, and ~crazy~. But don’t be fooled, anybody can have a sensitive nervous system and traumatic experiences, leading to BPD. 

4) BPD has no cure

People would be correct to say there is no quick fix or pill to take for emotional dysregulation. However, there are a few treatments that work well for BPD! Although one cannot change their biology or the invalidating environments/trauma they have experienced, they can work toward understanding and taming their emotional instability through skills building in areas such as mindfulness, distress tolerance, emotional regulation, and interpersonal skills. Once learning these skills, clients can and will have the ability to live lives with fulfilling relationships, jobs, etc. 

5) BPD is all bad news

Yes, it is true that living with BPD is difficult, and having relationships with people with BPD is challenging as well. However, people with BPD have many wonderful qualities that make them unique friends, partners, and family members. Living with BPD makes one highly sensitive to emotional stimuli, but with that comes a high level of sensitivity to the positive emotional experiences in life as well. I think of it as flowers smelling fresher, skies looking bluer, and ‘I love you’s’ feeling stronger. If someone with BPD is willing and able to wrangle some of their more difficult emotional responses, they can live fulfilling lives filled with positive emotional responses, leading to positive behaviors and relationships.