Borderline Personality Disorder - A Guide for Families
Borderline personality disorder is one of the personality disorders and affects an estimated 10 million Americans. The disorder is characterized by a pervasive pattern of instability of mood, interpersonal relationships and self-image. While we all feel moody, fear abandonment at times, experience stormy relationships and doubt ourselves, those with this disorder live with these feelings almost constantly. They also experience them much more strongly.
Histories of unstable and intense personal relationships figure are prominent. Frantic efforts to avoid real or imagined abandonment are common. Routine impulsivity and engagement in potentially self-destructive behaviors are also typical. These behaviors may include substance abuse, shoplifting, reckless driving, gambling, promiscuity, and binge eating. Moods shifts are often sudden and severe. Frequent and inappropriate displays of anger and rage are par for course. Recurrent suicidal threats or gestures may also occur, including self-mutilating behaviors such as cutting of the skin.
The person with this personality disorder lacks a clear sense of identity. They have chronic feelings of emptiness or boredom. It is almost as though they are looking for trouble - if none exists they will soon create it. Life is a relentless emotional roller coaster. Sustained periods of contentment are foreign to someone with a borderline personality disorder.
Obviously, living with someone with this cluster of traits can cause anguish. They often rage most at the people they love most. One day they may frantically pursue, and the next vocally reject. Like a child, they split the world into good guys and bad guys - heroes and villains. They have no room for the in between or gray area since they cannot tolerate ambiguity. They either idealize or devalue others. Often they make unrealistic demands, require immediate gratification and have very limited patience.
They are very sensitive to being slighted. They seem not to learn from their mistakes. Even though they may actively solicit affection, they also distrust expressions of caring from others.
Recognizing that someone suffers from this disorder may sound easy but can be quite difficult. On the surface they may function well, especially if their life or work is highly structured. They may be socially charming at times. Indeed, the hallmark of the disorder is the sudden, unpredictable anger from someone who seemed 'normal'. These outbursts are frightening and mysterious to family and friends. The mood shifts and suicidal threats or attempts may be interpreted solely as depression by family or even professionals. If the diagnosis of borderline personality disorder is missed, treatment will likely not be as
effective.
Involvement with someone with this disorder can easily lead to frustration and a vicious circle of responses. The person acts - the family member reacts - often with anger or overprotectiveness. Either reaction may escalate the problem. Those with this disorder are often quite skilled at manipulating and pushing buttons. The advisable way to react is to respond with support but not overreaction or overprotection.
You can't fight fire with fire. Don't attempt to debate or discuss. Stay calm or leave the situation. Agree to disagree at the time, and discuss the situation later when things are calmer. Don't tip toe around the person. Acknowledge their moods, support them and set limits. Don't beg and don't threaten. Don't overreact out of guilt. Do not allow yourself to be emotionally blackmailed by self-destructive threats.
Contact a mental health professional if suicidal threats or attempts are made and consider getting some professional support for yourself. Even if the sufferer will not seek out help themselves (and often they won't or will drop out of treatment suddenly), a counselor can help you learn ways to minimize your own stress.
