Borderline personality disorder (BPD) is a severe mental health condition marked by frequent mood changes, an unstable self-image, and intense and unbalanced relationships. While the disorder’s basic description and diagnostic process seem straightforward enough, the lived experience of the disorder is far more complex.
While there are nine criteria for diagnosing BPD, there are many variations of the disorder. This means that each person’s experience is unique and is likely to present quite differently. Unsurprisingly, then, BPD is one of the most misunderstood mental illnesses, and the diagnosis is often accompanied by misconceptions that negatively impact the lives of people who have the disorder. This has been my experience since being diagnosed.
Helping others, particularly those close to us, understand the day-to-day realities of borderline personality disorder can be a daunting task. As I have navigated conversations with family and friends, I’ve learned that what matters most is speaking my truth to the best of my ability.
Speaking out is how I — and, hopefully, others — can promote understanding and, subsequently, empathy for everyone impacted by borderline personality disorder.
Give Specific Information About the Disorder
In order to describe my experience with BPD to people who are unfamiliar with the disorder, I first list the nine diagnostic criteria:
- Extreme efforts to avoid real or imagined abandonment
- A pattern of unstable and intense relationships, often marked by alternating between idealization and devaluation
- An unstable self-image or sense of self
- Impulsivity in activities that are potentially self-damaging (like reckless driving or binge eating)
- Recurrent suicidal behavior or threats
- Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days)
- Chronic feelings of emptiness
- Difficulty controlling anger
- Stress-related paranoid ideation or severe dissociative symptoms
However, while presenting someone with the criteria is an excellent way to introduce them to the basis of what the disorder is, it can be difficult for them to fully comprehend and relate the symptoms of BPD to your personal story. This is why I try to communicate the symptoms that I personally experience with BPD and translate them in ways that are more understandable.
Focus on the Personal Impact
My experience navigating conversations about mental illness have taught me that people generally do not understand how severe and debilitating symptoms can be — or how much work goes into addressing symptoms. They do, however, tend to understand severity of physical injuries and symptoms.
For example, I tell people that my intense emotions and mood swings often feel physically painful. When I am heartbroken, it feels as though I have full-body injuries, and I am unable to think clearly, which often leads to impulsive actions. In these circumstances, my actions may seem manipulative, but they often come from a place of experiencing intense emotional pain.
In likening my symptoms to physical symptoms that someone else can relate, I have found that I’m more likely to relay the in-body experience and severity of my symptoms. This approach provides a higher chance of validation, while also creating a connection and igniting empathy.
Share the Positives
Unfortunately, I have come to find in my journey that BPD is often portrayed negatively in the media and in popular culture. The symptoms of the disorder are often used as a plot device or in a headline to inspire fear, ultimately furthering stigma and oppression for those living with it.
While highlighting the difficulties of the disorder is important in an open conversation, I also prioritize sharing the positives. For example, individuals with BPD tend to feel emotions intensely (and more strongly than many of our peers), which means that we experience love, happiness and excitement to a higher degree, which often makes many of our relationships more exhilarating. We often experience intense connections, and while relationships certainly have the potential to become unstable, they are often deep and meaningful.
Finding the positives in my symptoms of borderline personality disorder has not only helped me explain the condition to my loved ones, but it has also helped me to better connect to myself and release the judgment I placed on myself for having this diagnosis. Those with BPD are often some of the most empathetic, understanding people that I know, and we all deserve to be understood rather than judged based on the stigma surrounding this illness.
My hope is that people will be able to see borderline personality disorder in a more positive light, and that people living with the disorder will be able to relay their experience more easily to their loved ones.
Ultimately, people with BPD deserve the understanding of others who can see the whole person — not just a diagnosis.
Ashley Nestler, MSW, is a survivor of schizoaffective disorder, quiet borderline personality disorder, fibromyalgia, multiple eating disorders, generalized anxiety disorder, obsessive compulsive disorder and Complex PTSD. She is a mental health specialist, author and empowerment coach.