According to the Mayo Clinic, “People with borderline personality disorder often feel misunderstood, alone, empty and hopeless. They’re typically full of self-hate and self-loathing. They may be fully aware that their behavior is destructive, but feel unable to change it. Poor impulse control may lead to problems with gambling, driving, or even the law. They may find that many areas of their lives are affected, including social relationships, work or school.”
So, who would want to associate with such a seemingly problematic individual?
As an individual who struggles with Borderline Personality disorder and has personal relationships with others who do as well, I often find the stigma against people with BPD to be a touch unwarranted. As with any “diagnosis” (especially one the forthcoming DSM-V is considering greatly altering, which has been of much private and public debate), one size certainly does not fit all.
I understand, first hand, the grave horrors of such impulsivity; of horrifying suicidal ideation; of strong emotions that do not last, and often produce unwanted effects; and the battle with self-jury in its various forms. (For me, this frequently took the form of cutting, and I confess to needing stitches on one occasion I wish with all of myself I could take back. I am deeply proud to say I have been clean for over a year, and through Dialectical Behavioral Therapy and excellent psychiatry, know I can resist urges that inevitably arise).
And, in truth, some of the most thoughtful and bright people I have the great privilege of knowing have this diagnoses as well. It is important to remember that a diagnosis does not denote the entirety of one’s personality by any means. We are all people; as different and alike as anyone else. Further, there are four generally excepted classes of BPD. Naturally, depending on life circumstances, individuals can move between types. And with proper, ongoing therapy, such as DBT, studies have shown that this condition can be eradicated within 10 years: and that holds true for 86% of people diagnosed with Borderline Personality disorder.
The Five Types of Borderline Personality Disorder (BPD)
Low Functioning Borderline. The “Low Functioning” borderline is what most people think of when they are first introduced to the condition. Low functioning BPDs are a living train wreck. They have intense difficulties taking care of their basic needs, are constantly experiencing mood swings. They also have an extremely hard time managing any sort of relationship with another human being. Low Functioning BPDs are often hospitalized more than other BPD types, for the very reason that they can’t live productively without constant coaching and supervision. These patients are challenging for all but the most experienced psychiatrists. Unless otherwise treated, low functioning borderlines lead self destructive lives and attempt to manipulate those around them with desperate acts, including self harm (cutting, burning, etc.).
High Functioning Borderline. The High Functioning Borderline Personality shares many core aspects of the low functioning borderline personality, except for the fact that they can manage their lives, appear to be productive, and generally keep their relationships civil (even diplomatic in nature). High Functioning borderlines can appear to be normal, driven people one moment; then moody, inconsolable, and manipulative the next. Somehow, there is a mechanism within the minds of High Functioning Borderlines that allows them to lead somewhat “competent” lives, despite the fact that they are in a constant battle with BPD. High functioning BPDs are no “better” than low functioning, but at a different place in the struggle.
Extroverted Borderline. Anyone familiar with the Myers-Briggs personality tests will understand the psychological differences between extraversion and introversion. When these characteristics are mixed with BPD, there are two different results. The Extroverted Borderline pushes all their feelings, fears, manipulation, rage, and moodiness outward to the people around them. In essence, if you are around an extroverted BPD, you feel like you’re living through their emotions while coping with your own at the same time. Further, extroverted BPDs will attempt self abusive acts in plain view of others in order to avoid abandonment or to express their rage. For example, an Extroverted BPD might cut themselves and then immediately share it with family and friends around them, hoping to gain sympathy or attention. In many cases, these types of behavior frighten people who do not suffer from BPD (or those who do not understand its vast complexities), and they may wonder whether or not the Extroverted BPD should be committed to a psychiatric ward.
Introverted Borderline. Contrary to popular belief, “introverted” doesn’t necessarily describe someone who has the propensity to be rather reclusive (i.e., as caused by a condition such as Agoraphobia). Rather, introversion is characterized by experiencing life in a self-reflective, private, and at times distant manner. To others, introverts may appear shy or lacking in people skills. This might be true, however, introverts make up for their lack of social skills with rich inner lives, thoughts, and deep thinking. As a result, the introverted Borderline primarily focuses all their BPD emotions and reactions inward. Instead of having a rage episode in public, they might retreat to their rooms and cry for hours on end, perhaps even cutting themselves for their own amusement or as stress relief. Introverted Borderlines live in an odd world: on one hand, they spend most of their time in personal thought and reflection, looking to fill themselves with a viable sense of self; but on the other, they are conflicted by emptiness and the bottomless emotional pit that BPD produces. Introverted BPDs might be harder to “spot” unless you happen to know one personally, in which case you might notice occasional depressive symptoms and evidence of self harm.
Transparent Borderline. The Transparent Borderline is a bit of a mix between a high functioning borderline and either extroverted or introverted tendencies. In plain terms, Transparent Borderlines live double lives: on the surface, “in public”, they appear one way, but in private, amongst immediate family and friends, they appear completely different. As a result, they may or may not be high functioning due to this conflicted state of mind. Transparent Borderlines spend most of their emotional energy trying to balance the personality demands of Dr. Jekyll and Mr. Hyde, the both of which experience strong BPD emotions like anyone else with the disease. Like Introverted Borderlines, Transparent Borderlines are harder to spot, and often only confess their true disposition after a harrowing rage, major break up, or other severely traumatic event that brings all their BPD feelings to the fore.
And to those, like me, suffering with BPD: There IS hope! Resist the stigma, and get the help you deserve. You CAN get well.