The Basics: What Is BPD?

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Content note: Unfortunately, (and as no surprise to people with BPD and their loved ones), this post discusses suicide, abuse and ableism. If any of those are hard for you, I promise that your mental wellbeing is more important than my website stats. Go and find some cat videos 💙


Welcome to The Basics, a series in which I outline a concept that comes up a lot in my work! This time, we’re looking at Borderline Personality Disorder (also known as Emotionally Unstable Personality Disorder) – what it is, how it affects a person’s life, and what might help them. This article refers to “people with BPD” rather than “BPD sufferers” or similar, because I think the emphasis on suffering is unhelpful and because we are people. My personal opinions on whether it’s truly a personality disorder, versus a subtype of PTSD or a neurotype all of its own, are less than relevant here, but if significant new information comes to light along those lines you can expect an update to this post.

I was almost angry when I first learned about BPD, in that indignant way that you’re angry when you discover a resource that you had previously never heard of, sitting right in front of you. A while before I was formally diagnosed, I was already using BPD in my vocabulary and exploring how it might explain particular events scattered throughout my childhood. It explained so much, in fact, that I was formally diagnosed, and started writing a little more about having BPD.

BPD affects your mood, the way that you process and tolerate emotional distress, the way that you conduct your relationships and your self-perception. That’s a lot of things, so let’s start with the emotional bit. Sometimes I call my BPD “Big Emotions Disorder”, or “Tinkerbell Syndrome” in reference to the fairy in Peter Pan who can only feel one, extremely intense emotion at the time. These big emotions can cloud my judgement, especially when it comes to interpersonal interaction, and can escalate into an acute crisis very quickly. One problem with BPD is that our distress is so intense and specific that it can look very different to neurotypical distress, sometimes looking performative and thus not being believed – but we often are in that much distress, at least, and assuming otherwise is one of the reasons that people with BPD die by suicide at a rate of around 10%; for comparison, the Samaritans put the suicide rate of the general UK population at 10.0 per 100,000, or 0.01%

The relationship side of BPD is obviously impacted by the emotional side of it. BPD usually features an intense fear of abandonment and feelings of dependence on our loved ones, and our attachment styles can lead to clinginess and avoidance, sometimes both within the same person, same relationship and same hour. Relationships with a person who has BPD can often feature a lot of reassurance that you aren’t going to leave, as well as supporting the person when they have their characteristic Big Emotions. This can be taxing, especially when communication isn’t great, the person with BPD doesn’t know how to ask for reassurance (or even that that’s what they need), the person with BPD doesn’t take responsibility for their behaviour during times of Big Emotion, etc. Much like with the rest of the disorder, any stumbling block in the department of relationships is magnified so as to be almost insurmountable, so people with BPD report losing treasured relationships as well as ending up in terrible ones.

There is an argument to be made that entering terrible relationships, much like impulsive risky sex, drug use and dyeing one’s hair bright colours, is a self-sabotaging behaviour that we engage in because of our poor and typically unstable self-image. I personally think there is also an element of talented abusers finding and grooming people with BPD because we are likely to be grateful for the attention, eager to change and to please, and less supported by friends, family and professionals. Regardless, I’ve found in research and in my personal life that people with BPD are more likely to be abused in our interpersonal relationships than the general population, which is also more likely to do significant harm since we’re so sensitive to begin with.

(I also have to wonder whether dyeing one’s hair is definitely a response to unstable self-image, or whether it is sometimes done all or in part because of a desire to feel in control of one’s body and/or to make a statement. This is especially possible because there is an overlap between marginalised groups who dye their hair to be subversive, such as us gays, and people who are traumatised, what with trauma having known links to the development of BPD and all.)

Risk-taking behaviours are a real problem for people with BPD, and it can sometimes be hard to find the distinctions between deliberate risk-taking, altered perception of risk, and risks taken due to a feeling of passive suicidality. Personally, I’ve tried to obstruct a number of the risks I take, accidentally or on purpose, with things like a Blue Badge that stops me from wandering across car parks, and the deletion of Tinder from my phone. My experience with kink has given me, I think, a pretty good understanding of my ever-changing risk appetite and which risks I can take safely if I so need. I have to urge patience if there’s someone with BPD in your life taking risks that alarm you, especially because I know that sometimes I’m more likely to take risks if I have been specifically warned against them (there’s that avoidance coming through again). I also want you to trust that the adults in your life with BPD definitely are adults who can make adult decisions, and who will probably ask you if they need your help in managing their risk-taking. 

Personality disorders in general are heavily stigmatised, and this is especially true of what are sometimes called Cluster B personality disorders, like Antisocial Personality Disorder, Narcissistic Personality Disorder and Borderline Personality Disorder. I like to refer to Cluster A as “Cluster Your Problem” and Cluster B “Cluster Other People’s Problem”, because that does seem to be where the demarcation lies. BPD is among the disorders most vilified and misunderstood by the public, but I am here to tell you that there’s no personality disorder that makes you an inherently bad (or good) person – it’s your behaviour that dictates that. 

By the way, I’m going to insist on calling it BPD, instead of EUPD, or Emotionally Unstable Personality Disorder. There are a lot of reasons for this (including my inability to resist jokes about my European Union Personality Disorder), but my main one is that I think EUPD is misleading in two senses. The first is that it conveys that this is a primarily emotional disorder, which in turn conveys that it is perhaps less serious than other disorders, when in fact those emotions are a result of brain chemical activity just as in other mental health problems, and can be so intense as to lead to psychosis (delusions and hallucinations). The second is that it suggests a person with BPD is doomed to a life of emotional instability, which I don’t believe, having felt and witnessed the improvements that appropriate interventions can make. This doesn’t just mislead people who have BPD, rendering them desperately hopeless, but it also seems to mislead the public and professionals into thinking that severe emotional instability, and particularly distress, is so inevitable in people with BPD that it isn’t worth addressing in the way it would be addressed in anyone else.

This is not just a paranoid hunch I have; multiple articles point to a need for more research into BPD and how to treat its symptoms. Disorders aren’t chronically under-researched for no reason; funding goes to certain causes over others, which sucks because those other causes are usually also deserving of the funds. However, BPD isn’t as appealing or relatable to the public as disorders like depression, partly because of the very visible and vocal ways it presents. I also have to wonder whether it would get more research funding if it weren’t for the fact that “women present to services more often than men” (their cissexist language, not mine) and the related fact that we live in a patriarchal hellscape. Nonetheless, we don’t need research to approach people with BPD with the empathy and dignity that we deserve. It’s beyond time to stop treating BPD as Tantrum Disorder and start treating it like the complex constellation of traits and symptoms that it is – a disorder that can and does kill people. This dismissive attitude kills people.

In summary:

  • BPD is a disorder which acutely affects your relationships, your emotional state, your risk-taking behaviours and various aspects of your functioning
  • We are at high risk of harming ourselves but we are not fundamentally evil people bent on harming others
  • BPD is dismissed by professionals at an alarming rate, but the distress we’re communicating is legitimate
  • Helping people with BPD is the same as helping any other individual, but it will sincerely help us to elevate our voices and educate the public and professionals about the reality, and seriousness, of the condition
  • We need a lot more research on BPD, which you can also help to campaign for
  • If you have BPD and this post exhausted you emotionally, you’re not on your own. And if it helps at all, here is a photo of my cat:

My black-and-white cat on a blue-and-purple background, lying on his back with his legs spread wide. He learned this from me.

 

Borderline Personality Disorder and Relationships

Image is a selfie of Morgan, a white blue-haired nonbinary person with multiple facial piercings, who appears to have been crying very recently: their nose is pink, their face is damp and their mouth is sort of pulled off to one side because they are too sad to smile. They're holding two fingers up to the camera in the peace sign and their face is framed by the fluffy hood of their coat.

I’m going to have to start this post with a disclaimer. I was referred to a psychiatrist for an assessment as to whether I had BPD in 2017, and their conclusion was that I had borderline personality traits but didn’t meet the criteria for an actual diagnosis. My theory is that this decision was reached in part because my existing diagnosis of autism accounted for some of my symptoms and my trauma-related stuff means that I suppress or downplay some others. Regardless, I don’t want to position myself as an expert on BPD, and I’m using it as a piece of vocabulary which explains my experiences whilst trying not to attribute everything and anything to a diagnosis I don’t actually have.

With that out of the way, here’s the post proper:


I sometimes refer to my BPD as “Big Emotions Disorder”.

If you’ve seen Disney’s Peter Pan, you might recall that Tinkerbell, like other fairies, is so small that she can only experience one emotion at a time, and she experiences it so intensely that it clouds her judgement and she seems to forget anything that she has felt or experienced in the past, as well as forgetting the possibility that she might feel or experience anything different in the future. That’s how I feel emotions.

It fucking sucks.

It doesn’t always suck, of course: when I’m happy, I’m Big Happy, and that can be really pleasant, as can other Big Emotions such as Big NRE, Big Stoned and Big Inspired and Determined. But even those have their pitfalls. Big NRE can cause me to lose all sense of perspective, ignore or misread red flags and rush into relationships that are, at best, not well-suited to me and my circumstances (and are, at worst and alarmingly often, abusive). Even plain ol’ Big Happy can be detrimental in that it causes me to forget that I am, in fact, mentally ill, meaning that I over-commit to things, insist to medical practitioners that I’m doing fantastically and am horrified when I plummet back into depression and/or anxiety. This doesn’t just occur if I’ve been Big Happy for a number of days or weeks; a few hours of Big Happy is all it takes for me to become convinced that I was faking the depression, anxiety and PTSD all along.

And then, of course, there are the “bad” Big Emotions. Big Sad feels like an all-consuming tidal wave of despair and can be brought about from something as simple as Tesco running out of my favourite cookies. Big Scared triggers my fight-or-flight response in mundane situations such as visiting a new restaurant. Imagine every unpleasant emotion a human can feel multiplied by ten and made much, much easier to trigger – that’s my constant, day-to-day, exhausting experience of emotion. The one that seems to have the biggest impact on my relationships, though, is Big Insecure (and its cousin, Big Self-Hatred).

When I’m Big Insecure, I cannot see anything good in myself. Even the things I’m usually proud of, like knitting tiny hats for premature babies, are warped beyond recognition in my mind until I convince myself I’m only doing those things to earn praise or to hide my true (disgusting) nature. I grow to firmly believe that my partners only stay with me out of fear of the consequences our break-up might have, even though I’ve tried hard to make clear that they’re not responsible for my mental health or safety, or that they stay with me because I’ve manipulated them, taking advantage of trauma-bonding and their individual insecurities and sometimes-low self-esteem to ensnare them, so they can’t even see how despicable I truly am.

On average, I attempt to break up with at least one partner at least once a month. I explain that it’s for their own good, that I love them so much I could burst but that’s why I have to turn them loose from my machinations, that I never meant to manipulate them but I know that I have done so and that soon, once freed from me, they’ll realise exactly how awful I was and be unspeakably glad to have escaped. And my partners, every single time, have to spend hours reminding me that they are autonomous adults, that they love me, that I am not all that my brain says I am and that I do this all the time. They promise me that if I ever want to break up with them for my own reasons I’m welcome to do so, but firmly remind me that I can’t just break up with myself on their behalf: that’s their call. If I continue to spiral, sometimes they get me to take the PRN medication I keep on my person for acute episodes of anxiety, and sometimes they prompt me to phone my mum or get another partner’s opinion on the situation.

They do all this knowing that in three hours’ time I’ll be right as rain, planning my next sixty blog posts or an entirely new project that will most likely never see the light of day.

My BPD can put a strain on my relationships because I experience my lows so intensely and require so much reassurance to dig myself out of them, but I work hard to make sure my partners aren’t walking on eggshells around me. I remind them that even if they’ve done something that sparked a Big Emotion, it’s not their fault that the emotion is so Big. I tell them often that I want to be told when I’ve upset them, done something inconsiderate or otherwise could change my behaviour, but I also provide them with templates for how to convey that information to me in a way that minimises my unhelpful Big Emotional response. I go to therapy and I do my best to implement CBT techniques in my self-talk as well as teach my partners how they can help me to use them: they often ask me what evidence I have that I’m a terrible person, remind me of evidence that suggests I’m not, and gently suggest I may be misinterpreting evidence so it better fits my schematic beliefs. I also find healthy outlets for my Big Emotions, like baking bread (which is a constructive way to beat the shit out of something for ten-plus minutes), singing loudly, ugly-crying at documentaries or films, long walks, bad sketches and, when all else fails, screaming into cushions until my throat hurts.

It’s a lot of work and it’s never-ending, for both me and my partners, but I like to look on the bright side. My engagement with therapy coupled with my determination not to become the self-centred delicate monster I fear I might be means that I have a huge amount of insight into my emotions and my thought patterns, as well as some sophisticated ways to communicate about them. My Big Emotions make me fiercely loyal, unreservedly affectionate and as emotionally available as it is possible to be. My disordered personality isn’t a bad personality, or even an especially difficult one: having BPD as part of my vocabulary means that I know what challenges I face in relationships and can come prepared with reading material and my own bread flour, which puts me at an advantage over neurotypicals who haven’t done such intense introspection and research. It doesn’t make me a better partner, but it does help me be a more prepared one.

I wanted to write this because so much media regarding BPD and relationships is about how to be a good partner to people with BPD, except for the truly unkind stuff which argues that people with BPD cannot be good partners at all. I wanted to put into the world something from the perspective of a borderline person who is doing their fucking best and who does, whatever Big Insecure says, have a number of fantastic qualities that make them an excellent friend, partner, family member, employee and whatever else they want to be. I wanted to be a voice that says, “I’m borderline and it’s hard as hell but it’s worth it, it’s so worth it to pursue relationships and love people in the unabashed, unreserved and totally unconquerable way that us borderlines do.”

I’m Big Hopeful that I’ve achieved that.