Theraverse
.
February 12, 2025
Receiving a mental health diagnosis can feel like stepping into uncharted territory given the uncertainty, fear, and self-doubt that often accompany the process. For personality disorders, particularly Borderline Personality Disorder (BPD), these emotions can be amplified by the stigma that surrounds the condition. Many people worry that being diagnosed with a personality disorder means they are “broken” or “beyond scope of help.” Others fear they will be judged or abandoned by loved ones.
A personality disorder is not a moral failing. It is a mental health condition shaped by a combination of genetic, environmental, and neurological factors. Individuals with BPD, for example, often experience extreme emotional sensitivity and reactivity due to differences in brain function, particularly in the amygdala which is responsible for emotion regulation. Environmental factors often include adverse childhood experiences and cPTSD needs to be ruled out as a differential or co-morbid diagnosis.
Statistically speaking, 71 percent of people with BPD admitted they had gone through at least one traumatic experience in childhood. 48.9 percent with BPD said they were physically neglected in childhood. 42.5 percent were subjected to emotional abuse. 36.4 percent said they were victims of physical abuse and 32 percent of sexual abuse.
Borderline personality disorder symptomatology:
* A strong fear of abandonment. This includes going to extreme measures so you’re not separated or rejected, as a response to perceived fear.
* A pattern of unstable, intense relationships, such as believing someone is perfect one moment and then suddenly believing the person doesn’t care enough or is cruel.
* Quick changes in how you see yourself. This includes shifting goals and values, as well as seeing yourself as bad or as if you don’t exist.
* Periods of stress-related paranoia and loss of contact with reality. These periods can last from a few minutes to a few hours.
* Impulsive and risky behavior, such as gambling, dangerous driving, unsafe sex, spending sprees, binge eating, drug abuse.
* Threats of suicide or self-injury, often in response to fears of separation or rejection.
* Wide mood swings that last from a few hours to a few days. These mood swings can include periods of being very happy, irritable or anxious, or feeling shame.
* Ongoing feelings of emptiness.
* Inappropriate, strong anger, such as losing your temper often, being sarcastic or bitter, or physically fighting.
Challenges
People living with borderline personality disorder unfortunately face high levels of prejudice and discrimination from both the community and medical professionals. The stigma surrounding personality disorders can have far-reaching consequences. Many people avoid seeking help due to the stigma and fear of being labeled. The emotional dysregulation that underlies the condition may cause what is wrongfully perceived as dishonest or manipulative behaviour from the outside.
Even within mental health settings, individuals with BPD often report feeling dismissed or misunderstood by professionals. This stigma not only delays treatment but also exacerbates feelings of isolation, shame, and hopelessness making it harder for patients to receive the right care and for qualified professionals to minimise drop-outs from therapy. This further highlights the need for education and systemic change.
Treatment
Dr. Marsha Linehan is a psychologist who developed dialectical behavior therapy (DBT) which aims to address the symptoms of BPD by replacing maladaptive behaviors with healthier coping skills, such as mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. Marsha Linehan herself was diagnosed with BPD and has shared her journey publicly to reduce the prejudice against it.
Apart from DBT, other techniques inspired from other schools of thought in psychology such as CBT, ACT, Trauma work and so on can also be coupled with and customised to fit the needs of the patient. And medication if and when required especially in the presence of any co-morbid conditions would be highly recommended.
Helplines in India for suicide prevention
https://mhi.org.in/partner/details/sneha-foundation-trust/
https://www.thelivelovelaughfoundation.org/find-help/helplines
by,
Jensita Grace,
In-house Psychologist, Talk Therapy Clinic
.
Resources:
