Borderline personality disorder (BPD) is a complex mental health challenge that will typically emerge by early adulthood. Impulsivity, unstable personal relationships, self-image disturbance, and a feeling of emptiness characterize BPD. The resulting emotional instability contributes to significant distress and impaired functioning.
BPD negatively impacts the individual’s quality of life and is also a source of disturbance and suffering in the individuals who regularly interact with the person. When symptoms become so erratic and destabilizing, it is appropriate to consider more intensive interventions at an inpatient BPD treatment center. These residential programs provide a more targeted treatment approach while the patient takes a break from daily stressors.
About Borderline Personality Disorder (BPD)
According to the National Alliance on Mental Illness, an estimated 1.4% of the U.S. adult population, or approximately 4 million individuals, suffer from borderline personality disorder. BPD involves a cluster of destabilizing thoughts and behaviors that lead to daily emotional distress and suffering. At the center of BPD is an inability to regulate emotions, which can shift dramatically in an instant. A triggering event might cause impulsive behaviors that are harmful, such as self-harming or substance abuse.
A common feature of BPD is a low self-image that accompanies an intense fear of being abandoned by their loved ones. These feelings that they are unworthy of love and will therefore be abandoned drive the often absurd attempts to avoid the imagined abandonment. This then results in the other person desiring to distance him or herself, which in turn motivates the abandonment action like a self-fulfilling prophecy.
Although BPD is a serious mental health disorder, with the right treatment approach and patient compliance following treatment the individual has an excellent prognosis. By recognizing the signs of the disorder and obtaining treatment early on from a provider that specializes in this complex disorder, the overall outcome improves significantly.
What Causes BPD?
BPD is a bit of a mystery with no clear-cut cause yet identified by scientific research. However, certain risk factors have been identified as possibly playing a role in the development of the disorder. These risk factors include:
- Genetics. It has been found that individuals with a close family member who also struggles with BPD may have an increased risk of developing the disorder.
- Environmental and social. Traumatic life events, such as being the victim of physical or sexual abuse, abandonment, attachment disorder, general adversity, or interpersonal instability may be factors in BPD.
- Brain factors. Brain imaging studies on individuals with BPD have shown structural and functional abnormalities in the limbic region where impulse control and emotional regulation occur.
Symptoms of BPD
Diagnosis of BPD is challenging as individuals who struggle with this mental health disorder often present with co-occurring disorders. These might include depression, bipolar disorder, anxiety disorder, eating disorders, or substance use disorders. The presence of a coexisting disorder complicates the diagnostic process and the treatment protocol, as each issue must be addressed along with the treatment received at inpatient BPD treatment centers.
Symptoms associated with BPD include:
- Anger and angry outbursts
- Compulsive behaviors, including self-harming, binge eating, and substance abuse
- Unstable and tumultuous relationships
- Difficulty regulating emotions, extreme mood swings
- Dissociation, seeing oneself from outside the body, feeling cut off from self
- Extreme fear of real or imagined abandonment
- Suicidal ideation
- Difficulty trusting others, suspicion
- Distorted self-image
- Chronic feelings of emptiness
Each individual with a BPD diagnosis will have a unique mix of symptoms. Some may exhibit only a few of these symptoms, where others may have a more severe form of the disorder and have multiple symptoms present. It is common for those with BPD to see things in the extreme, as black or white with no middle ground. This only contributes to the mood swings and impulsive behaviors so prevalent in BPD.
How BPD Affects People Around Them
People who associate with or are related to someone with BPD suffer the effects of the disorder. The afflicted individual may seem kind and loving one day, and the next day is seen as an enemy. These extreme and erratic shifts keep those individuals in their sphere perpetually off balance. They may wonder if they are somehow misinterpreting the behaviors of the person with BPD. This causes relationships with someone with BPD to often be emotionally painful and strained.
Because the person with BPD is deeply fearful of being abandoned they may go to extreme measures to prevent the possibility from happening. This can cause the other person to feel manipulated and controlled through the dramatic pleas and crossing of boundaries. The individual with BPD will often go to great lengths to exert control or dominate the other person in an effort to keep them attached to them.
People may find themselves engaging in co-dependent behaviors with the individual with BPD. The chaos that is characteristic of being in a relationship with a person struggling with BPD may lead to unhealthy enabling or codependency in an effort to maintain peace. Attempts to keep things calm can begin to cause feelings of suffocation and of being manipulated.
How is BPD Managed?
After a diagnosis of BPD has been made, the individual will be prescribed a two-pronged treatment protocol. If there are any co-occurring disorders, such as substance use disorders or eating disorders, they will also be addressed in the treatment planning.
Medication is generally a core treatment element for borderline personality disorder. In many instances, a combination of medications will be considered in an effort to manage the various presenting symptom, as there is not one specific medication for treating BPD. Some of these drugs include antidepressants, mood stabilizers, and antipsychotics.
Psychotherapy is usually prescribed alongside the medication. For BPD it has been found that two types of evidence-based therapies are effective in helping individuals with this mental health disorder. These include psychodynamic therapy, which examines childhood events and other environment and social factors that might be driving the disorder, and cognitive behavioral therapy, which helps the individual learn new coping techniques when triggered.
Inpatient BPD Treatment Centers
When the BPD leads to severe impairment or impulsive and harmful behaviors that place the person or others in danger an inpatient BPD treatment center is the necessary level of care. These programs offer an opportunity to delve into the specific features of the BPD and then establish an individualized treatment plan. Inpatient care is more intensive, providing multiple therapeutic activities throughout the day, as well as 24-hour monitoring. An inpatient stay may last a week to several months, depending on the severity of the BPD, how the individual responds to medication and psychotherapy, and his or her achieving emotional stability.
While engaged in the mental health treatment program the individual will participate in the following therapies and activities:
- Individual psychotherapy. A residential program for BPD will access several types of psychotherapy to assist the patient in attaining better functioning and a better quality of life. Evidence-based psychotherapies used for treating individuals with BPD include dialectical behavior therapy (DBT), cognitive behavioral therapy (CBT), psychodynamic therapy, and acceptance and commitment therapy.
- Group therapy. DBT skills training and practicing CBT techniques are an essential aspect of group sessions. The small group sessions provide a safe and nurturing space for opening up and sharing personal experiences and emotions while under the guidance of a licensed therapist.
- Trauma therapy. In some cases, BPD coexists with trauma disorder, such as PTSD. To help augment the clinical results from the psychotherapy the individual with a history of trauma may participate in prolonged exposure therapy or eye movement desensitization reprocessing (EMDR).
- Addiction treatment. If a substance use disorder overlaps with the BPD it will be addressed simultaneously with the mental health treatment. If there is a need for detox, a medically monitored detox program will be completed prior to beginning treatment.
- Complementary activities. Some experiential or holistic activities can help the BPD patient learn to better regulate their emotions and reduce stress. These might include mindfulness, yoga, guided meditation, massage, art and music therapy.
Living with BPD
Managing BPD after inpatient treatment is critical, so transitioning to day treatment or an outpatient program is an essential next step. Individuals with BPD are at a higher risk of engaging in behaviors that pose a danger to their wellbeing, such as self-harming behaviors, violence, and suicide attempts. It is important for the individual to comply with their medication’s dosing schedule and to engage in outpatient activities and healthy lifestyle choices that will help support healing and stability. These might include:
- Outpatient psychotherapy. Ongoing psychotherapy sessions are an integral component of continuing care.
- Support groups. BPD support groups are a source of social support where there is a common experience with the challenges of this disorder
- Nutritious diet. Reducing exposure to refined sugars, processed foods, simple carbs, fast food, and alcohol can improve overall wellness and functioning
- Holistic therapies. Integrating holistic therapies, such as deep breathing exercises, therapeutic massage, yoga classes, and meditation can help control stress
- Regular exercise. Studies confirm the significant mental health benefits of regular exercise, especially aerobic activities such as walking, running, swimming, and cycling.
Mental Health Hope Offers BPD Guidance and Treatment Options
Mental Health Hope provides important resources for individuals experiencing the difficulties of borderline personality disorder. Ask our experts questions about this complex and destabilizing mental health disorder and the team will provide suggest treatment options such as an inpatient BPD treatment center. Get the help you deserve to live a fulfilling and productive life. Call Mental Health Hope today at (877) 967-9274.