It’s the most dramatized of the personality disorders (Glenn Close in Fatal Attraction with her boiled bunny, anyone?) but one of the least understood. This week, Savvy Psychologist Dr. Ellen Hendriksen clears the air with nine signs of borderline personality disorder.
Sign #5: Maxed-out mood swings. Your emotions are both intense and fragile. It’s hard to break out of feeling sad, angry, or irritable, but you seem to flip from feeling fine to feeling horrible like a light switch. People may comment that the intensity of your reactions doesn’t seem to match the situation at hand. To make matters worse, while others may be able to let problems and hassles slide off their backs, somehow your baggage sticks like glue.
Sign #6: Anger. Your temper is hot, your fuse is short, and your anger is explosive, plus it’s often stronger than the situation warrants. You pick fights, yell, throw dishes, or even throw a punch. But you don’t spare yourself, either—you rage at yourself in addition to everyone else.
Sign #7: Emptiness. You often feel empty inside, like you have no emotions at all. You feel nothing. There is a hole inside you that nothing can fill. Which may lead to…
Sign #8: Self harm. Sometimes you hurt yourself—you cut or burn yourself and find the pain to be a relief. You’d rather feel something—even pain—than nothing at all. Or, you’d rather feel physical pain, which at least you can control, rather than emotional pain.
Sometimes, you might threaten to kill yourself to see if anyone cares, or as the classic cry for help. You might make suicidal-ish gestures like collecting pills. You may even try to kill yourself, but often without an intent to die; rather, you simply want to end this pain and emptiness. And tragically, with some folks with BPD, it works: the suicide rate in BPD is 50 times higher than the general population.
Sign #9: Small departures from reality. When you’re stressed, you may feel numb or dream-like, as if your life is a movie, or that it isn’t real. In addition, you may get a little paranoid, feeling like others are out to get you.
What to do about all this? Luckily, there’s Dialectical Behavior Therapy (DBT), the go-to treatment for BPD. There are four skills. Two of them fall in the “change” camp: first, there’s emotion regulation, otherwise known as being able to work with your emotions rather than just letting them break over you like a wave. Second, there’s what’s called interpersonal effectiveness, or how to ask for what you want, as well as how to say no, while leaving your relationships intact. The other two skills fall in the “acceptance” camp. The third is mindfulness—observing and describing the present moment without trying to change it. The last? Distress tolerance—building up your ability to endure emotion that otherwise might have sent you into a tailspin.
According to the New England Journal of Medicine, effective DBT can reduce hospitalizations as much as 90%, and lead to relapse rates as low as 15%. Indeed, whoever said you can’t change your personality didn’t know about DBT.
If you saw yourself in today’s episode, have hope: change is possible. Seek out treatment with an experienced DBT provider. If you’re worried about affording therapy, don’t be afraid to see a student. He or she will be supervised by a licensed provider, which is like getting two brains in one. They can help you build, as DBT asks you to envision, a life worth living.
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