Borderline Personality Disorder, or BPD, is one of many personality disorders affecting a large number of individuals. Roughly, 1.6% of the population is affected by BPD. BPD is one of the most difficult personality disorders to diagnose, however, due to the varying number and intensity of symptoms which are necessary for diagnosis. In many cases, individuals living with BPD are misdiagnosed with depression, bipolar disorder, or narcissistic personality disorder due to the nature of BPD to mimic the symptoms associated with these disorders. It is also possible that an individual with BPD may also suffer from other forms of mental illness.
Borderline Personality Disorder symptoms are viewed in two categories. In order for an individual being diagnosed with BPD, they must meet specific criteria in each of these categories.
Category 1 symptoms include:
- Low self-esteem
- Avoidance of considering the future or future events
- Difficulty establishing empathy
- Messy relationships
A diagnosis of BPD is given when the individual exhibits two symptoms from Category 1.
Category 2 symptoms include:
- Crippling anxiety
- Fear of Abandonment
- Mood swings
- Uncontrollable anger
- Risk-taking behaviors
A BPD diagnosis can occur when the individual meets at least 4 of these criteria and must include either uncontrollable anger, impulsivity, or risk-taking behavior. The varying degree of symptoms and intensity allow BPD to be a chameleon disorder, taking different forms in individuals who experience the disorder.
Like many mental disorders, there are different levels at which an individual can suffer. These degrees of the disorder are arranged on a spectrum. There are several scenarios in which individuals can go through their entire lives without realizing or indicating that they are struggling with this disorder. In other cases, however, the symptoms are exhibited prominently and are easier to recognize by those around the individual.
Some individuals experience low-functioning BPD in which the symptoms are intense enough to interrupt the individual’s ability to navigate everyday life without extreme difficulty. Individuals who experience low-functioning BPD are often more inclined to behaviors such as self-harm or extreme depressive episodes. On the other hand, individuals may suffer from high-functioning BPD. Individuals with low-functioning BPD experience more difficulty with concealing their symptoms, giving a higher rate of diagnosis for these individuals. Individuals with low-functioning BPD are often those who require institutionalization or hospitalization in order to avoid inducing harm to themselves or to others.
Some individuals experience what is referred to as moderately-functioning BPD. These individuals are most likely to experience triggers which set off their symptoms, such as explosive rage or impulse control issues. These individuals seem to harbor any traumatic experience and attempt to recruit others in their loathing of the person, object, or event which has triggered the trauma.
High-functioning Borderline Personality Disorder
Individuals with high-functioning BPD often have an easier time with concealing their symptoms. They are able to navigate life without any real difficulty that is noticeable to others. They may have relationships for many years without anyone recognizing that they are suffering from the mental disorder. In fact, these individuals can appear to be like everyone else but may have episodes of anger or attempts at manipulation through tactics like gaslighting to exert control over those around them.
For individuals with high-functioning BPD, there is a less likely chance for treatment as they will often ignore or deny that they need treatment. Their symptoms will not be noticeable to those who are not in direct contact with them on a constant basis. Co-workers or social connections may not be present for the most extreme of symptoms. However, spouses, partners, and family members will most likely be the ones who begin to recognize the patterns of behavior such as impulsivity or their uncontrollable anger.
Unlike individuals with low-functioning BPD, individuals with high-functioning BPD have more ability to control their own emotional responses. When enraged, they are more likely to regain control of their emotional response and can make a conscious effort to avoid harming those around them, particularly when it is someone they are intimate with.
In relationships, individuals with high-functioning BPD can be difficult. Relationships for anyone suffering from BPD are often more complicated than relationships for other people due to the issues of fear of abandonment, explosive anger, and rage. For individuals with high-functioning BPD, these issues may not be as pronounced as they are for other forms of BPD.
One note, however, is that individuals with high-functioning BPD may be more resistant to attending options for improving or strengthening the relationship. While they may be aware of the issues they have which result from BPD, in many cases they are often in denial that they need to seek assistance or therapy to help them to cope with these issues. Additionally, individuals with high-functioning BPD may become resentful and withhold their feelings when they experience any form of rejection from their partner.
Interesting enough, individuals with BPD are not proven to have a higher rate of divorce than those without BPD. In fact, when compared to those without BPD, individuals with BPD have a lower rate of divorce and also have a lower rate of remarrying after divorce.
For any individual living with BPD, treatment options can include a combination of medication and therapy to help establish coping skills. When individuals with high-functioning BPD seek the appropriate and necessary treatment, they can find managing their symptoms to be significantly easier. The difficult part of seeking treatment is that often individuals with high-functioning BPD do not believe that they need treatment or do not wish to seek treatment. For many individuals with BPD, there are issues with establishing trust with professionals to share their problems. Additionally, for those in relationships, high-functioning BPD individuals may find marriage counseling and retreat programs especially helpful in not only learning coping skills but also providing their partner with the information and skills for engaging in a relationship with someone with BPD. If you or someone you know is suffering from this disorder, it is important to seek out assistance to help you alleviate and cope with those symptoms and ensure the successful continuation of your relationship.