If you have come to understand borderline personality disorder (BPD) through personal experience with an individual suffering from the disorder or your own struggle with it, the road has most certainly been a rocky one for you. For people with BPD, life is a bit like riding a rollercoaster with a blindfold on – not only are the highs and lows extreme and often back to back, but they are often unexpected, as well.
Impulsivity and instability are two of the major markers for BPD, which was coined in 1938 by Adolf Stern. Low self-esteem, fear of abandonment and deep-seated anger issues are common among sufferers. BPD makes a person highly sensitive to criticism or any other type of perceived rejection. Those with this disorder tend to see most aspects of life in black or white.
Their extreme thinking creates a “with me or against me” approach to assessing relationships at every level. People who are in a sufferer’s life are often idealized and seen as exceptionally good or demeaned and seen as exceptionally bad or even evil. Psychologist Marsha M. Linehan once described those with the disorder, which she had once been treated for as an adolescent, as having no “emotional skin.”
What Is Discouraged Borderline Personality Disorder?
There are four subtypes of BPD. One of those subtypes is discouraged borderline personality disorder. When a person suffers from discouraged borderline, much of how they think, feel, and behave is driven by the dependent aspects of their personality disorder. In fact, according to Psychology Today, from an outside perspective, a person with discouraged borderline might look a bit like someone with dependent personality disorder. This person displays signs of codependence in most relationships in life.
The dependence of a discouraged borderline type is often most noticeable when they become dependent on a person with whom dependence is inappropriate – a casual friend, for instance, or a boyfriend or girlfriend who they just started dating. A person with this subtype might seem outwardly depressed or serious, especially when compared to some of the other borderline disorder subtypes.
Discouraged borderline is marked by noticeable clinginess and a passive “follower” type of mentality. While on the outside this person might just seem indecisive or, at worst, weak-willed, they normally experience internal turmoil about their lack of leadership and bitterness toward those around them. This type of borderline disorder in a person might yield self-harm in the form of self-mutilation or even suicide.
Who Has This Disorder?
Both women and men from any background can develop BPD and its discouraged borderline subtype, though the diagnosis is seen more in women than in men. This might be related to the possible neurobiological factor of disturbed estrogen levels or perhaps a bias created by institutionalized sexism. Some research has suggested that the disorder actually does affect men and women equally, but that women are more likely to seek treatment, be encouraged to seek treatment, or to be officially diagnosed or misdiagnosed as BPD. This diagnosis usually is not made until adolescence, at the earliest, and it is typically made before young adulthood comes to a close. It is estimated that around 1.6 percent of Americans suffer from BPD in any given year.
Signs of Discouraged Borderline Personality Disorder
There are many different signs and symptoms of BPD, according to the DSM-V. The following are signs that professionals look for when attempting to diagnose BPD or the discouraged borderline subtype. These are considered to be impairments in personality functioning.
- Impairments in self-functioning. These types of impairments might include an unstable or poor self-image, excessive self-criticism, chronic feelings of emptiness, and stress-induced dissociative states. This might also include instability in goals, values, career plans, or general aspirations.
- Impairments in interpersonal functioning. These types of impairments might include decreased levels of empathy, which can manifest as a lowered ability to understand the position of others, a heightened and dramatic sensitivity to perceived criticism, or rejection and black-and-white thinking even regarding people – most people are seen as good or bad. Impairments in interpersonal functioning might also include intimacy issues. These types of issues might arise as incredibly intense and unstable relationships marked by high conflict, mistrust, clinginess, a fear of abandonment, and either over-involvement or withdrawal at different times.
There are other signs that distinguish a person with borderline BPD from others. Some of these signs and symptoms might include:
- Unstable emotional experiences
- Easily aroused emotions
- Emotions that are significantly intense or disproportionate to the cause of the emotion
- Increased nervousness, tension, worry, panic, or general anxiety
- Fixation on unpleasant experiences from the past or possible unpleasant experiences in the future
- Fearfulness and uncertainty
- Discomfort with uncertainty
- A fear of losing control
- A fear of rejection
- Separation anxiety
- Excessive dependency and loss of autonomy or a fear of an “inevitable” loss of self
- Depressed or hopeless feelings
- Suicidal thoughts or behaviors
- Difficulty creating or sticking to plans
- Distress-induced urgency
- Dangerous risk-taking behavior without regard for consequences
- Hostility, especially in relation to perceived criticism or rejection
- Disassociation or “zoning out” and difficulty concentrating
Some BPD signs that are specific to the discouraged borderline include:
- Loyalty, even to an excessive degree
- Pliant and easily swayed by others, even when it goes against one’s own desires
- Submissive and passive even when desiring a leading role
- Humble as a result of low self-esteem, insecurity, and vulnerability
- Constant feelings of vulnerability and weakness
- Constant feelings of being in jeopardy
- Feeling hopeless, helpless, powerless, and depressed
- Excessive dependence upon others
- Tearful episodes
- Feelings of emptiness
- Self-persecution and self-victimization; believing others are constantly attacking or ill-meaning
- Destruction or intentional loss of belongings, whether through physical violence toward belongs or a cycling of acquiring and then giving away or selling
- Reliance on fantasy as a means to escape, often engaged in fantasy-based media (novels, movies, comics, etc.)
- Chronic or recurring illness complaints, sometimes somatic
- Self-deprivation (as opposed to self-indulgence), rooted in feelings of worthlessness
- Substance abuse
Causes and Correlations
Like all mental health disorders, it is difficult to pinpoint the cause of BPD or its discouraged subtype with precision. Researchers understand the cause of this disorder to be multifaceted and not easily or immediately identifiable.
Although the cause of BPD is thought to be multifaceted and complex, involving many different life factors, there are some potential contributing causes that many professionals in the field seem to agree on. Some of these causes and correlations include:
- Post-traumatic stress disorder (PTSD) might be related to BPD
- Childhood trauma, particularly abuse and neglect, often involving sexual abuse
- Congenital brain abnormalities, like a smaller hippocampus or amygdala
- Genetics, particularly in genes DRD4 and DAT and chromosome nine
- Neurobiological factors, like estrogen levels
- Environmental factors (aside from trauma) like family and social stability levels
- Social factors, including social experiences as a child
Difficulty With Diagnosis
BPD and its subtypes are not necessarily easy for even the most seasoned mental health professional to diagnose. As discussed in a 2011 Scientific American article, the diagnosis of the disorder is often flawed in one sense or another.
To complicate diagnosis further, women with the disorder are particularly prone to experiencing co-occurring disorders that might make a proper diagnosis more difficult. Some of the other illnesses often found to be comorbid with BPD include major depression, anxiety disorders, eating disorders, substance abuse, or antisocial personality disorder. Many of these concurring disorders also involve a low self-esteem or unstable self-image.
The management and treatment of BPD is essential in order for sufferers to lead functional and fulfilling lives to the best of their abilities. This is especially important because BPD carries a serious risk of suicide. People suffering from BPD make up a large chunk of suicides on an annual basis, so all self-harm and suicidal tendencies on behalf of a person with BPD should be immediately addressed and taken very seriously. If you or someone you know is at risk for suicide, it is important that you get help as soon as possible.
Psychotherapy is the primary method used for managing and treating BPD. Although there is no cure-all medication that can address BPD, some of the comorbid conditions that often coincide with BPD can be treated with prescription medication, which can increase the overall success rate of treatment. It is important to understand that these medications cannot treat BPD, but that the treatment of concurring conditions can help clear the way for a more successful treatment of BPD through psychotherapy.
Depression and anxiety are among the two most common comorbid conditions that are treated with medicine while the patient is treated for general BPD with psychotherapy. Antipsychotics might be used to reduce anger or suicidal tendencies as well as impulsivity, psychotic paranoid symptoms, anxiety, and depression.
It is important that comorbid conditions are examined and treated appropriately when treating a patient who suffers from BPD. Before treatment can truly begin, comorbid issues should be addressed and treatment should be initiated. For example, the substance abuse that often accompanies BPD should be removed as a factor for disturbed behavior before true treatment can begin. If it is not, a patient’s cognitive function might be impaired, and it might be difficult for a professional to accurately examine the patient.
Get Help Today
Recovery from BPD is possible and has been reinforced as possible through many studies. Managing, treating, and recovering from BPD is no easy task, but when attempted alongside the right medical professionals and support groups, it can be done.
At Optimum Performance Institute, we help people with this diagnosis, especially adolescents and young adults, to transition more easily into a self-sufficient adult life. We equip young adults suffering from BPD with the resources and skills they need to overcome their illness through our OPI Intensive, which is a specialized program within our institute. Through a 30-day immersion phase followed by a 30-day transformational phase, we have been able to see significant improvements in the young adults we treat.
We treat young adults on an individual basis while giving them all that they need in a group setting to persevere and succeed. Our approach to treating BPD, including its discouraged subtype, is like no other. That’s why Psychology Today named our OPI Intensive as the “Best In Treatment” available for BPD sufferers. Call us today for more information on our program.