This article was co-authored by Ran D. Anbar, MD, FAAP. Dr. Ran D. Anbar is a pediatric medical counselor and is board certified in both pediatric pulmonology and general pediatrics, offering clinical hypnosis and counseling services at Center Point Medicine in La Jolla, California and Syracuse, New York. With over 30 years of medical training and practice, Dr. Anbar has also served as a professor of pediatrics and medicine and the Director of pediatric pulmonology at SUNY Upstate Medical University. Dr. Anbar holds a BS in Biology and Psychology from the University of California, San Diego and an MD from the University of Chicago Pritzker School of Medicine. Dr. Anbar completed his pediatric residency and pediatric pulmonary fellowship training at the Massachusetts General Hospital and Harvard Medical School and is also a past President, fellow and approved consultant of the American Society of Clinical Hypnosis.
There are 15 references cited in this article, which can be found at the bottom of the page.
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You may feel many emotions after receiving a diagnosis of borderline personality disorder (BPD). Perhaps you feel in shock or even angry at the person who diagnosed you. Maybe you feel resistant to treatment or overwhelmed by what treatment may entail. While your mind and emotions may feel overwhelmed, take a step back and focus on coping well with your diagnosis. Give yourself time to think about it, explore your treatment options, and allow yourself to return to a stable outlook on life.
Amy Morin, LCSW, is the Editor-in-Chief of Verywell Mind. She's also a psychotherapist, the author of the bestselling book "13 Things Mentally Strong People Don't Do," and the host of The Verywell Mind Podcast.
If you have borderline personality disorder (BPD), your emotions can be overwhelming. Symptoms of BPD, include erratic mood shifts, self-harming behaviors, suicidality, intense emotional experiences, sensitivity to problems in your relationships, and problems with impulsive behaviors. These symptoms may all be related to one core feature: emotion dysregulation.
Because of emotion dysregulation, you may have very strong emotional responses and difficulty managing those responses. Unfortunately, many people with BPD turn to unhealthy behaviors in an attempt to cope with emotional pain, such as violence, self-harm or substance abuse. Coping skills can help to reduce emotion dysregulation and other symptoms of BPD.
Benefits of Coping Skills
Since emotion dysregulation is such an important feature of BPD, many treatments for BPD emphasize the importance of building coping skills to better manage emotions when they arise. What exactly are coping skills? They are healthier ways of addressing situations and their resulting emotions.
Learning new ways to cope provides possible benefits. These techniques may:
- Build confidence in your ability to handle difficult situations
- Improve your ability to be able to continue to function well even when in stressful circumstances
- Reduce the intensity of the emotional distress you feel
- Reduce the likelihood that you will do something harmful (e.g., engage in self-harming behaviors) to attempt to escape from the emotional distress
- Reduce the likelihood that you will engage in behaviors that destroy relationships (e.g., physical aggression) when you are upset
- Ultimately reduce your overall experience of emotion dysregulation
If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see our National Helpline Database.
There are literally thousands of different coping skills that people use to manage stressful situations and the emotions that result. Here are a few types of coping skills that work for many people.
Play music that creates an emotion that is the opposite of the one you are struggling with. For example, if you are feeling very sad, play happy, upbeat music. If you are feeling anxious, play slow, relaxing music.
Coping with a new borderline diagnosis can be challenging. Here’s a step-by-step guide on how to accept your borderline diagnosis and start healing.
If you’re anything like me, you probably left your intake appointment feeling a mix of confusion, resentment, anger, and sadness. In fact, I think most of us go through a grieving process every time we’re presented with a new diagnosis.
But a diagnosis isn’t a death sentence, especially not in the case of borderline personality disorder (BPD). Remember that your symptoms were already present. The only thing that’s changed is the name.
A New Borderline Diagnosis Guide
1. Take a Deep Breath
When I was first diagnosed as borderline, my emotional intensity was through the roof. I hated the therapist who gave me the diagnosis. I hated that I would have to join a dialectical behavioral therapy (DBT) program. I hated that I wasn’t normal.
In retrospect, it would have done me a lot of good to take a few deep breaths.
After receiving your borderline diagnosis, give yourself a day or two to practice self-care in whichever form feels best. Take a bubble bath, read, go for a long walk, or bake some cookies. Try repeating the mantra, “I am okay. I am safe. Nothing bad is happening in this moment.”
It’s true. Nothing bad is happening. Your diagnosis is just a name.
2. Educate Yourself on Borderline Personality Disorder
BPD is not a disease, but a name for a cluster of symptoms that typically arise in sensitive people with trauma histories. Knowing this has been extremely helpful for my own process. Understanding the parallels between trauma and BPD can alleviate some of the shame around the latter diagnosis and reiterate that the symptoms are not our fault.
Diagnoses are given to us for insurance purposes and as a way to figure out the best treatment options. You are not your diagnosis. Try replacing the thought, “I am borderline” with “I have been diagnosed with BPD, but it doesn’t define me.”
3. Stay Away from Books and Websites that Perpetuate Borderline Stigma
There’s a lot of harmful information about BPD in the world. People who have had bad experiences with borderlines are often very vocal and tend to make sweeping generalizations about the lot of us. It’s not fair and it’s not right, but it’s our current reality.
As with any illness, people hone in on only the most extreme cases of BPD. Have you ever run a Google image search for a standard skin rash? You’re usually met with photos of oozing skin, swollen blisters, and peeling scabs. Obviously, not everyone with hives looks like they just waltzed with a swarm of bees. Similarly, not everyone with borderline personality disorder acts like Angelina Jolie in Girl, Interrupted.
Turn to people who understand and empathize with the diagnosis. A DBT therapist is a good bet, or you can check out one of the many blogs or memoirs written by borderline sufferers.
4. Look into Treatment Options for Borderline
Though the symptoms of BPD aren’t your fault, seeking help will, ultimately, be your responsibility. It’s a bummer, but it’s worth it.
The most popular treatment for BPD is dialectical behavioral therapy (DBT), which is broken into four distinct modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Each module targets specific elements of borderline personality disorder.
If DBT doesn’t feel right, you can check out its cousin, cognitive behavioral therapy (CBT). Those who have acute or prolonged trauma can opt for a trauma-specific therapy, such as somatic experiencing (SE), eye movement desensitization and reprocessing (EMDR), or exposure therapy.
The time it takes to recover depends on both the severity of your symptoms and your dedication to your specific treatment program. I graduated DBT within a year, but some are in the program for two to four years. Everyone is different, so recovery processes naturally vary in length.
5. Have Hope
Have hope to cope with your borderline diagnosis. If you’re willing to look at yourself, make some adjustments, and proceed courageously, your life will continue to improve. Trust me.
The opening paragraph from this PT article by Susan Krauss Whitbourne Ph.D. may sound very familiar for people living with BPD:
“When something bothers you, do you find that it runs through your mind on an endless loop? Do you replay situations in which you said or did something foolish, like making a bad joke at someone’s expense? Perhaps you were on an online video chat in which you made what you meant as a humorous remark to someone else, a person you know relatively well, but instead managed to say something that the person clearly found belittling. In person, you could probably have handled this mild teasing incident by saying something privately afterward, but in the online environment, there’s no such opportunity. Instead, you think over and over again about how you inadvertently offended this person and how much it’s hurt your future relationship.
It’s natural to think back on situations like this and wish they’d gone differently, but another to let them preoccupy you to the point that you can hardly think of anything else.”
Dr. Whitbourne goes on to discuss Repetitive Negative Thinking, RNT, and how it relates to those living with Borderline Personality Disorder.
Coping With Bipolar and Borderline Personality Disorder Diagnosis
I was diagnosed with bipolar disorder almost seven years ago. I was in my first year of university, studying classics, and had the world at my feet. Within a few short months, my life crumbled around me. I found myself emerging from an inpatient stay, medication in hand and appointments filling my days.
Learning to cope with bipolar has been one of the hardest tasks I’ve been faced with, but slowly I’ve built up a recovery tool kit to help me overcome the challenging situations that the disorder has thrown at me.
However, my diagnosis and thus my life is further complicated by my secondary diagnosis — borderline personality disorder (BPD) (also known as emotionally unstable personality disorder or EUPD in the UK). I’ve only had the diagnosis confirmed in the past couple of years; however, a personality disorder is something that was suspected for a long time.
Doctors were reluctant to label me as having borderline personality disorder as this is, unfortunately, often stigmatized within the mental health field, and can also mean the patient is harder to treat.
BPD can often entail the temper being lost to extremes, with the sufferer clinging desperately to people in attempts to avoid rejection, or pushing everyone around them away, suddenly impatiently sick of those they professed to love only days ago.
Whilst exact figures are challenging to pin down, there is believed to be a high number of cases of bipolar disorder and borderline personality disorder existing alongside each other. Some doctors estimate that the actual number may even be higher than published figures, as BPD is often under-diagnosed, possibly due to the associated stigma.
Bipolar Disorder vs. Borderline Personality Disorder
One of the hardest challenges I have found from having both bipolar disorder and BPD is distinguishing the mood swings. My bipolar is rapid cycling and so it is often difficult to ascertain whether a sudden burst of hyperactive behavior, overspending and/or irritability is the short, sharp hit of BPD, which often passes in a few days, or the warning signs of a bipolar related manic episode emerging.
There are a couple of ways I can usually distinguish between them – for example, a BPD flare-up will hit hard and fast, almost immediately, whereas with a hypomanic/manic episode it takes a while for irritability and other mood symptoms to set in. Another way I can usually identify the cause of the way I am feeling is the length of time; borderline episodes never seem to last past a few days at their most intense, so if anything continues beyond that point it is important that I alert my medical professionals immediately.
There are definitely complexities that have arisen from having the two disorders concurrently. There is a much higher risk of suicide amongst people with bipolar and BPD, and having the two alongside each other can exacerbate this risk even further. It is important therefore that I monitor my moods and their changes effectively, and alert the relevant professionals and those around me if I begin to feel unwell.
People with a diagnosis of both bipolar and borderline personality disorder are also more likely to suffer from substance abuse issues than the general population, or those who have the disorders separately. This could be due to attempts to fill the chronic empty feelings that the BPD can leave someone with.
There is a risk of these behaviors becoming a vicious cycle where the sufferer seeks out new experiences, sensations and highs to fill the void that they feel. The use of stimulants runs the risk of triggering a hypomanic episode, which can lead to repeated relapses and is, therefore, something that must be monitored effectively if you have a dual diagnosis.
Some of the main characteristics of BPD are fear of abandonment companioned with frantic efforts to avoid rejection, fractured and distorted self-image, impulsive behavior, unstable and volatile personal relationships, and self-destructive tendencies such as self-harm or binge drinking.
This can make a person hard to understand at times, and often leads to them being emotionally dependent on those around them. Add into this mix bipolar disorder and the impulsive behavior it can bring with it, and there is a much greater risk of relapsing.
Borderline episodes often involve an intense temper or episodes of rage, and during these times the sufferer might be tempted to argue against taking medication, or refuse on the grounds that they do not need it anymore. If you begin to feel like this, it is vital to try to remember that the reason your bipolar episodes have been so stable is likely the medicine you have been prescribed keeping the chemical imbalance in order.
Learning to Cope With Bipolar Disorder and Borderline Personality Disorder
Whilst the two disorders coexisting can be hard to cope with, there are a few ways I have learned to handle my life:
- Track episode length. As I mentioned before, tracking the length of time an episode sets in for is important. If it continues past a certain number of days, it is important that you alert someone ASAP in case you are heading into a bipolar episode (though please also seek help for borderline episodes)
- Try not to push those around you away. During a rage episode, it might be tempting to say hurtful things, but it is important to remember that your friends, family and doctors are there to support you during difficult times
- Take your medication as it is directed. This is so important. Whilst there are not many medications currently being used to treat borderline, having your bipolar well managed will help to control your life somewhat
- Avoid drugs and alcohol. These can often trigger an episode and will only make things worse in the long run. It might be tempting to seek out these things during bad times in order to self medicate, but it is extremely risky
- Embrace therapy. If you are offered therapy, then take it with both hands. The main therapy for treating borderline currently is DBT — dialectical behavior therapy. DBT has also recently been used for some bipolar patients, however firm results are yet to be seen. Talking therapy, in general, is also beneficial. Many patients who have a diagnosis of borderline may have had some trauma in the past and working through this may help along the road to a more stable position
The most important factor in moving towards mental stability is seeking help as soon as you feel you are becoming unwell again. If you begin to recognize signs of either disorder setting in, contact the relevant medical professional as soon as possible.
Individuals with Borderline Personality Disorder (BPD) suffer from unstable emotions and relationships. If your spouse suffers from significant symptoms of this disorder, you are most likely affected on a daily basis. Understanding what your spouse is feeling and what causes her to feel that way will give you new tools that you can use to stabilize your relationship.
Do you find yourself struggling to anticipate and understand your spouse’s feelings and the behaviors that follow? Does your spouse often go very quickly from one emotion to another? Does she have difficulty accepting if she doesn’t get her way? If so, your spouse may be suffering from symptoms of BPD.
The effects of BPD are most severe in intimate relationships. The spousal relationship is perhaps the most intimate of all. This is because individuals with BPD tend to suffer painful feelings of emptiness almost all the time. They desperately seek out others to make them feel whole. This causes anxiety and fear of abandonment, which leads them to feel insecure about the relationship. Consider the following exchange between Brett and Jasmine as they lay in bed.
Jasmine: Wake up!! Wake up!! How can you be sleeping?
Brett: Why shouldn’t I be sleeping?
Jasmine: Because I am lying here!!
Brett: We made beautiful love and then I fell asleep.
Jasmine: Yeah, you got what you wanted and then just rolled over and rolled away.
Brett: What do want me to do? Sit up and look at you all night?
Jasmine: I don’t want you to do anything. I don’t even want to be married to you.
This interaction illustrates how BPD can cause a married couple to go from passionately loving to alienation in a matter of minutes. Relationships generally don’t change that quickly, particularly when one party is asleep. More likely these changes are due to instability in Jasmine’s view of the relationship. The intensity of the intimacy felt during passion with her husband induced fears of abandonment, which prompted her to wake Brett and confront him. Here is another example.
Brett: Would you like to go out to dinner tonight?
Jasmine: How could you ask me that? You know I had a difficult day at work and I am exhausted.
Brett: That’s why I asked you to go out.
Jasmine: You have no idea who I am. You don’t pay attention to me. Why are we together?
Continued interactions like this one may leave Brett feeling like Jasmine will see anything he does as wrong and he may give up on the relationship. Empathic understanding of Jasmine’s feelings will allow him to respond to her more constructively and more supportively. The two exchanges above both reflect Jasmine’s insecurity in intimate relationships. They are her way of saying to Brett I am afraid that you will lose interest in me and leave.
Brett did not hear this message. Instead, he felt accused of doing something hurtful to her. He felt defensive. He was confused by this because he had no intention whatsoever of hurting her. To the contrary, these were efforts to please her.
So how does Brett learn to hear the emotion that Jasmine does directly express? Empathy is the process that allows us to feel the emotions of others. Of course, this is easiest and most efficient when the person expresses their feelings articulately, but many individuals have difficulty doing so. Those suffering from symptoms of BPD have particular difficulty because the intensity of their emotional experience often overwhelms their ability to differentiate strong emotions and put them into understandable terms. Instead, the emotions are acted out, like in the examples above.
The first step in deepening empathic ability is to become aware that there is always an emotional component, or subtext, to communication between people in intimate relationships. This allows you to actively seek it out.
One way to do this is by asking directly. You can do this by asking general questions, such as:
- Are you worried about something?
- Did I hurt you?
- What are you feeling?
Or you can do this indirectly by making inferences from vocal tone, body posture, and context, such as waking someone from sleep.
In future posts, additional tools will be described and illustrated to further increase your ability to understand the emotions of people you care about and craft responses that are both effective and loving.
1. Sometimes I Act Crazy – Living With Borderline Personality Disorder
Written by Jerold J. Kreisman and Hal Straus (Wiley, 2006).
This follow-up to Kreisman’s 1989 book, I Hate You, Don’t Leave Me, delves further into the world of BPD including a better understanding of treatments and of the disease itself. Along with a BPD checklist of symptoms, this book for borderline personality disorder begins each chapter with a “patient.” Each of these BPD patient/therapist discussions offers therapeutic answers to known BPD behaviors such as self-centeredness, anger, suicidal and harming habit behaviors.
The goal here being the reader is able to match book-patient behaviors and learn the best way to deal with each. For example, Chapter 2 is about a common BPD behavior–fears of abandonment. The behavior is explored and steps are offered on how to deal with these fears or symptoms when they occur.
The book is written for a general audience and doesn’t use complex medical terms. It can help understanding of symptoms such as mood swings, self-esteem, destructive impulses and even offers a section on where to find professional help in the reader’s area.
2. Stop Walking on Eggshells Workbook
Written by renowned BPD experts Randi Kreger and James Paul Shirley, this “Eggshells” book is part of a series, but we’ve chosen it as a top book for borderline personality disorder sufferers and their loved ones because it is also a workbook. It is full of scenarios and follow-up exercises
Another inspiring feature is the book’s ability to address BPD in real terms—with no excuses for the BPD sufferer. Kreger offers up tips on communicating from both ends of BPD, how to cope with rage or put-downs and how to enforce personal borders. When it comes to managing the symptoms of BPD such as hoovering the exercises are extremely helpful.
The key to the exercises in this book is following through with each one. For example, in one of the real life scenarios a BPD patient continually calls a non-BPD spouse at work to argue with them. The call only ends when the bipolar person has caused so much concern that their spouse agrees to come home early.
After the scenario is presented, the workbook offers two types of exercises. One is for the BPD sufferer and the other for their spouse. In this example the bipolar person is asked to identify what caused him or her to make the phone calls and how they could have handled the situation differently. Ample space is provided for writing down triggers and on subsequent pages, answers can be compared with what is therapeutically recommended. For the non-BPD person, a list of possible fixes is suggested to stop the behavior before it starts – by setting allowed and accepted borders.
3. Get Me Out of Here: My Recovery from Borderline Personality Disorder
From actual BPD sufferer Rachel Reiland (a pseudonym) comes this first-hand experience. It’s a great book for borderline personality disorder on how to cope with the disease.
For those just diagnosed with BPD, Rachel, an accountant and mother doesn’t leave anything out including symptoms of BPD such as sexual escapades, anorexia, and stays in mental hospitals. It is not offered as a “treatment” BPD book, more it’s a general understanding of what “…many professionals view as an untreatable…” disease.
This book explores what it feels like to have BPD inside and out and lands on our list of BPD books because it answers the “why and hows” about the condition, and its novel-reading format is an enticing page turner. Note: The Library Journal review on Amazon says this book is “recommended for all public and academic libraries as a complement to treatment guides.” It does, however, offer graphic language and scenes.
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Border-line personality disorder [BPD] is a serious long-term mental disorder of abnormal or unusual behavior, characterized by an unstable sense of self and relationship with other people, unstable emotions, and pervasive instability of mood.
Marriage and borderline personality disorder
If you know someone with a borderline personality disorder, then you know that the struggle is real.
The relationship is hard enough with the additional stress of the mental disease. Especially, if you are married to someone with the borderline personality disorder. Though contradictory to popular belief, couples, where one suffers from a borderline personality disorder, are not doomed.
According to statics, such couples are less likely to divorce when compared to regular and normal happily married.
Though the chances of getting married with the disease known are very less, and more so if someone with a borderline personality disorder does get divorced, it is highly unlikely that they will be able to marry again.
Quality over quantity
Thought the divorce rate ratio is low, however, there is no research done on the quality of marriage that such an unusual couple has.
Although, if your partner does suffer from a borderline personality disorder, it is not at all humane or advisable to leave them high and dry. However, the point of this article is not to romanticize the idea as well.
Regular and normal marriages are strenuous on their own. You do not need to add to the stress by knowingly marrying someone with such a consuming mental disease.
Spare yourself of the heartache and pain.
The challenges of living with a spouse having a borderline personality disorder
Having a constant negative self-image, engaging in self-harming behavior, making risky or impulsive choices, and a plethora of mood swings or intense emotion – mix it all together and you have a perfect recipe for a tumultuous and disastrous relationship.
The above-mentioned symptoms are of borderline personality disorder.
Imagine, you are someone who got married thinking that paying taxes, mortgage, and your child’s tuition money is all the stress you will face, and suddenly you come to know that your spouse is a patient of borderline personality disorder.
It is challenging to be in a relationship with someone having a borderline personality disorder.
The fear of abandonment raises the mistrust for their partners.
They have to work harder than usual to make their partners believe in their love and feelings for them. The fear can stem from anything minor to major. It can stem from a childhood trauma such as parents getting divorced, or getting lost, or loss of a family member or friend.
Unfortunately, as time passes, this disease set its root with the mind and body of its victim way deep, and it gets harder to make them believe otherwise.
On the other hand, people with borderline personality disorder are hyper-sensitive when it comes to the mood and feelings of their loved ones. They can sense the subtle change of mood before the person having hem would be able to recognize. It is all good but, sometimes people like to be left to their own devices, at least for a time being.
But sadly, people suffering from such a disorder, do not have this filter to know when they are wanted and when not.
This can cause the already strenuous relationship more strain. As people start to feel suffocated like they cannot even feel something without being interrogated. People suffering from similar disorder will never be able to keep a lid on their feelings nor will they be able to see it coming [ironic, isn’t it?]
The littlest of the things can set them off and they go back and forth with their feelings faster than a pendulum. You can never predict or plan anything beforehand.
All you can do is enjoy the good moments while they last.
Is divorce the way out?
Hey, no one will judge if you want out.
Border-line personality disorder takes a lot from a relationship.
If you have exhausted all options and you are running low on self-esteem, remember, living together is not enough. If you hate yourself, your life, or your partner for it, is it worth it?
Though there is no easy way to answer it. At the end of the day, the decision will not be easy, this is someone you vowed to love and be with for all of eternity, to see them wither away right in front of your eyes, and to be there to witness it is not an easy task.
Whatever you choose, it will be for the safety and health of your mind.
Don’t jump ship though
Even if your spouse has been diagnosed with borderline personality disorder, do not assume the worst. All is not lost. In this day and age, with proper treatment, and medication a lot can be salvaged.
Though it won’t be perfect and nothing will be like it was before. However, you did say in ‘in sickness and in health’.