Borderline Personality Disorder

I’m sorry to be all over the place, my mind doesn’t know how to stop, but I’d rather rise up to the insanity, than to further depress on the drop. - Vera Hollins In this chapter you will learn: About the three clusters of personality disorders. Common risk factors that make you vulnerable to various personality disorders. Exploring Personality Disorders A personality disorder is a mental disorder that affects 9% of US adults and 6% of the global population (Cleveland Clinic, 2022). It is characterized by rigid or distorted thinking patterns which affect how you perceive the world and others, as well as your decision-making and emotional regulation skills. Without having a correct awareness of reality, you are more likely to feel vulnerable to stimuli in your environment. A loud sound might feel as frightening as hearing a gunshot, being yelled at might cause you to think the other person hates you, and being in an uncertain situation might cause you to act impulsively. It is also common to think that these behaviors are normal, particularly if you are living with people who are neurodivergent (people who also think differently). You may blame your behavior on other people or situations in your environment, such as thinking that if your family didn’t do certain things, you wouldn’t resort to thinking or behaving the way you do. There are various types of personality disorders which are grouped into three clusters based on their similarities. It is possible to display symptoms of one or two personality disorders within the same cluster. You don’t need to show all of the symptoms listed under each personality disorder to be diagnosed with it. Let’s take a closer look at the three clusters and the personality disorders grouped under them. Cluster A Personality Disorders Personality disorders falling under this cluster are characterized by unusual or eccentric behaviors or thinking patterns. The following disorders fall under this category: Paranoid Personality Disorder Paranoia is an unshakeable suspicion or mistrust of others, without sufficient evidence to justify being suspicious. People living with paranoid personality disorder often believe that others are conspiring against them. Symptoms associated with this disorder include: Being suspicious of other people’s motives. Unwarranted belief that others are being deceptive. Fear of confiding in others because you believe they will use the information against you. Perceiving innocent remarks as insults or threats. A tendency to keep score of wrongdoings and hold grudges. Schizoid Personality Disorder A personality disorder characterized by a consistent pattern of detachment and signs of disinterest in interpersonal relationships. This pattern may also cause people living with the disorder to show very little range of emotions when engaging with others. Symptoms of schizoid personality disorder include: Little interest in social and personal relationships. A tendency to spend time alone. An inability to pick up on social cues. Being perceived as cold or aloof by others. Little interest in sexual activities. Schizotypal Personality Disorder Similar to schizoid personality disorder, those who live with this disorder have little to no interest in close relationships and may even feel uncomfortable being around people for too long. Those who do manage to form relationships may struggle to maintain them due to their unusual behaviors and superstitions. Some of the symptoms related to schizotypal personality disorder include: Unusual dress sense, thinking, or behavior. Illusory perceptual experiences, like hearing voices. Social anxiety. Believing that they can influence people or situations with their thoughts. Behaving as though they are indifferent or being suspicious of others. Cluster B Personality Disorders Personality disorders under this cluster are often characterized by overly emotional, dramatic, or unpredictable behavior. People who are diagnosed with any of the following personality disorders will typically express intense and unstable emotions and behaviors. Antisocial Personality Disorder (ASPD) People with ASPD tend to show a lack of respect toward others, as well as a reluctance to follow social norms and conventions. They are not afraid to break laws or inflict physical or emotional harm, even if it gets them into trouble. Some of the symptoms of ASPD include: Refusal to take responsibility for unlawful or harmful behavior. Showing blatant disregard for the negative consequences of their actions. A tendency to deceive others by lying or stealing. Repeated criminal violations or trouble with the law. Displaying irresponsible and impulsive behaviors. Borderline Personality Disorder (BPD) BPD is characterized by low emotional regulation and difficulty maintaining close relationships. People with BPD may also struggle to perceive reality correctly, choosing instead to believe inconsistent thoughts about others. The following symptoms are associated with BPD: Engaging in risky behaviors, like gambling, unsafe sex, or binge drinking. Fear of being alone or abandoned. Intense and volatile relationships. Frequent mood swings, often as a reaction to stressful events. Chronic feelings of emptiness. Histrionic Personality Disorder People with histrionic personality disorder have a distorted self-image and often experience intense and unstable emotions. In order to feel good about themselves, they depend on the approval of others. When they are not validated, they can react negatively and display dramatic and inappropriate behaviors. Symptoms of histrionic personality disorder include: A strong desire to be validated by others. Displaying inappropriate behaviors (like being sexually provocative) to gain attention from others. Excessive preoccupation with physical appearance. Believing that you have closer bonds with people than you really do. Being easily influenced by other people’s behaviors. Narcissistic Personality Disorder (NPD) NPD is characterized by a consistent pattern of thinking that one is superior to others. People with this disorder tend to have a larger than life personality and they feed off the praise and admiration they receive from others. Underneath this grandiose exterior is often low self-esteem and a lack of true confidence. The following symptoms are associated with NPD: Believing that you are ‘chosen’ or different from others. Fantasizing about gaining power, status, or wealth. An inability to empathize with others. Being envious of those you believe are better than you. Expecting constant affirmation and attention from others. Cluster C Personality Disorders Personality disorders that fall under Cluster C tend to produce a sense of fear or anxiety. To escape the perceived threat, people with these personality disorders will turn to the fight-flight-freeze response: They will either act impulsively, develop a dependency, emotionally withdraw, or seek complete control over their environment. The following personality disorders fall under this category: Avoidant Personality Disorder As a defense mechanism against feeling rejected by others, people living with avoidant personality disorder tend to avoid social interactions. This is because they are extremely sensitive to perceived judgment, as a result of their chronic feelings of inadequacy. Symptoms associated with avoidant personality disorder include: Being extremely sensitive to criticism. Feeling inferior to others. Avoiding group activities that require interaction with others. Extreme shyness in interpersonal relationships. Fear of embarrassing themselves in front of people. Dependent Personality Disorder People with dependent personality disorder have a chronic need to be cared for by others. This might involve taking the submissive role in relationships and behaving as though they are incapable of taking care of themselves. It is common for these people to enter codependent relationships with people who are willing to be their caretakers or enablers. Symptoms of dependent personality disorder include: Being excessively clingy or needy in a relationship. Fear of making independent decisions. A need for constant reassurance from others. Fear of confrontation or making others upset. Tolerating poor treatment in relationships due to a fear of being alone. Obsessive-Compulsive Personality Disorder (OCPD) OCPD is characterized by the obsessive need for order and cleanliness; this is how people with the disorder regulate their anxiety and feel a sense of control. They may even develop an expectation for perfection, which makes it difficult for them to complete tasks within the allotted time, be present in their relationships, or enjoy the simple pleasures of life. Some of the symptoms associated with OCPD include: Obsessing over small details, processes, or experiences. Feeling disappointed when tasks are not completed perfectly, or when people fail to meet your high expectations. The desire to control people, situations, and tasks, and feeling anxious when placed in situations or encountering people whom you cannot control. Inability to let go of unused or broken items. Being inflexible when it comes to your morals, values, and ethics. Please note that OCPD is a separate condition from Obsessive Compulsive Disorder (OCD), which would be classified as a type of anxiety disorder. People with OCD are aware of their compulsions and the kinds of situations that trigger them. In contrast, those with OCPD are often unaware of their compulsive behaviors and the stressful impact they cause on their lives. It is common for people to be diagnosed with more than one personality disorder. Generally speaking, it is only during adolescence that personality disorders can be detected: This is because, until then, one’s personality hasn’t fully developed. Thus, most people only receive a diagnosis after the age of 18, with the exception of antisocial personality disorder, which can be detected as early as 11 years old. What Causes Personality Disorders? Since there are so many different types of personality disorders, it can be confusing to distinguish between bad behavior or a negative character trait and a symptom of a personality disorder. To help you identify a personality disorder, keep the following signs in mind: Personality disorders attack your identity and sense of self. There is a difference between feeling insecure and having a distorted image of yourself. Everybody experiences insecurities from time to time, especially in this modern era of social media. However, when your self-image is unstable, meaning it changes often or may be unrealistic (for example, you think too low or highly of yourself), then this may be a sign of a personality disorder. Due to your inability to self-regulate, your relationships suffer. It is common to have disagreements with people whom you are close to. However, when the source of conflict is frequently due to your own inappropriate behaviors or the unfounded conclusions you have drawn about people, then the issue isn’t about the quality of the relationship, but rather the inner conflict you feel within yourself that is being projected onto another person. Apart from these two distinct signs, you can also identify a personality disorder based on certain risk factors that make you more vulnerable to this experience. Below are three risks factors associated with personality disorders: Social and Environmental Factors The family or community you grew up in can affect how you develop a sense of identity. Oftentimes, being raised in a dysfunctional home environment or community can expose you to violence, trauma, emotional neglect, and abandonment. Below are some of the social and environmental experiences that can make you vulnerable to developing a personality disorder: Living with a mentally ill parent or a parent who has a drug or alcohol abuse problem. Having little to no contact with your parents due to their busy work schedules or being taken care of by extended family, such as living with your grandmother. Having little to no support after experiencing trauma like rape, bullying, being chronically ill, surviving a car accident, etc. Being a victim of poverty and discrimination. Early Childhood Experiences Similar to the first factor, early childhood experiences have a lot to do with how you were raised, the coping mechanisms you adopted, and the type of behaviors that were modeled in front of you. As a way to cope in such a tumultuous environment, you might develop beliefs about yourself and others that shape your experience of reality. Some of the traumatic experiences that can make you vulnerable to developing a personality disorder include: Childhood neglect. Loss of a parent or someone close to you. Witnessing domestic violence. Feeling emotionally invalidated by your parents. Fear of expressing your thoughts and emotions. It is worth noting that not all traumatic events will lead to developing a personality disorder. What often makes a trauma survivor vulnerable is the lack of support during difficult times, as well as their conceptualization of their traumatic experiences (the stories they create about what happened to them or how their experiences shaped them). Genetic Factors Researchers are still investigating how much of a personality disorder is due to the individual’s personality and how much of it is a result of genes. Nonetheless, we know that there are aspects of our personality that are hereditary (such as inheriting impulsivity from a parent who is also impulsive, or inheriting an addictive personality). There is also an argument that some aspects of our personality are due to modeled behavior during early childhood. For example, being raised by a narcissistic parent who uses love as a tool for manipulation can influence how you perceive love or the meaning you ascribe to relationships. Similar to your parent, you may grow up believing that people are objects used for your end goal, instead of respectable individuals who think and feel for themselves. Chapter Takeaways Personality disorders are mental disorders that affect how you see yourself and relate to others. These disorders are prevalent in 9% of the US population and 6% of the global population (Cleveland Clinic, 2022). There are three broad clusters of personality disorders, consisting of conditions with similar symptoms and characteristics. It is common to be diagnosed with more than one condition within the same cluster. Some of the risk factors that can make you vulnerable to developing a personality disorder include the type of environment you grew up in, your early childhood experiences (such as being a survivor of trauma), and inheriting or learning certain behavioral traits from your caregivers. Now that you have a deeper understanding of personality disorders, we will take an in-depth look at BPD and how it might shape your sense of self, your relationships, and your experience of reality.