Borderline Personality Disorder: Myths and Facts

Borderline Personality Disorder: Myths and Facts

Myth: Borderline personality disorder cannot be treated.

Fact: While it is true that borderline personality disorder (BPD) can persist into old age, the disorder can be managed with medication and therapy. Medication is used as a supportive measure to relieve the person of symptoms that can disrupt daily life or cause issues that prevent them from going to therapy. Intense time-bound therapy is used to treat BPD by addressing the underlying issues that affect the emotions and behaviours of the person. Dialectical behavior therapy (DBT) and mentalization-based therapy (MBT) are effective forms of treatment.

Myth: People with BPD don’t have any real disorder; they are just doing it to manipulate others.

Fact: BPD is an illness, just like diabetes or arthritis. Some of its underlying issues are low self-esteem, impulsive behavior, intense mood swings, self-harming behavior and a fear of rejection or abandonment. These issues may cause persons with BPD to behave in ways that others see as unpredictable, strange, manipulative or attention-seeking. A person with BPD does not intend to harm or manipulate others. These may be maladaptive coping mechanisms. With the help of treatment, moods and behavior can be regulated and interpersonal relationships can improve greatly.

Myth: People with BPD are not capable of staying committed to a romantic relationship.

Fact: A common misconception is that a person with BPD cannot stay committed in a relationship; and that they are likely to cheat or be promiscuous. Persons with BPD do struggle with interpersonal relationships and this could affect their romantic relationships as well. But this said, their behavior stems from their difficulty in recognizing their own strengths, and a fear (whether real or perceived) of abandonment. This leads to an attachment forming quickly; their going to great lengths to keep partners in their life; distancing themselves when they feel vulnerable (due to a fear of their flaws being exposed) and preemptively ending relationships owing to their fear of abandonment. Therapy helps untangle these issues allowing them to have healthier relationships; recognize and act on toxic relationships.

Myth: If I have BPD, I have to stay on medication forever.

Fact: BPD is an illness that, in essence, does not have a cure. Medication — largely prescribed as a supportive measure — is used to manage symptoms like depression, anxiety, psychosis and mood dysregulation. However, doctors do aim to wean persons with BPD off medication when they start to feel better. Some people don’t require medication and recover with the help of therapy alone. 

Myth: Men don’t get BPD.

Fact: There is a global gender disparity in the diagnosis of BPD - more women tend to be diagnosed. But men are also equally likely to have BPD. This disorder is not caused by a person’s gender. It is due to a combination of biological, psychological and social factors that are at play during the development of a person’s personality. There are many cultural elements that can lead to a person with BPD feeling invalidated. With changing time, as fluidity between and within genders and cultures increases, the gender disparity in BPD diagnosis is likely to decrease. 

Myth: People with BPD are victims of sexual abuse.

Fact:  Many people with BPD are found to have experienced trauma in their lives but trauma alone does not lead to a person developing the personality disorder. There are different social factors like parental neglect, emotional abuse, and bullying that could lead to this. A person diagnosed with it may have had a social upbringing with no history of trauma but can still show the same symptoms of the personality disorder as others. It stems from a person feeling invalidated no matter what their past experiences or surroundings were. 

Myth: People with BPD don’t actually want to die when they attempt suicide. They’re just trying to be the center of attention.

Fact: People with BPD do not attempt suicide to be the centre of attention. Thoughts or attempts of suicide are very common among people diagnosed with BPD. There are many reasons why someone with BPD might attempt deliberate self-harm or suicide:

  • One of the most common symptoms of BPD is experiencing severe emotional pain. A person with BPD may attempt suicide to relieve themselves of this pain. In moments of desperation this can also include self-harm or attempting suicide. 
  • People with BPD may attempt suicide as a way of gaining a sense of control. Suicide may also be triggered by other difficulties they experience in their life as a result of the disorder, and that can lead to them feeling powerless or helpless.  
  • BPD often causes a person to have high levels of impulsivity. This means they may act quickly without considering the consequences. This could lead them to harm themselves when they experience severe emotional pain.

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