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Borderline Personality Disorder (BPD)

People who live on the edge of their emotions!

“Hearts out of control. Jealousy, anger, impulsiveness… being borderline is like that!!…”.

How to deal with people diagnosed with BPD?

We all have moments of outbursts of anger, sadness, impulsiveness, stubbornness, mood instability, intense jealousy, affectionate attachment, despair, lack of emotional control, fear of rejection, personal dissatisfaction. And, almost always, this causes inconvenience and harm to ourselves and/or to the people who live directly with us.

However, when these behaviors present themselves frequently, intensely and persistently, they end up producing an existential pattern marked by difficulties in adapting the individual to their social environment.

When this occurs, we may be facing borderline personality disorder.

People with this diagnosis have emotional hyperactivity, that is, it's a lot of feeling and a lot of emotion. They tend to deal very poorly with any type of adversity, especially those involving rejection, disapproval and/or abandonment. When faced with such a situation, they trigger a much more intense and far-reaching stress reaction than expected.

This is called borderline, because they live on the edge of emotions.

Is it the disorder of love?

It is the disorder of affections. Because love must be functional, positive. What people with borderline have is dysfunctional affect.

Is there a borderline personality and a borderline personality disorder? How's that? What is the dividing line?

Personality is the set of outstanding characteristics of a person.

It is the biological part added to what we learn, to culture. The joining of these two parts will generate a series of recurrent behaviors, which characterize the personality of each person.

The borderline personality is marked by difficulty in interpersonal relationships, low self-esteem, reactive mood instability and impulsiveness. When these characteristics are very dysfunctional, they are called a disorder.

Can different personality types, even with seemingly negative traits, be requirements for Borderline personality disorder?

It only reveals a disorder when it presents serious problems for the person, when it is so dysfunctional that the person ceases to be productive. Apart from that, the borderline personality, or, as we say, the borderline trait, can be very interesting if the person doesn't have tantrums, or addictions. Great social causes demand people with a great capacity to feel empathy, with great sensitivity and who need a high degree of acceptance. Another common characteristic of these people is fluid self-awareness.

People with borderline traits make great actors. When treating someone with the disorder, we have to keep in mind that, first of all, this is a way of being, an established base that doesn't change. What we are looking for in the treatment is to transform the disorder into a trait: that is, the person will continue to be sensitive, emotional, but they will not fall back on that, they will channel them towards productive things.

How much of the disorder is biological and how much is the result of the environment?

Most people with the disorder had very hard lives, marked by sexual abuse, physical aggression, abandonment. How can you say this is biological?

What is known is that 50% are biological and 50% are related to nurture, environment, culture. When the person has the biological factor, but lives in a normal environment, the disorder presents itself in a much milder form or as a trait. The genetic structure does not change, but it is possible to shape the way it presents itself.

How is the life of those who have the disorder?

The person has a very big difficulty in relationships. They have their self-esteem destroyed. They see themselves much worse than they are, in a derogatory way, and think that the solution lies in the other; it is in the emotional dependence of the other that they seek security and legitimacy. And they are very impulsive. But this impulsiveness is manifested in a very specific way: it is related to outbursts of anger.

People with a diagnosis are those people who literally go blind with rage.

Anyone who has ever lived a mad passion knows what it's like to be borderline: this is the BPD's way of expressing what the person feels. The state of passion, according to science, lasts from two months to two years precisely because, if it lasts longer, no one can take it. But people with BPD manage to live like that.

It is a disorder that affects many more women than men. Does neuroscience explain why?

We know that 75% of patients are women. We don't know exactly why, but it's not a big surprise if we think that the disorder is related to a hyperactivity of the limbic system, which is our real heart, the region of the brain that regulates emotions.

On people with BPD, the system is too active, at the extreme of emotions.

In moments of greater impulsiveness, it is as if there is a total shock to the system, a short circuit.

As the issue of emotions is naturally more marked for women, it is to be expected that they are the majority of patients. On the other hand, men, with more rational brains, are the majority of those who suffer from psychopathy disorder - in which the limbic system does not work or works very little, which makes them incapable of empathy, of being sensitive to suffering, of others.

Adolescence is a time when emotions are much more intense. How is the disorder at this stage of life?

The disorder first appears at this stage, which is usually when the first breakup or non-reciprocal affect occurs. This rejection triggers the short circuit. Adolescence is the time of passion, impulsiveness, sexuality, risky behavior. It is the time when teenagers have to take risks to learn. It's an emotional eruption. Borderline, however, is a haemorrhage. Self-harm is a recurrent behavior. And if you ask him why he did it, he'll say it's to alleviate the anguish, the emptiness.

And does it really alleviate? Why?

Yes. They feel much better because they don't feel anguish anymore. When there is a physical threat to the body, the defense and stress system is triggered. The substance released to block aggression is endorphin, which is an anesthetic. Therefore, a great treatment is intense physical activity, which releases endorphins.

Is there a treatment?

It is possible to reduce hyperactivity of the limbic system with specific medications in specific doses — often minimal. With this, you greatly reduce rage attacks, destructive acts, aggressions; lower limbic system activity. But, at the same time, therapy is needed, a very specific psychotherapy, directed more towards the present than the past, which will train the person to live with less intensity, to bleed less. Not to die of hemorrhage.

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