6 mins

I have BPD: what should I do?

Whilst times are (slowly) changing, many mental health issues still wrongly have a lot of stigma attached to them. And sadly it’s personality disorders which tend to bear the brunt. For many people, hearing the word ‘personality’ implies that the symptoms associated with these disorders are inherent and purposeful; something someone is born with and unwilling to change. 

This belief couldn’t be more wrong. The majority of personality disorders are acquired as a response – or ‘coping strategy’ – to difficult circumstances growing up. Likewise, personality disorders are incredibly challenging to manage without the right support, and Borderline Personality Disorder (BPD) is no different. 

BPD is not something someone can just “get over” or “get on with” alone. 

Unfortunately, for this reason, many people with BPD struggle for a long time before receiving the right treatment. 

So if you’ve just been diagnosed with BPD – or suspect you’re suffering from it – be self-compassionate. Remind yourself that awareness alone puts you one step above the rest. Now you’re in the best place possible to go about getting the right support. 

How do I know if I have BPD?

The only surefire way to know that you have BPD is to get a formal diagnosis from a qualified psychiatrist. Don’t try to diagnose yourself. Many mental health disorders have overlapping symptoms, and relentlessly reading around is going to be unnecessarily anxiety-inducing.

For many BPD sufferers, being diagnosed is a lightbulb moment where things finally “click” into place. It’s the first step on the path to recovery.  

What are the symptoms of borderline personality disorder?

The main signs and symptoms of BPD are the following:

  • Intense, short-lived relationships with a push and pull dynamic (sometimes sabotaging relationships for fear of abandonment).
  • Intense mood swings and emotional instability (emotional states can change dramatically throughout the day).
  • Extreme sensitivity to criticism and mis-reading it as rejection.
  • Self-harming in order to ease intense emotions (physical self-harming, substance abuse, unsafe sex).
  • Tendency to act very impulsively.
  • Paranoia due to low self-esteem e.g. constantly thinking your partner’s cheating on you, being suspicious of friends etc.
  • Angry outbursts.

How does BPD develop?

In most cases, developing BPD is completely out of a person’s control. It’s generally considered to be caused by a mix of biological, genetic and environmental factors. 

One common theme for those suffering BPD is that their emotional needs were not tended to as a child.

Sometimes this is obvious and plain to see – in the case of neglect, abandonment and abuse, for example. Other times it can be more subtle but just as impactful. Snide, invalidating comments, for instance, can come disguised as “compliments” or disempowering and demeaning dynamics can be hidden in the guise of parental discipline and “care”.

The following environmental factors tend to be common in people who develop BPD:

  • Experiencing a lot of distress, upheaval and fear as a child i.e. a dysfunctional family
  • Abuse (physical, emotional or sexual)
  • Parental insensitivity to the needs of the child
  • Neglect e.g. having to fend for oneself at an early age, having a parent who was sick/addicted to substances and couldn’t properly look after you

What to do next

Once you’ve got a formal diagnosis, there are few things you can do to make sure you have the right support in place to help you improve your day-to-day life.

Build a support system

If you’re suffering from BPD, you might already have a strained relationship with your family. Maybe that’s a result of the dysfunctional relationships you had around you growing up, past trauma or the symptoms of BPD which may have got in the way of you being able to form healthy, stable relationships with family members. Building a support system in really important, whether that involves family or not. Volunteer, join clubs or social groups – whatever needed – in order to build a social support network you can turn to when life gets difficult.

Commit to practising self-care everyday

One of the standout symptoms of BPD is self-sabotage which makes committing to self-care paramount. Create and maintain a realistic and healthy daily routine: eat healthily, keep sleeping patterns consistent, exercise at least 3 times a week etc.

Drown out your inner critic

If you suffered abuse, neglect or abandonment as a child, these experiences internalise and you’re going to have a harsh inner critic. Your inner critic is one of the main driving forces behind maladaptive behaviours (self-harm, depressive episodes, feelings of emptiness etc.) so you want to be working hard to recognise it and call it out. Practice self-compassion as much as possible. Be kind to yourself and try celebrating all your victories, no matter how small. That nasty voice inside that mutters criticisms to you isn’t yours – it’s voices and opinions from the past. Take back your internal landscape and start rooting for yourself.

Take up mindfulness meditation (even if only for 10 mins a day!)

Mindfulness is going to help you become more aware of your thoughts. And once that happens, you’ll get better at choosing the ones you want to engage with and the ones you don’t.

Don’t feel ashamed about taking medication if it helps

If your psychiatrist suggests it, never feel ashamed about deciding to go on medication. Some people find medication a huge help in managing their symptoms. It’s different for everyone, and it’s about finding what works for you.

Dialectical behaviour therapy (DBT)

DBT is a structured, skills-based therapy that was initially developed specifically for treating BPD with a focus on helping you manage strong emotions. DBT is carried out both in one-on-one sessions with your therapist and also in group skills sessions where you get to interact with others and build a reliable support network.

Schema Therapy

Schema Therapy is another type of therapy developed specifically for treating BPD. Schema Therapy is focused on helping people change entrenched, self-defeating life patterns (or “schemas”) using a combination of cognitive, behavioural and emotion-focused techniques. Recent studies have shown that it leads to complete recovery for 50% of people with BPD and a significant improvement for two-thirds.

Borderline Personality Disorder treatment in the UK: how can therapy help?

If you’re suffering from BPD, life probably feels very overwhelming at times. Let’s be clear: this is not something you are expected to manage by yourself. Getting the right support is vital and will help you get a better understanding of your thought patterns and responses (without self-blame or judgement). It’s important to say that feeling emotions very intensely isn’t always a bad thing. In therapy, you will learn how to ride the emotional waves instead of getting swept up in them. And when that happens, you’ll be able to channel this sensitivity healthily into the areas of your life that deserve it – and ultimately live a more stable and rewarding life. 

At the clinic, we have a number of psychologists who specialise in treating BPD. To find out more, head here.

Dr Elena Touroni

Dr Elena Touroni

31 August 2023

"Dr. Elena Touroni is a skilled and experienced Consultant Psychologist with a track record of delivering high-quality services for individuals with all common emotional difficulties and those with a diagnosis of personality disorder. She is experienced in service design and delivery, the management of multi-disciplinary teams, organisational consultancy, and development and delivery of both national and bespoke training to providers in the statutory and non-statutory sector."

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Marina Hilleary

Dr Marina Hilleary is a Clinical Psychologist working in the NHS and private practice. She completed her BSc in Psychology at the University of Exeter, graduating with first-class honours and was subsequently awarded an MSc in Mental Health Studies and a Doctorate in Clinical Psychology at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London.

Dr Hilleary has 9 years of clinical experience in various NHS mental health settings, her current position being on a Specialist Adolescent Team at a Community Child and Adolescent Mental Health Service (CAMHS). She has a specialist interest in working with children, young people and their families and has worked with young people presenting with a wide range of difficulties including depression, low self-esteem, anxiety (specific phobias, GAD, social anxiety, separation anxiety, panic and OCD), PTSD, behaviours that challenge and additional neurodevelopmental needs.

Dr Hilleary is experienced in carrying out comprehensive psychological assessments (including cognitive assessments) and recognises the importance of working towards a shared understanding of the presenting difficulties to enable a positive therapeutic outcome. She draws on a range of evidence-based psychological therapies and models, including Cognitive Behaviour Therapy (CBT), Dialectical Behaviour Therapy (DBT), Compassion Focused Therapy (CFT), Acceptance and Commitment Therapy (ACT) and Mindfulness-Based approaches. In addition, Dr Hilleary utilises systemic family approaches when working with young people and their families.

Dr Hilleary adopts an integrative, compassionate and person-centred approach to engage young people, building their motivation to participate in decisions around their care plan and achieve their therapeutic goals. She works creatively with her clients and, where appropriate, alongside any of their important support systems.