Relationships are challenging enough as it is. When you add the dynamic of trying to love someone who displays the disturbing personality traits associated with borderline personality disorder (BPD), it adds layers of drama, antics, and sometimes public displays of intense emotional outbursts to the mix.
What is borderline personality disorder?
According to the definition of the National Institute of Mental Health (NIH):
"Borderline personality disorder is an illness marked by an ongoing pattern of varying moods, self-image, and behavior.
These symptoms often result in impulsive actions and problems in relationships with other people. A person with borderline personality disorder may experience episodes of anger, depression, and anxiety that may last from a few hours to days. Recognizable symptoms typically show up during adolescence (teenage years) or early adulthood, but early symptoms of the illness can occur during childhood."
The Diagnostic & Statistical Manual (DSM) IV stated that women account for 70-75 percent of people diagnosed with this personality disorder, research conducted prior to the publication of the updated DSM 5 has shown this to be an error caused by gender bias on the part of clinicians.
However, while BPD is now understood to be equally prevalent across genders, "there appear to be notable gender differences with regard to personality traits ... comorbidity [of other mental health issues], and treatment utilization histories."
More specifically, "Men with BPD are more likely to demonstrate explosive temperaments coupled with high levels of novelty seeking. Men with BPD are also more likely to evidence substance abuse whereas women with BPD are more likely to evidence eating, mood, anxiety, and posttraumatic stress disorders ... [And] men with BPD are more likely to have treatment histories for substance abuse whereas women with BPD are likely to have utilized more pharmacotherapy and psychotherapy services."
As explained in laymen's terms by John Oldham, MD, professor of psychology at Baylor College of Medicine in Houston, “While BPD is reported to be more prevalent in women than men, that is not correct. What is correct is that patients in clinical treatment settings [i.e., receiving therapy] are much more likely to be women than men.”
What causes borderline personality disorder?
The exact cause of this and all other personality disorders is still unclear. However, it's believed that certain factors either play a role in or increase the risk of development of BPD.
Brain structure and function
Other environmental, cultural, and social factors
So, no, it's not anyone's fault if they have this disorder. It typically goes hand in hand with having experienced a traumatic event early in life or growing up in a home rife with unhealthy family dynamics.
But don’t make the mistake of allowing someone to make you feel sorry for them, especially not to the extent that they use BPD as an excuse to make you feel bad or like you have to put up with their abusive behaviors.
Treatment is available, and anyone diagnosed with BPD absolutely has a choice to get professional help.
In order to protect yourself from potential emotional, verbal, or physical abuse, there are warning signs you should be aware of before entering into a relationship tornado that's unlikely to ever pass.
Based on the symptoms described by the NIH, here are 10 common personality traits found in women with borderline personality disorder.
1. Unrealistic view of themselves
Women with BPS tend to have distorted views of themselves and/or others. They often mask their fears and insecurities by exaggerating their sense of self.
2. Emotionally unstable relationships
They may have a pattern of unstable relationships with family, friends, or romantic relationships.
It's common for women with BPD to have a fear of abandonment or loss in a relationship. Often, this is something that occurred during her childhood and is now being replayed unconsciously in later life in an effort to avoid further feelings of rejection and abandonment.
Women with BPD may feel apart from their own selves. It is though they are removed and watching themselves from the outside.
They can be impulsive in regard to drinking, reckless driving, spending, unsafe sex, and eating binges. However, it's important to note that if these behaviors occur during an elevated mood, they may be a sign of a mood disorder rather than borderline personality disorder.
Women with BPD often have difficulty trusting others. They frequently worry that people have bad intentions toward them and may do them harm.
Women with BPD are prone may be prone to sudden mood changes that last anywhere from hours to several days.
They may have frequent thoughts of wanting to self-harm through means such as cutting themselves.
10. Potentially suicidal
They may have frequent thoughts of suicidal ideation, or they might often make threats about suicide to others.
While someone diagnosed with BPD may not experience all of the symptoms listed above, this is a solid list from which you can identify possible signs of someone who will be extremely challenging as a partner in a relationship, even if they don't technically have borderline personality disorder.
People with BPD have a tendency to triangulate relationships. This means they may pit people against one another in order to feel closer to one of the people in the triangle.
Their feelings may also change from one extreme to the other quite quickly, and they will often create drama in an attempt to bring their partner closer to them emotionally.
If you decide to exit the relationship, you can have a talk with her and tell her the relationship just isn't a fit and doesn't work for you and that you need to end it. Be aware, however, that no matter how to you say it, she will experience the breakup as abandonment.
If possible, I recommend breaking up in a public setting. Do not break up with her in your home. She will likely react strongly, and may even react dangerously. You need to be able to exit easily and safely.
Above all, do not label her as having borderline personality disorder without her already having received a professional diagnosis.
If you decide break off the relationship, you need to set strong, consistent boundaries from the outset.
If she threatens to hurt herself, you can give her the number for the National Suicide Prevention Lifeline — 1-800-273-TALK (8255). And if you are concerned for your own safety, you can call the National Domestic Violence Hotline for guidance at 1-800-799-7233 (SAFE) or 1-800-787-3224 (TTY).
This is very difficult to deal with, I know, but consistent boundaries are the only way to deal with this challenging situation.
The good news is that anyone with BPD can get professional help. But that is their choice and theirs alone to make.
In today’s medical world there are skills she can learn to help her manage life issues. But you are not in control of whether or not she seeks help. That is her own responsibility and decision, one way or another.
Susan Saint-Welch, LMFT, is a marriage and family psychotherapist who has been practicing in-person and online for over 20 years, helping families and couples learn healthy communications skills, and guiding single men and women to get un-stuck and find the lasting love they deserve. For more, visit her website.