Borderline Personality Disorder (BPD) is part of somebody’s psychological makeup — it is not something that happens to a person. It is part of a person’s personality. However, that does not mean that they cannot change or get better.
The foundation of BPD is that a person does not understand who they are on the inside. Their sense of self is extremely weak; in some cases, they do not think that it is really there at all.
As a result, the way they feel is determined by the way other people treat them. If people treat them well, then they feel like a good person. But if people do not treat them well, they feel like a bad person. While this is generally true for every person, the swings are massive in a person with BPD.
For example, if a person with BPD texts their partner, and they do not receive a reply, then their thought process immediately goes down the line of “they hate me, they don’t care about me, they are going to break up with me”, etc.
People with BPD overinterpret situations that people without BPD would not. People without BPD do not freak out when their partner does not respond to their texts immediately because they have a basic sense of confidence in who they are as a person. They understand that their partner cares about them and they are settled in that belief. However, people with BPD do not have that foundation.
Since people with BPD treat themselves like they observe other people treating them, they start to form behaviors that make people treat them well. They express suicidality, and as a result of that, everyone else stops what they are doing and sweep in to help and express concern. Over time, this behavior gets reinforced.
However, eventually, their caregivers get tired of this behavior and burn out. This tells the person with BPD that the strategy they are currently employing to elicit a response of care from their caregiver/friend is not enough, and as a result, the intensity of their behavior escalates.
Bipolar disorder is a mood disorder — it is something that happens to you. Mood disorders are independent of who you are.
For example, the flu happens to you. It does not mean you ARE the flu, you just have the flu. When people get depressed or are diagnosed with bipolar, it does not change who they are as a person.
Bipolar disorder is characterized by mood swings that last from weeks to months at a time. It results in persistent moods that are either elevated or depressed for weeks at a time. People with bipolar disorder might experience depression for weeks to months at a time for most of the day. They have low self-attitude, which means that they think they are bad people.
They feel like they are a burden on other people. They have thoughts such as “people might be better off without me.” They can also have low energy levels and some of them even describe walking as extremely difficult activity.
The other side of bipolar disorder is the manic side, which is the opposite of depression. People who are hypomanic need less sleep, have an abundance of energy, and tend to have great ideas. They think that they are able to perform at a very high level.
People who are severely manic think that they can do things that other people cannot. They feel superhuman and might feel that they can solve worldwide issues on a global level. They tend to function very well on very low amounts of sleep. Some people who are truly manic will sleep two hours or less per night and perform very highly during wakefulness.
In order to be diagnosed with depression in bipolar disorder, you need to be depressed on most days for two weeks. For mania in bipolar disorder, the timeframe is one week.
If someone does not feel like a valued person, then they are probably paranoid about the fact that their partner will see them for “who they are.” They feel as if they have tricked their partners into being with them, and if their partner were to find out who they really were, they would leave.
This results in them exhibiting paranoid behavior and trying to control their partner’s life. This leads to the self-fulfilling prophecy, in which the more paranoid and controlling behavior they display, the further away they drive their partner.
If they succeed in driving their partner away, that confirms to them that they were right all along. That also results in them invalidating every good thing their partner had said to them because their paranoid belief has been confirmed.
As they engage in more relationships, their self-esteem gets lower, their paranoid behavior becomes stronger and they drive future partners away as well. This perpetuates the cycle.
We have this tendency to connect actions and responses. When a person with BPD expresses suicidality, and they immediately receive care and attention, they learn to associate the behavior of expressing suicidality with the outcome of receiving love and care. To prevent this, one needs to retrain how they get what they want.
Pavlov was a behaviorist famous for his experiments with his dogs. Before feeding his dogs, he would ring a bell. The dogs would smell the food and start salivating, after which he would feed them. Over time he realized that when he rang the bell, the dogs started to salivate — he did not even have to feed them to produce that response.
For example, if a kid throws a temper tantrum, we do not respond to it. Instead, we ask them what they want, and wait until they ask nicely. Once they do that, we reward that behavior by giving them what they want.
In the case of someone with BPD, instead of dropping everything and rushing to them when they express discomfort or suicidality, one needs to schedule some time with them in the near future. They still get the love and care that they want, but it is no longer in response to them expressing suicidality.
The idea is to remain relatively neutral, yet caring. If you let people know that you have boundaries and limits. If you do not compromise your boundaries, then it does not mean that you do not care.
When someone you know is exhibiting signs of BPD, the best approach is to encourage them to see a medical professional. When you do not give them the response they want when they express suicidality, and they turn to someone else, there is not much you can do. You cannot control what another person does.