Borderline Personality Disorder and How to Have a Life Worth Living
May 22, 2018

We’ve all had a “moment”. Gotten angry, hurt, or scared. Slammed a door, honked a horn, raised our voice. But if you are part of the 1.6% of the U.S. population (or 4 million people) diagnosed with borderline personality disorder (BPD) these instances can be much more than a passing “moment".

Closely linked with other mood disorders like depression and bipolar disorder, BPD is described as an established pattern of abnormal behavior affecting an individual’s relationships, sense of self, and emotions. The fundamental instability of this illness impacts those afflicted across the board; work, school, personal lives, long-term goals, etc. Moreover, difficulty regulating and managing emotions can make someone with BPD prone to violence and/or self-harm.

This blog will focus on how individuals diagnosed with borderline personality disorder, despite the unpredictability of their illness, can achieve a life worth living. For someone with BPD this might mean being able to complete your daily tasks or setting and pursuing reasonable goals. Happiness, fulfillment, love, and acceptance are all components of a life worth living. With treatment, support, and courage individuals with borderline personality disorder can achieve their life worth living. But, while attainable, this is no easy process.

Often, individuals with BPD (especially those who go untreated) find it very difficult to manage their day-to-day lives; It can be hard to attend school or hold a job; To maintain and build relationships; And in some cases, even completing simple tasks can seem insurmountable. With treatment, medication, and counselling, most individuals suffering from BPD can build a life worth living but the dynamics of the illness make emotion dysregulation a reoccurring obstacle that can sometimes cause major setbacks (legal issues, loss of sobriety, physical injury, etc.) and push a life worth living further out of reach. 

The challenges regulating emotions someone with borderline personality disorder experiences often lead to impulsive acts (an outburst, throwing something, making a scene). This is due to emotion dysregulation. Though not exclusive to BPD, emotion dysregulation is an emotional reaction, or emotive response, that would not be perceived as conventionally acceptable.

Someone with borderline personality disorder can decrease the propensity of impulsive acts and outbursts due to emotion dysregulation by undergoing Dialectical Behavior Therapy (DBT). DBT, a blend of cognitive-behavioral-therapy and mindfulness practice, is an effective treatment for people who struggle with BPD. Originally, DBT was developed to treat borderline personality disorder but due to the versatile treatment modality variations are regularly utilized for bipolar disorder, depression, anxiety, weight management, chemical dependency, and a host of other conditions.

DBT has 4 skill modules:

  1. Core mindfulness
    The practice of being present in the moment is a surprisingly effective treatment for helping manage BPD. The DBT Mindfulness philosophy helps people who have emotion dysregulation regulate their emotional mind (impulsive, intense, in the moment), reasonable mind (logical, responsible, thinks ahead), and consequently access their wise mind (a blend of reasonable mind and emotional mind).
  2. Distress tolerance skills
    Distress tolerance skills enable individuals with BPD to calm themselves when they experience a sudden emotional shift. These skills help individuals to make better decisions regarding reacting in the moment which leads to better interaction outcomes.
  3. Emotion regulation skills
    In the same way distress tolerance skills help those with BPD calm themselves under intense emotional circumstances, emotion regulation skills help to counteract emotion dysregulation outcomes. Focused on the function of emotions, these skills help people to decrease the intensity of their feelings and more intense emotions without impulsively or recklessly acting on them.
  4. Interpersonal effectiveness skills
    Interpersonal effectiveness involves putting in the work and developing effective ways to interact with others and foster healthy relationships. Effective communication, navigating negative interactions, and saying ‘no’ are critical skills.

Though they take practice and commitment, the DBT skills modules are critical to managing borderline personality disorder and attaining a life worth living. If you are struggling with BPD or have any questions regarding Dialectic Behavior Therapy (DBT), contact me directly using the information provided below. 

Diane Levy-Rubinstein, LMSW
The Center for Relationship & Sexual Health
Phone (248) 399-7447

Download this blog: Borderline Personality Disorder and How to Have a Life Worth Living.

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