If you are just beginning to learn about Borderline Personality Disorder, you may find relief in knowing that the chaos and stress you’ve been living with are common, that you’re not alone, and that there are methods for improving the quality of your life and relationships.

BPD Books

There are many ways to begin to increase your understanding of BPD and Borderline Personality Disorder treatment. Many people who are endeavoring to learn about BPD in an effort to cope with the difficulties of living with someone who has it start their education with what is considered to be the go-to beginner’s guide to living with someone who has BPD: “Stop Walking on Eggshells,” by Paul T. Mason and Randi Kreger. This book is an excellent educational foundation on which to build from, as it covers the primary symptoms, causes, and common problems associated with BPD. It also offers coping and communication skills for family members and loved ones of people suffering with BPD.

Online BPD Resources

In addition to the numerous books about Borderline Personality Disorder, the online BPD community also offers a bounty of resources for families seeking therapy, support, and information about BPD and Borderline Personality Disorder treatment. Online are blogs, articles, and forums that can give you empowerment and relief in finding that there are many people out there who understand the BPD experience and have successfully navigated the ups and downs of living in the orbit of someone who has BPD.

Simply reading or hearing the stories of others can be all the encouragement you need to buoy your spirits and motivate you to continue your efforts to improve your relationship with the person in your life who has Borderline Personality Disorder.

BPD Videos

BPD videos may also be a valuable resource to supplement family therapy for Borderline Personality Disorder. On bpdvideo.com, you will find access to a BPD video series that takes you through various aspects of BPD, including first-hand descriptions of what it’s like to live with BPD yourself and what it’s like to live with someone who has BPD.

These BPD videos cover such topics as: understanding Borderline Personality Disorder, causes of Borderline Personality Disorder, diagnosing Borderline Personality Disorder, treating Borderline Personality Disorder, and coping with Borderline Personality Disorder. These BPD videos provide a comprehensive guide to Borderline Personality Disorder and an excellent resource for everyone who is attempting to better their understanding of BPD and BPD treatment.

Importance of Family Therapy for BPD

Borderline Personality Disorder behaviors and related crises can have a snowball effect and cause families to descend into a pattern of dysfunction and ineffective communication. It is not uncommon for loved ones to develop their own psychological issues, such as depression or anxiety, as a result of the stress caused by struggling through unrelenting crises.

Seeking education about Borderline Personality Disorder, becoming active in the BPD community, and even seeking your own therapy (whether as part of family therapy for BPD or individual therapy) can help alleviate some of the worst stressors and give you the ability to develop better coping skills. Support groups such as the National Education Alliance for Borderline Personality Disorder Family Connections groups can also provide you an invaluable way to get more education and needed support.

Remember, you’re not alone, and neither is your loved one with BPD. Find the resources and Borderline Personality Disorder treatment that you need and be proactive in the recovery process, of yourself and your loved one.

Borderline Personality Disorder is a diagnosis that can cause stress in and of itself. It is a difficult disorder to treat, and treatment for BPD is often an intensive process. However, it is possible to recover from BPD and begin living a more balanced, emotionally healthy life.

Treatment for Borderline Personality Disorder

To begin the process of making living with BPD manageable, you must first receive a proper diagnosis from a mental health professional in order to receive specific treatment for Borderline Personality Disorder. BPD therapy can offer invaluable lessons about coping with the emotional rollercoaster that those with BPD experience on a regular basis. If you are living with BPD, controlling your emotions can be next to impossible without the skills taught through BPD therapy.

In conjunction with BPD therapy, medications are often prescribed to help mitigate the negative effects of such BPD symptoms as depression or anxiety. By effectively treating some of BPD’s most problematic symptoms with medications, therapists can help give you relief from some of the fears, anxieties, and negative emotions that interfere with your ability to cope with life’s ups and downs. This can create the space necessary for you to get the most out of your BPD therapy.

Committing to Change

Attending BPD therapy on a regular basis and committing to the process of healing is the single most important thing one can do to help manage living with BPD. People with Borderline Personality Disorder experience emotional extremes on a regular basis, causing them to act out in destructive ways to relieve overwhelming negative emotions. Until you learn new ways of coping with emotional distress, you will continue to live in a world of endless emotional triggers and struggle to maintain your most important interpersonal relationships. In order to overcome this cycle of pain, you must learn new ways of processing emotions and develop coping skills that lead to solutions.

Support of Loved Ones

In addition to treatment for Borderline Personality Disorder, managing BPD is much easier with the support of family, friends, and significant others. Like any serious illness, mental or physical, recovery can be an intensive, challenging, and sometimes lengthy process. If you are seeking treatment for Borderline Personality Disorder, have a frank conversation with the most important people in your life and ask them to support you on your journey to recovery.

BPD can make relationships extremely strained, regardless of who has BPD and who doesn’t. Communication is a two-way street. If you can get your loved ones involved in the recovery process, they too can learn how to facilitate better communication and problem solving with you.

Even if your family is reluctant to participate fully in your treatment for Borderline Personality Disorder, you will find that there are many support groups and websites that represent a community of people invested in their own BPD recovery or that of their loved ones.

With proper diagnosis, medication, BPD therapy, and support, there is no reason to doubt that you can overcome the worst aspects of the disorder and go on to a life where healthy relationships can be achieved and personal goals can be reached.

A marked and persistent fear of social interaction is often diagnosed as Social Anxiety Disorder, and it is a common co-occurring disorder for those with Borderline Personality Disorder. It may even be an initial diagnosis if it presents as the biggest problem a patient has to address through the therapeutic process.

Social Anxiety Disorder Symptoms

Fear of public speaking has long been one of the most common phobias people face, regardless of whether they suffer from a mental illness or have been diagnosed with a psychiatric disorder. Even celebrities find themselves suffering from Social Anxiety Disorder.

Many of us loathe the notion of standing up in a room full of strangers and subjecting ourselves to their judgment or scrutiny. It is a normal human concern: we all want to be accepted by others and successfully integrate in group situations.

For people suffering from Social Anxiety Disorder, this common fear can reach such debilitating levels that they isolate themselves almost completely from having to interact with strangers, even to the point where phone calls can be difficult.

In those with Borderline Personality Disorder, Social Anxiety Disorder can reach such extreme levels that isolation becomes the norm, thus causing dependency on other people and exacerbating feelings of low self-esteem, depression, and helplessness. People with BPD often become dependent on others in an effort to avoid abandonment. Family members become caretakers who are obligated to care for the person with BPD, as their social anxiety inhibits them from working or completing regular errands. In this way, people with BPD attempt to keep others from leaving them.

Intense fear of social interaction can cause physical responses that are close to “fight or flight” in some people, meaning that the idea of mingling with others can cause a racing heart, excessive sweating, trembling, nausea, and muscle tension. These types of physical responses are common in anyone with Social Anxiety Disorder, but they represent imagined rejection rather than an actual threat.

Treatment for Social Anxiety and BPD

Borderline Personality Disorder treatment (especially Dialectical Behavior Therapy) addresses this kind of anxiety by teaching patients to be mindful of their feelings without allowing them to take over and cause severe emotional responses.

Mindfulness, or present moment awareness, can teach us to sit with our feelings and thoughts without magnifying negative emotions by putting more energy into them. In conjunction with learning to transform and disempower negative thoughts through mindfulness, medications can be prescribed that reduce anxiety and give you a greater ability to cope with social situations.

With proper treatment, both social anxiety and BPD can be overcome to a degree that allows you to improve your social skills, move on to develop healthy relationships with others, and reach life goals that otherwise would have been impossible.

Few people with Borderline Personality Disorder recover without the benefit of professional treatment. In BPD treatment, patients acquire a whole new set of life skills that can help manage their borderline personality symptoms and reduce the amount of conflict and stress in their lives.

Before entering Borderline Personality Disorder treatment, it is a good idea to carefully consider your options. You will want to assess your situation and decide on the approach to BPD treatment that best suits your needs and lifestyle.

Here are five things to consider in your decision-making process:

1. How severe are my Borderline Personality Disorder symptoms?

Taking an honest look at how borderline personality symptoms are manifesting in your life will help you determine what your immediate needs are when it comes to Borderline Personality Disorder treatment. If you are feeling suicidal or engaging in self-harmful behaviors, you should seek BPD treatment as soon as possible, and preferably in a residential BPD treatment environment. Untreated BPD can result in life-threatening behaviors, and should be addressed accordingly.

2. Will my current health insurance plan cover my BPD treatment?

Dealing with insurance companies can be daunting and often frustrating, but knowing exactly what your coverage is for mental health treatment is the best place to start when you’re exploring your options for BPD treatment. What mental health providers can you choose from? How many sessions are covered? Will your insurance company supplement costs of residential BPD treatment? Knowing the answers will empower you to make the best decision based on your available coverage.

3. What is the best therapeutic approach?

Most Borderline Personality Disorder treatments involve a combination of some form of Cognitive Behavioral Therapy (CBT) and medication to treat related borderline personality symptoms. Dialectical Behavior Therapy (DBT) is currently considered the most effective road to recovery for people with BPD, but other options such as Schema-based therapy and Transference-focused therapy have also shown to be successful approaches to BPD treatment.

4. How do I choose a BPD therapist who is right for me?

When you enter Borderline Personality Disorder treatment, you will be doing some very difficult and intensive work on building new life skills, changing old thinking patterns, and discovering what your triggers are. You will want to do this with someone who has training and experience treating patients with BPD. You are hiring someone to help you on this journey, so bring questions to your first meeting, express any concerns you have, and don’t choose someone you don’t feel completely comfortable with.

5. What level of BPD treatment do I need?

Borderline Personality Disorder treatment is a process that takes time and energy. How much time and energy do you realistically need to spend on your recovery based on how your borderline personality symptoms are affecting your life? Residential treatment, day treatment, and outpatient treatment are all options for BPD treatment that offer choices for those who must work concurrently while in treatment, as well as those who can dedicate more time to BPD treatment. When making a decision about the time you can commit to BPD treatment, keep in mind that the more you can immerse yourself in the process, the faster you can begin to acquire the skills you will need to recover from BPD and move forward in a positive direction.

Based on the prior commenting period in 2011, members of the DSM-5 Task Force and Work Groups revised their diagnostic criteria and made other changes throughout the manual. The revised criteria also reflect updated research findings and field testing of the criteria.

Key changes during this round of public comment are as follows:

Bipolar and Related Disorders

• Hypomanic Episode: Criterion A revised to include increased energy/activity as a core symptom
• Manic Episode: Criterion A revised to include increased energy/activity as a core symptom
• Major Depressive Episode: Proposed removal of the bereavement exclusion and addition of a footnote to clarify for clinicians how to differentiate bereavement and other loss reactions from Major Depression

Depressive Disorders

• Mixed Anxiety/Depression: Proposed for Section III, a section in DSM-5 in which conditions that require further research will be included
• Major Depressive Episode: Proposed removal of the bereavement exclusion and addition of a footnote to clarify for clinicians how to differentiate bereavement and other loss reactions from Major Depression

Anxiety Disorders

• Specific Phobia: Duration criterion changed (from “The duration is at least 6 months” to “The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months”) and minor wording changes
• Social Anxiety Disorder (Social Phobia): Duration criterion changed (from “The duration is at least 6 months” to “The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months”) and minor wording changes
• Generalized Anxiety Disorder: The number of associated physical symptoms has been reduced from six to two; minor wording changes
• Panic Attack: Minor wording changes
• Panic Disorder: Minor wording changes
• Agoraphobia: Duration criterion changed (from “The duration is at least 6 months” to “The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months”) and minor wording changes
• Separation Anxiety Disorder: Duration criterion changed (from “The duration is at least 6 months” to “The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months”; age of onset requirement has been dropped; and minor wording changes
• Addition of criteria for Substance-Induced Anxiety Disorder
• Addition of criteria for Anxiety Disorder Attributable to Another Medical Condition
• Addition of criteria for Anxiety Disorder Not Elsewhere Classified

Trauma- and Stressor- Related Disorders

• Post Traumatic Stress Disorder: Wording changes (e.g., adding “directly” in criterion A1); PTSD in preschool children proposed as a subtype of PTSD instead of a separate diagnosis; and proposal of a dissociative symptoms subtype
• Addition of criteria for Persistent Complex Bereavement Disorder: This is being proposed for Section III, a section of DSM-5 in which conditions that require further research will be included
• Addition of criteria for Trauma- or Stressor- Related Disorder Not Elsewhere Classified

Substance Use and Addictive Disorders

• Minor wording changes to most of the criteria
• Hallucinogen Disorders have now subsumed Phencyclidine Disorders
• Sedative/Hypnotic-Related Disorders renamed from Sedative, Hypnotic, or Anxiolytic Disorders
• Stimulant Disorders renamed from Amphetamine and Cocaine Disorders
• Updated the Severity Specifiers and Remission Specifiers
• Removal of Substance-Induced Dissociative Disorder
• Addition of criteria for Neurobehavioral Disorder Associated With Prenatal Alcohol Exposure: Proposed for Section III, a section of DSM-5 in which conditions that require further research will be included
• Addition of criteria for Caffeine Use Disorder: Proposed for Section III, a section of DSM-5 in which conditions that require further research will be included
• Addition of criteria for Internet Use Disorder: Proposed for Section III, a section of DSM-5 in which conditions that require further research will be included
• Addition of criteria for Drug Specific “Not Elsewhere Classified” diagnoses

Personality Disorders

• Addition of more extensive rationale for proposed changes in the diagnosis and classification of Personality Disorders
• Minor wording changes to all diagnostic criteria

For more information on the proposed DSM-5, and to make any comments, visit the DSM-5 website.

Sometimes it feels as if all options have been exhausted. You’ve tried holding your ground, giving in, arguing facts, or even avoidance, but nothing seems to change. As much as you may have the best intentions and be putting great effort into resolving conflicts with someone who has Borderline Personality Disorder, without some guidance it can be hard to know how you can approach conversations in a way that doesn’t escalate emotions or snowball into further conflicts.

Whether you are dating someone with Borderline Personality Disorder, related to someone with BPD, friends with someone who has the disorder, or a co-worker, there are things you can do to improve your communications. In BPD therapy, mental health professionals teach some simple and effective communication skills that can go a long way toward reducing the severity and frequency of high-conflict conversations. All that’s needed is a willingness to learn and practice.

Here are just a few ways to better communication with someone who has Borderline Personality Disorder:

Provide Validation

Many people with Borderline Personality Disorder were raised in homes with an invalidating environment in which their feelings, desires, and concerns were frequently dismissed as being wrong or unmerited. People with BPD can seem irrational. They often overreact to perceived slights and misinterpret other people’s intentions.

It’s easy to respond to them at times with phrases such as, “That’s ridiculous. I don’t know how you can feel that way when I was just asking you a simple question.” Statements like this may seem like a rational response to an irrational reaction on the part of the person with BPD, but what they do is effectively discount the person’s feelings and further escalate their emotions.

Validation can make a world of difference. Replace the above response with something such as, “Let me understand. When I asked you about work, it made you feel as if I think you are doing poorly at your job? I can see how that would upset you.” By simply acknowledging how the person with BPD feels, we do not condone bad behavior or rage, but we do demonstrate that we are listening and not judging their emotions.

Other Tips for Better Communication with Someone with BPD

When someone with Borderline Personality Disorder feels heard, understood, and validated, they are much more likely to engage in problem solving. Here are some other things you can do to improve communication with your loved one with BPD:

• Listen. Provide your full attention when your loved one is talking. Ask questions and repeat back what they’ve said to show that you heard them. Keep distractions to a minimum and set aside time devoted to talking.
• Be patient. Don’t get frustrated. Understand that communication may be difficult for your loved one with BPD and it may take them some time to feel comfortable communicating with you.
• Think before you speak. Instead of responding immediately to what your loved one has said, take some time to think about your response. This may allow you to find a better way to respond that furthers your communication instead of stifling it.

Borderline Personality Disorder Treatment

Borderline Personality Disorder has a profound ripple effect, and all of the friends and family around the person who suffers from BPD will also suffer the adverse effects of the associated damaging behaviors. As well, many times the root causes of BPD can be traced back to an invalidating home environment or physical and psychological abuse. For these reasons, family members and loved ones are strongly encouraged to participate in the recovery process and be a part of BPD treatment.

In honor of May’s Borderline Personality Disorder Awareness Month, we’ll present an overview of borderline personality symptoms and discuss Borderline Personality Disorder treatment.

Criteria for Borderline Personality Disorder

To begin to understand Borderline Personality Disorder, it is important to know what the BPD symptoms are and contemplate how they may be manifesting in yourself or your loved one.

Borderline Personality Disorder is diagnosed using a set of nine criteria listed in the DSM-IV. Six of the nine criteria are necessary to merit a diagnosis of BPD. Symptoms must be chronic and persist for years in order to indicate a personality disorder. The nine criteria are as follows:

1. Frantic efforts to avoid real or imagined abandonment.
2. A pattern of unstable and intense personal relationships characterized by alternation between extremes of idealization and devaluation.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self damaging, such as spending, sex, substance abuse, reckless driving, or binge eating.
5. Recurrent suicidal behavior, gestures or threats, or self-mutilating behavior.
6. Affective instability due to a marked reactivity of mood, such as intense episodic dysphoria, irritability or anxiety, which usually lasts for between a few hours and several days.
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, or recurrent physical fights).
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

Borderline Personality Disorder causes such elevated states of emotional distress in those who live with it that they often resort to impulsive behavior or rage in order to relieve their intolerable feelings. When emotional distress is an ongoing issue and the skills required to cope with it are not in place, people with BPD can wreak havoc in their own lives as well as other people’s, and put themselves in harm’s way.

Borderline Personality Disorder Treatment

Through no fault of their own, patients with Borderline Personality Disorder lack the knowledge and practice of self-soothing. Most BPD behaviors stem from the inability to self-soothe, or calm down when emotions take over. Treatment for Borderline Personality Disorder must effectively address this core issue before patients can begin to truly see the signs of recovery.

BPD treatment seeks to teach patients the coping skills required to tolerate difficult emotions in a healthier way. “When we know better, we do better” is a quote from the renowned poet Maya Angelou. It applies well to the simple goal of BPD treatment: giving clients a better ability to weather life’s ups and downs without triggering severe emotional responses or damaging behavior.

Currently, the preferred treatment for BPD is Dialectical Behavior Therapy (DBT) which takes a multi-pronged, comprehensive approach to the therapeutic process. Other approaches to BPD treatment, such as Cognitive Behavioral Therapy (CBT), have also been shown to be effective.

Without Borderline Personality Disorder treatment, whether outpatient BPD treatment, residential BPD treatment, or BPD day treatment, BPD can be a devastating and even life-threatening issue. If you or a loved one is suffering with BPD, help is available and a better quality of life is possible through BPD treatment.

About 40 percent of those who engage in self-harming behaviors also harbor thoughts of suicide. However, most people who engage in self-harmful behaviors are not attempting to commit suicide, but rather are trying to find temporary relief from other distressing symptoms of BPD.

It may be surprising to some reading this that self-harming behaviors are actually soothing and result in positive feelings for a person with Borderline Personality Disorder. This may be why self-harmful behaviors are more likely to be recurring and chronic as opposed to suicide attempts, which are far less frequent in those with BPD.

Obviously, these statistics indicate a serious need for effective therapeutic treatment for self-harmful behaviors and suicidality in patients with BPD.

How DBT Works to End Self-Harmful Behaviors

Dialectical Behavior Therapy (DBT) provides people with Borderline Personality Disorder the skills needed to help them better regulate their emotions so they no longer feel compelled to engage in self-harmful behaviors.

One of the skills taught in DBT is how to self-soothe. Follow the link for tips on how to use DBT to help you to self-soothe instead of self-harm.

Unfortunately, if you love someone with Borderline Personality Disorder (BPD), this is a subject that bears serious consideration. Not only will around 70 percent of those diagnosed with BPD attempt suicide, but around 8 percent to 10 percent will succeed in taking their own lives.

The rate of suicide for those with Borderline Personality Disorder is higher than that of any other psychiatric disorder, and it is included in the DSM criteria for BPD. For these reasons, if you care for someone who has BPD, it is important to recognize the signs that they may be suicidal.

Borderline Personality Disorder causes such intense negative emotions that those suffering from it frequently engage in risky or impulsive behaviors in an attempt to relieve feelings of distress. BPD is not a short-lived condition, and those who suffer from it can be forced to bear years of unhappiness, instability, and conflict if they are not actively in BPD treatment.

Self-harm, substance abuse, and eating disorders are common among those with BPD and can be seen as ways to alleviate unwanted feelings. Sadly, these co-occurring symptoms can in and of themselves lead to further risk of impulsivity, accidental death, and suicidal behavior.

Warning Signs of Suicide

Here are some key signs that your loved one with Borderline Personality Disorder may be seriously contemplating suicide:

• Marked change in personality
• Inability to cope with daily life or problems
• Change in sleeping or eating patterns
• No interest in activities that are usually enjoyable
• Difficulty concentrating
• Alcohol or substance abuse
• Thinking or talking about suicide

Other signs may include a bright and cheery outlook following a period of deep depression or giving away belongings. These types of abnormal behaviors may indicate a resolve to commit suicide.

How to Help Someone Who Is Suicidal

If you believe that someone you love may be demonstrating suicidal behavior, whether or not they have Borderline Personality Disorder, there are things you can do to try to intervene:

• Tell them not to kill themselves (this sounds obvious, but it is often important that the person hears you don’t want them to kill themselves)
• Ask what emotions your loved one is feeling
• Validate their emotions and experiences
• Stay focused on the moment and don’t drag up old issues
• Communicate your faith in their ability to overcome this crisis
• Ask how you can help
• If possible, remove lethal weapons from the home
• When in doubt, call a professional or 911

Reaching out with compassion, empathy, and an openness to help can be all it takes to move someone from thoughts of suicide to a place of greater hope. However, it is important to keep close tabs on how your loved one is coping and behaving so that you can get professional help if you feel your intervention is not sufficient to prevent a suicide attempt.

If your loved one is struggling with Borderline Personality Disorder and thoughts of suicide, get them needed BPD treatment before those thoughts turn into actions.

Clearview’s 2012 Consumer Lecture Series will feature experts in the field of Borderline Personality Disorder treatment, and help you to get the needed answers to your questions. Scheduled for 2012 are the following lectures:

Wednesday, June 6 – Introduction to Dialectical Behavior Therapy

Dr. Alina Gorgorian, clinical director of Clearview Women’s Center, will provide you an overview of Dialectical Behavior Therapy (DBT) and the four DBT skills: mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation.

Wednesday, August 1 – How Do I Get My Family Member into BPD Treatment?

Learn techniques to get your loved one the treatment they need to recover from Borderline Personality Disorder.

Wednesday, October 3 – Stop Walking on Eggshells!

Author Randi Kreger teaches essential skills for family members of those with Borderline Personality Disorder.

All of the workshops will be held during the evening in Venice, Calif. For more information, visit Clearview’s website.