What It's Like to Have Borderline Personality Disorder

Borderline personality disorder (BPD) is a serious mental health condition estimated to affect roughly 1.8 percent of the general population. It is characterized by a pattern of instability in social relationships, self-image, and emotion regulation and a significant increase in impulsivity starting in young adulthood.

What Is It Like to Have BPD?

This elusive question was the focus of a new study led by Christian Moltu of the District General Hospital of Førde in Norway. More specifically, he and his collaborators were interested in how those with BPD experienced relationships with both themselves and others. The nature of these relationships has important implications for diagnosis and treatment but is often misunderstood.

To that end, Moltu and his team recruited 12 study participants (all women) who were recently diagnosed with BPD. They conducted in-depth, face-to-face interviews with them about what it was like to be diagnosed and live with the condition and their experiences in treatment. From there, the research team analyzed participants’ narratives for themes.

The results were striking. The overarching theme of “reaching for firm holdings” emerged, highlighting the ongoing search for stability and security. The particular phrase “reaching for” spoke to the participants’ chronic anxiety over losing that which they had fought hard to control. The women’s interior lives were marked by chaos and confusion, as they described feeling fragmented, not knowing who they were, and feeling existentially insecure. Their own thoughts and feelings scared them and often proved unbearable.

Reaching for firm holdings also encompassed someone or something that could provide an escape from the intensity of their experiences. It could be self-defeating, such as doing drugs, drinking alcohol, self-harm, or unyielding perfectionism. But it could also tilt to the positive, including seeking connection with and attempts at trusting others.

This overarching theme yielded five related sub-themes, which are outlined below.

1. Captive of emotions.

Participants described their inner lives as a cacophony of voices trying to scream over each other. The intensity of their emotions engulfed them like a tidal wave that led to mental and physical chaos and drove them to desperately search for calm and escape. The uncontrollable and unpredictable nature of their feelings was most distressing, as they could also feel intense joy. Consider a participant’s reflection:

“I can wake up feeling depressed, and then three days goes by, and I'm high up. I have no middle; either I'm down or I'm up. Either I'm happy and blue eyed and the world is really nice and everything is just ‘yes,’ or it's death, destruction, war, kill me! I'm like that.”

2. Keeping undeservedness at bay.

Many women wanted to be perfect—but didn’t know what they were trying to achieve or what attaining perfection would actually mean. Their pursuit of flawlessness stemmed from feeling damaged and worthless, and being perfect was a way to fend off these feelings. However, the participants’ efforts at perfection left them “wandering in blindness” and informed their relationships. A participant shared:

I would feel insecure a lot; I still do. I need confirmation several times a day, to confirm that I do things right, because I will judge myself a lot. I have this perfectionist in me; if it’s not perfect, then it's not good.

This perfectionism was destructive. When they could not reach their impossible standards or didn’t receive validation from others, some women resorted to punishing themselves via self-harm (e.g., self-cutting) or self-talk that could escalate into suicidal ideations.

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3. Distrusting oneself.

The participants described feeling unmoored as if floating around within themselves and among others. They felt unequipped to hold, soothe, and validate themselves. They were confused between that which was self and other and doubted their thoughts, emotions, and perceptions of the social world. Being alone was particularly difficult as if risking the evaporation of self. One participant explained:

I struggle a lot with the fact that I lose myself when I am alone. Life can become hopeless, and I can’t seem to do anything, even if I would like to draw or something, I rarely manage to do anything when I'm home (…) It’s just about passing the time until it's time to go to bed.

4. Dependence as stability.

Many participants engaged in dependent relationships with both things and other people, including alcohol, drugs, love, exercise, or relationships. In this vein, addiction could be depended upon in the storm of inner and outer confusion. It was a predictable, known quantity that could at least temporarily fill the lonely void. One participant, for example, found relief from daily challenges in prescription pills:

I have a really addictive personality; I easily get dependent on people. I can become really obsessive and think that, “If I only have her as a friend, others don’t matter.” I have been in love with people I don’t even know and responded to that by getting high, drinking alcohol, or taking pills. I have been addicted to anxiety pills; I have used them to not feel the intense feelings inside me or to handle certain situations better. So, I easily get addicted.

5. The uncertainty of reaching out.

While the women experienced others as constantly changing and insecure, they also sought relationships for stability and security and to counterbalance the insecure relationship they had with themselves. A bind between self and others arose, in which participants reached out to others for security—but that meant they risked losing their hold on themselves.

This fear led some participants to “test” their friends and family’s love, tolerance, and security. A participant expressed feeling so “unsound” in herself that she urgently wanted to be nurtured by someone who was reliable and secure:

It might be what this personality disorder entails, because all I wanted was that someone would take me home with them, you know (cries). Take me home and take care of me. That’s what I wanted and still want, but that’s not good, or what I want does not go together with what is actually good for me.

The women in the study found that it was both intolerable to be with and without others. But despite the overwhelming pain this wrought, reaching out helped them hold on and face the next day.

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