Borderline: the Personality Disorder
Writing about Borderline Personality Disorder is hard…
…Managing it is harder. And I’ve been putting this article off for several weeks.
On the one hand, there are so many ways to experience BPD that attempting to summarize the internal experience of this large group of people in a 2000 word Substack post could feel dishonest and grossly insufficient, especially for people who so often feel (and are) misunderstood. On the other hand, I think this could add something useful to the conversation, whether for someone experiencing these traits or someone trying to understand them. However, this article is not meant to aid in self-diagnosis.
For these reasons and more, I’m going to keep my descriptions broad. There are many, many other resources online that dive deep into the lived experience and diagnostic criteria of BPD (I’ll link some at the end of this article).
BPD is a condition that affects someone's inner and outer world. It is heavily stigmatized by not only the general population, but also by the medical and mental health industry. I’ve witnessed this first-hand.
BPD is characterized by difficulties in maintaining relationships with others and regulating emotions. People with BPD often feel misunderstood and “too much” for others. Their reactions to social, environmental, or internal experiences can be far more intense than someone without BPD might expect or imagine. Many folks with BPD traits experience intense and short-lived relationships, and may use destructive coping mechanisms to deal with overwhelming emotions, such as substance use and self-harm.
In my early days of learning about BPD, long before starting my studies in psychology, I came across a video posted by Katie Morton, a YouTuber and mental health professional. She describes people with BPD as “emotional burn victims.” What a depictive and effective image. It’s stayed with me since. What can feel mundane and unimportant to one person can feel like a thousand knives of emotional pain for someone with BPD. I’m sure you can imagine how stigma around BPD develops. These traits seem distressing and intense, to say the least. That said, I want to introduce nuance to this “personality disorder”. I want to DEpathologize our perception of BPD. Because the people being diagnosed with this condition are complete and complex human beings who are more than a diagnosis or a series of traits.
Revealing myself as a ‘90s kid here… but this feels like a perfect place to quote the one and only Demi Lovato, who has struggled with their mental health and shared about it publicly for years:
I'm just trying to keep my head above water
I'm your son, and I'm your daughter
I'm your mother, I'm your father
I'm just a product of the problem
People with BPD traits are all around you. They are the people you sit next to on the bus and they are the people you care about.
If we don't depathologize BPD, we risk vilifying, stigmatizing, weaponizing, and dismissing an entire group of people. Not for their individual actions, but for a label intended to help them access resources and, hopefully, rehabilitation.
Understanding the diagnosis and its limitations
BPD, along with its diagnosis, is not cut and dry. Professionals diagnose BPD by gathering clusters of traits or symptoms the individual presents with and, if the individual meets 5 of 9 criteria, they may receive a diagnosis. Because of this, someone with BPD traits can go without diagnosis and treatment for years, sometimes their whole life.
They may be left feeling destined for short-lived relationships, a fragmented sense of self, and uncontrollable moods, wondering, why am I like this? I have spoken to so many people who just want to understand themselves and figure out what the heck is going that makes them feel so different from everybody else.
And what happens to those who meet 4 out of 9 criteria for BPD instead of 5? Those people are still struggling, and a lot of professionals want to recognize that. I have heard stories of physicians and psychiatrists giving a tentative label of “BPD traits” instead of a full-on BPD diagnosis to clients. One reason for this is stigma, medical and otherwise. A BPD diagnosis can be harmful and dangerous for people out in the world.
I am not attempting to argue that a BPD diagnosis is unnecessary or always unreliable. If it helps someone access care, I am all for it. But pathologizing the condition isn’t the answer either. A diagnosis is ultimately a cluster of experiences and traits that we’ve grouped together for clarity and efficiency. Underneath that is a person who is suffering and needs help, regardless of whether they meet 3, 5, 7, or all 9 criteria.
Okay, so what does it look like to depathologize BPD, though?
Stop judging a book by its cover.
Learn about BPD and listen to people’s experiences instead of relying solely on diagnostic criteria. Diagnostic manuals are a good starting point, but they are also wildly imperfect. You can’t take an x-ray or a blood test to determine if you have BPD. Understanding the condition means looking at the whole human: observing behaviours, history, patterns, and emotions. It is inherently nuanced and qualitative.
Unless you are someone’s psychiatrist or medical practitioner, I generally recommend looking beyond the diagnostic criteria and towards the individual's humanity.
Separate the Label From the Behaviours.
I can’t count the number of times people have stopped me mid-sentence to dismiss someone’s behaviour, or piped in with a copy/paste response before I am finished speaking: “Well, they have BPD. Of course they’re going to snap at one point or another," "They’ll always do this,” or the classic “What did you expect?”
There’s something to be said for making space for growth by holding back assumptions. It's hard to give someone that space when you've already decided what they're going to do, and why.
There’s also (in my opinion) a certain lack of ownership when we blame or associate someone’s actions with their diagnosis. And maybe that’s another article (let me know if you’d want to hear more about this).
Remember that it’s not all bad
There’s a flip side to these levels of sensitivity: there can also be immense joy, empathy and happiness that some less sensitive people will never experience in their lifetime.
Mad Pride is a complex topic that has offered solace and self-identity for many, while simultaneously causing hurt and misunderstanding for those seeking treatment and rehabilitation. Seeing this firsthand in my community, I know this is a line I want to walk intentionally.
I don't want to dismiss the suffering associated with BPD, but I also don't want our understanding of it to begin and end there. BPD stereotypes focus on the bad stuff. That’s what we see in the diagnostic criteria; it’s why doctors wrongfully and negligently refuse care; it’s why people make harmful assumptions behind closed doors, or sometimes quite openly.
People who experience these extremes of emotional sensitivity are also capable of deep bonds, high emotional highs, and a depth to their lens of life that others may never experience. These are facts, and these are beautiful things. Personally, I see that as quite incredible.
There is a depth to the experience of BPD that cannot be quantified by others’ perceptions. Next time you hear or think about someone with BPD, I challenge you to view them as a whole, unique person rather than a list of destructive behaviours.
Let’s ask why
This is not an exact science, and 1 + 1 doesn’t always equal 2. There can be so many reasons that these specific traits are present in an individual, and this level of nuance is not always recognized by either professionals or by the general population. What gets interpreted as a permanent character defect may instead be a complex and painful response to trauma, or a survival mechanism.
We know that there are associations between BPD and caregivers having similar traits, as well as experiences of emotional neglect in childhood. There may be heritable vulnerabilities, but decades of observation also suggest that how a child is raised can contribute to the patterns we associate with BPD.
Ultimately, many people with BPD traits have experienced a level of adaptive self-hatred that begins at a young, young age. Younger than any person should know what hate is, during such a formative, tender time of life.
Think back to that “emotional burn victim” analogy. For some, this level of sensitivity develops through a thousand micro-burns in childhood. A child can grow up not knowing themself, hypervigilant of others' intentions, questioning their own emotions, reactions, and desires… to the point that they don't know a world without this hypersensitivity being their truth.
The big picture
We don’t need to know exactly where BPD comes from or have a clear diagnosis in order to do the work of depathologizing: to begin looking at the whole of the person before us; learning about the context and history of behaviours; and understanding behaviour as trauma response and dysregulation.
Let’s start from the human being instead of the label, and go from there.
Organizations and Peer Resources
Emotions Matter: A nonprofit dedicated to reducing stigma, offering peer-led support and resources reviewed by individuals with lived experience.
BPD Alliance (formerly NEABPD): Provides the Family Connections course and a resource library focused on compassionate, evidence-based support for individuals and families.
The BPD Bunch: A peer-led podcast and video series featuring 17 people in functional recovery, sharing diverse experiences and pathways to healing.
Recommended Books and Authors
"The Buddha and the Borderline" by Keira Van Gelder: A memoir that humanizes BPD through the lens of recovery, DBT, and spirituality.
"Building a Life Worth Living" by Marsha Linehan: A memoir by the creator of Dialectical Behavior Therapy (DBT), offering insight into overcoming BPD.
"Loving Someone with Borderline Personality Disorder" by Shari Manning: Focuses on compassionate understanding and actionable support strategies for loved ones.
"Borderline Personality Disorder Demystified" by Robert O. Friedel: A guide to understanding causes and treatments without pathologizing language.
Dr. Daniel Fox: A psychologist who provides educational, non-stigmatizing content on BPD via YouTube and his book, The Borderline Personality Disorder Workbook.
Websites and Videos
BPD Alliance (bpdalliance.org): Features a comprehensive resource library and conference recordings from a lived-experience perspective.
DialecticalBehaviorTherapy.com: Offers free, evidence-based DBT skills training and lessons.
Borderliner Notes: A YouTube channel developed by a filmmaker with BPD, providing educational content on the disorder.
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