The Face of Borderline Personality Disorder (BPD)

I was diagnosed with borderline personality disorder (BPD) two years ago. At the time, my diagnosis meant little to me. It was just another medical term. It seemed more like a fad to me. There was a movie, Girl, Interrupted, that didn't really reflect my story. I was not a hip teenage girl, I was a middle aged man whose cutting days were in the distant past. I was convinced that my real problems lay elsewhere. It took a marital separation, two suicide attempt and several hospitalizations to convince me otherwise.

The DSM-IV is a diagnostic and statistical manual that catalogs mental illnesses. It identifies nine diagnostic criteria. A patient who exhibits five or more criteria is considered to have BPD, while a person with less than five criteria is considered to have borderline traits. Looking at my own life, I can see that all nine criteria apply to me.

In this part of my series, I will discuss the first two.

1. Frantic efforts to avoid real or imagined abandonment

People who suffer from BPD fear abandonment, whether it is real or imaginary, and they will go to great lengths to avoid it. Such efforts can include threats of self harm and bargaining, but they can escalate to more desperate measures. These efforts to avoid abandonment are indeed frantic. A borderline patient may become verbally or even physically abusive when he or she fears a relationship is threatened. A BPD sufferer may also make threats, legal or physical, toward a partner or the target's friends. The website Helen's BPD Resources offers a lengthier list of actions a BPD patient may take in order to avoid abandonment.

It is hard to admit, but I myself have used almost all of the above tactics when I believed my relationships were threatened. I have threatened my partners with suicide on more than one occasion. Sometimes I would overcompensate. I'd do more than my share of the household chores, plant a garden, redo the kitchen floor and so forth. I'd do anything to convince my partner I had turned over a new leaf. If I believed my partner was cheating, I'd immediately create a mental list and threaten her to "expose" them or otherwise hurt them.

2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

Borderline patients have intense relationships that are characterized by a black and white view of their partners. They will alternates between periods of idealization and devaluation. An idealized person can do no wrong in the BPD view. However, when the cycle of idealization is over, that person can do no right. Borderliners tend to sulk a great deal, and those who live with BPD patients often feel that they have to walk on eggshells. Borderline patients often have a Jekyll/Hyde personality. When they are Dr. Jekyll they are wonderful to be around. The problem is that no one can predict when the Mr. Hyde side erupts.

What those who spend much time with me fear the most is my complete unpredictability. I can be charming and wonderful one moment, and the next moment I can be a raging lunatic. My wife was either a saint or a goldbricker. And I treated her accordingly. When my stepdaughter did her chores right she was wonderful, but if she missed one tiny detail she was, in my view lazy and useless. My views of them were purely guided by my emotions; reality had nothing to do with it. I realize that I have a lot of amends to make.