Borderline Personality Disorder

Definition

Borderline Personality Disorder (BPD) is a mental health disorder that is characterized by instability in moods, self-image, behavior, relationships and emotional dysregulation. People with BPD tend to be highly emotionally sensitive and reactive and feel emotions more intensely than others. BPD is defined and diagnosed by 5 of the 9 criteria found in the Diagnostic and Statistical Manual for Mental Health Disorders, Fifth Edition (DSM-5).

Symptoms

BPD is most commonly found in adults, however, research proves that symptoms often start as early childhood and adolescence and is more common in women than men.

Chronic feelings of emptiness
Difficulty controlling anger or intense and inappropriate anger
Unstable self-image, sense of self, low self-esteem
Emotional instability, rapid mood swings
Intense fear of abandonment (real or imagined)
Unstable and intense relationships characterized by extreme idealization and devaluation
Impermanent, stress-related paranoia (e.g. the whole world is against them/certain people are against them) or severe dissociative symptoms
Dangerous impulsivity that can be self-damaging (e.g. unsafe sex, substance abuse, binge eating, spending, reckless driving)
Recurrent suicidal behavior, threats or gestures, or self-harm

Causes and Treatments

The causes of BPD aren’t fully understood yet — BPD has been linked to many Neurobiological, Neuropsychological, and Environmental findings. These findings include things such as genetics, brain abnormalities, and childhood abuse (sexual or physical), and childhood related stress.

Treatment for BPD begins with psychotherapy which is a very important component in order to help people understand their symptoms and learn how to manage it on a day to day basis. There are many psychotherapeutic approaches that have proven to be very effective in the treatment of BPD such as Dialectical Behavioral Therapy (DBT) and Cognitive Analytic Therapy (CAT). Medications also play an important role in the treatment of BPD due to the fact that they are proven to reduce three of the four major symptoms of BPD, enhance the quality and rate of improvement from psychotherapy, and are effective in treating other emotional disorders that are associated with BPD (Friedel).

Instructional Strategies

It is important to remember that children and teens with BPD are in a state of emotional vulnerability so it is always important for a teacher/parent to:

Educate yourself on BPD and get to know the student.
- Research on BPD may sound negative and scary but it is very important to educate yourself in order to understand the child/teen. Everyone’s BPD manifests differently so it is also important to get to know your student/child in order to help them become successful.
Acknowledge the child/teen and their feelings.
- By doing this, you are showing the child/teen that you understand them and you are not going to dismiss or invalidate their feelings.
Don’t discount or minimize their emotional reactions because they might seem inappropriate or exaggerated.
- This can cause a sense of not feeling understood or supported and make them feel alone and become disconnected.
Do not take things personally.
- Children and teens with BPD have huge reactions to things that might seem minor to others. They have quick and intense reactions due to them not being able to regulate their emotions and don't know how to deal with it appropriately causing rifts with others. What they need the most is someone to support them.
Build safe spaces inside and outside the classroom.
- It is helpful to remind the child/teen that they are safe both inside and outside your classroom. Help them find a place where they feel comfortable if things get overwhelming for them.
Make sure they have healthy coping mechanisms available to them.
- Children and teens with BPD suffer from dangerous impulsivity and suicidal behavior. Introduce and teach them about healthy coping mechanisms such as coloring a picture, reading a book or magazine, writing a story or about their feelings, building things made out of blocks or legos, doing a sport that they feel safe and comfortable in, discovering new hobbies that they might enjoy.
Find different ways to accommodate to their needs in the classroom.
- Every child is different and they will need different accommodations. The best thing one can do is to get to know the child and learn the different areas they need the most support on.

Strengths and Qualities of BPD

It is important to remember the strengths that people with BPD have. A lot of the research about BPD revolves around its symptoms and may portray people with BPD as dangerous, manipulative, hopeless, incurable, etc. but we have to remember that it doesn't define a person and that there is so much more to them than their disorder. By focusing on this, teachers will be able to see students with BPD as the strong beings that they are. Below is a list of the upsides BPD has as written by the Women's Centre for Health Matters (WCHM) from their Borderline in the Act website.

Helpful Websites

National Education Alliance for Borderline Personality Disorder

This website focuses on BPD and has an abundance of international resources such as podcasts, videos, articles, etc.

Borderline in the Act

Borderline in the act is a website that focuses on ending the negative stigma that surrounds BPD by providing many different resources and creating events to bring awareness.

Self-Care for BPD

This website created by Mind not only provides more information about BPD but has a page dedicated to self-care tips and an abundance of healthy coping mechanisms.

Exceptional Learners