Borderline Personality Disorder is breaking many relationships: Doctor explains

It's normal for women to feel mood swings and irritability before their menstruation, but what if the sensitive phase extends to a level beyond, making the person come across as extremely arrogant and hard to deal with? What if they become susceptible to criticism, while also fearing abandonment? In our part of the world, people are quick to label such women as 'dhikkari,' 'thantedi' or 'thonnyavaasi' (obstinate and wilful) quite soon. The traits can also become relationship breakers for them in no time.

However, do you know that all of these can be the symptoms of an underlying personality disorder? Dr U Vivek, Consultant Psychiatrist at Renai Medicity Hospital, Kochi, says that every month, he diagnoses 10 to 15 people with Borderline Personality Disorder, aka BPD, which is also known as Emotionally Unstable Personality Disorder (EUPD). BPD is ubiquitous in the West that there are psychiatrists who specialise solely in handling patients with this disorder. Dr Vivek tells us more about its symptoms, underlying causes, the struggle such women go through and other details.

What is Borderline Personality Disorder (BPD)?
Dr Vivek explains that BPD is a personality disorder, characterised by mood swings, impulsivity, low stress tolerance, sensitivity to criticism, fear of abandonment, relationship issues and self-harm. "It's seen mostly in women," explains the doctor, who says life becomes a roller coaster ride in circles for those suffering from it and those who are close to them. "For those suffering from BPD, most things in life are either black or white; and nothing is grey. They either love or hate things. They can be exceptional performers in professional lives, but personal lives can be extremely messed up." Apparently, they can have many good qualities, but their undesirable traits can cloud them. 

BPD is often misdiagnosed
The doctor says that often, BPD traits are misdiagnosed as depression or anxiety. People can also term those suffering from them as 'head strong,' 'diffident' or arrogant. They might also repeat the same mistakes and burn their hands repeatedly. "Sadly, it's the disorder making them act in this manner. It's also a relationship and marriage breaker. A significant number of cases are ending up in our family courts, with this trait as being undiagnosed or not treated. Unless a partner is extremely understanding, it would be tough to handle someone with BPD," the doctor says. 

How BPD develops
The disorder doesn't develop out of the blue, Dr Vivek explains. Apparently, it begins at the age of 12 or 14, when a woman's adolescence period starts. "They start experiencing mood swings, irritability, impulsivity, relationship issues and fear of abandonment, and their defence mechanism would be getting angry, seeking help or attention. They can also resort to harming themselves - cutting hands, thighs and the like, at times," the doctor says. 

Personal life gets messed up
While those with BPD might have successful careers as film stars, lawyers, doctors, engineers or IT professionals, in personal life their tolerance to stress can be very low, says the doctor. "They can struggle to handle even minor personal matters or rejections. They can experience panic attacks or meltdowns, suicidal tendencies, and cry for no reason for hours. At times, we might see them experiencing breathlessness or palpitations too, but medical tests can come back as 'normal.' They can also often have multiple unstable relationships. The symptoms can worsen two or three days before menstruation, he says. 

Interpreting BPD symptoms
While many women can experience the following symptoms, what determines whether it's pointing to BPD is the increasing frequency and intensity of these signs as years go by. The symptoms can become severe enough to affect their biological functions, such as sleep and appetite. It can also affect their relationships with peers and potentially creep into their professional life.

Mood swings
Sensitivity to criticism
Low stress tolerance
Impulsivity
Fear of abandonment
Relationship issues

What triggers BPD?
Dr Vivek lists the factors that cause BPD
1. Hormonal fluctuations
2. Troubled childhood
3. Sexual abuse
4. ADHD in childhood
5. Broken families

Risk factors of BPD
Apparently, those who suffer from BPD can tend to develop drug abuse and addiction. "They depend on these as a defence mechanism, a temporary way to calm themselves. However, relying on them can only have adverse effects," Dr Vivek says. 

Medicines and therapy for BPD
Dr Vivek says that medicines can help reduce the occurrence and frequency of BPD symptoms. "There are also techniques like Real-time behaviour management, where we empower the patients to face problems and solve them, especially on the personal front. Dialectical Behaviour Therapy (DBT) is one such treatment that helps them handle intense emotions. 

Dr Vivek adds that the reason why the number of people suffering from BPD is going up can be the advent of nuclear families with not enough support systems, and also the increase in awareness about the disorder. "In the past, it was often considered solely a Western problem. It's even considered a raging epidemic in that part of the world," he adds. Although the BPD patients' numbers are rising in Kerala, it's reassuring that we also have enough specialists now to help them address its challenges.