Borderline personality disorder is a pervasive pattern of unstable interpersonal relationships, self-image and affect. Individuals with this disorder typically will make efforts to avoid any abandonment. They have a persistently unstable self-image and can be impulsive in areas such as spending, sex, substance abuse or eating disorders. They also may have recurrent suicidal gestures or threats, and sometimes self-mutilating behaviors.

Individuals may report chronic feelings of emptiness, display a marked reactivity of mood, or have difficulty controlling their anger.

Individuals with BPD are often sensitive to small changes, such as someone being a few minutes late, interpreting the event as being abandoned, and implying they are “bad.” They are intolerant of being alone and may engage in attention-seeking efforts to gain someone’s attention to avoid the abandonment. They may constantly be engaging in activities to avoid boredom and emptiness.

Individuals also may idealize relationships for more than what they are worth, have high expectations, and overshare early on. The switch may flip quickly if the relationship is not reciprocated. They have extreme reactivity to stressors, hold on to bitterness, or may have outbursts. Symptoms may last from minutes to hours, and the return of someone’s affection may alleviate their symptoms. Individuals also tend to undermine themselves as soon as a goal is about to be realized.

Treatment for borderline personality disorder mainly includes counseling, specifically dialectical behavior therapy, which uses a skill-based approach to teach someone how to manage their emotions, tolerate distress and improve relationships. Medications may help with some of the symptoms associated with it, such as impulsivity or depression.

If you or someone you know are displaying these symptoms, it is advised to see a mental health professional for evaluation and treatment.

Pottkotter is a board-certified psychiatric nurse practitioner at ProMedica Physicians Behavioral Health. If you have a mental health question, please write to: Mental Health Moment, The Courier, P.O. Box 609, Findlay 45839.