How are crises experienced when you suffer from borderline personality disorder?

Borderline personality disorder (BPD) is a diagnostic category defined in DSM-5. It has frequently been sketched in fiction through films or stories that sought to bring us closer to a reality that must be understood in order to help. Help them, their families, while along the way we grow as a society. So yes, it is a category, but above all It is the suffering of many people who experience exponentially that feeling that we have all experienced at some point, that of not fitting in..

In his profile he highlights a dominant pattern of instability of interpersonal relationships, self-image, emotions, and intense impulsivity, which begins in the early stages of adulthood and is present in various contexts. It manifests itself in at least five of the following points:

Desperate efforts to avoid real or imagined abandonment. Pattern unstable and intense interpersonal relationships which is characterized by an alternation between extremes of idealization and devaluation.Identity alteration: intense and persistent instability of self-image and sense of self.Impulsiveness in two or more areas that are potentially self-harming. Behavior, recurring attitude or threats of suicideor self-mutilating behavior.emotional instability due to a notable reactivity of the mood Chronic feeling of emptiness.Inappropriate and intense angeror difficulty controlling anger.Transient paranoid ideas related to stress or severe dissociative symptoms.

Although these criteria exist, the reality is that Within TLP there is a fairly wide spectrumin which we can find people with some features that are more marked than others or with more or less serious symptoms.

Point out that heThe criteria only give us a reference, but the experience of the person with BPD is much broader and more complex. It is for this reason that patients with borderline disorder can be very similar or very different from each other.

What we can highlight as a common core of the disorder is the great fear of possible abandonment and the marked self-destruction and impulsivity.. These characteristics make the transition to a more or less normal life extremely difficult, since they usually occur in outbreaks or crises that sometimes catch the patient himself and, obviously, those around him by surprise.

How does a BPD patient experience a crisis?

A person who suffers from borderline personality disorder is a totally normal individual a priori. You may study, have your job, have a family, your circle of friends, etc. The problem arises when a crisis appears.

Borderline personality disorder attacks are often preceded by stressful events or some biological factor., such as the beginning of menstruation or the consumption of some drug. At other times, it is not related to anything in particular.

The moment the outbreak catches a person with BPD, the personality blurs. That is, it is as if the individual had two personalities: one that is always there, is practically normal, pleasant, stable and calm and another, which appears from time to time and is responsible for destroying everything built by the original personality.

“A kind of “short circuit” is created by which it becomes impossible to control the actions. The BPD outbreak invades the entire being and turns the mood, which until now was stable, into another dysphoric, sad and empty one. Suddenly, the things that made a lot of sense and generated well-being stop doing so. The dreams and projects that he wanted to carry out are seen with pessimism and melancholy. The mind begins to develop thoughts of loneliness: You are alone! You don’t even have a close friend to call! No one is going to love you with that attitude! It is better that you throw yourself out the window and stop bothering you! ”

“People who are important become enemies. Above all, those who love each other the most. In the middle of the outbreak, that is when I most need the love and understanding of those close to me, but the way to ask for it is through lack of respect, aggressiveness or destruction. I can even attack a family member, both verbally and physically. And deep down, what I am demanding is attention and affection.”

Borderline personality disorder crises make the patient endure boredom and frustration very poorly. Everything that is even the least bit uncomfortable seems like a world to him.

In this context, they can carry out self-destructive or impulsive behaviors such as: taking drugs, destroying objects, wasting money, embarking on projects without having made a coherent plan, being unpleasant to a friend, telling people they don’t know that they are in trouble. full crisis or even make a suicide attempt.

“Once in the middle of the crisis I managed to set up a business in a matter of days. I felt like a failure and even began to have thoughts of suicide. I then decided to look for a location, an advisor and carry out all the procedures to set up my company. As the days passed and the crisis ended, obviously, I regretted it.”

What comes after the crisis of borderline personality disorder

Borderline personality disorder attacks usually last from a few hours to a week or so.. As we have mentioned, it frequently occurs in women during the premenstrual period. The majority of patients with BPD confirm that after crises the feelings that flourish the most are two: shame and guilt.

Imagine that for a small period of your life you feel “possessed” by someone who has nothing to do with you. That “someone” will do things that you would never do under normal circumstances. Well, this is precisely what happens during a BPD outbreak. Therefore, It is obvious that shame and guilt are so present in the post-crisis period.

Shame is felt, above all, for having been impulsive. The impulsivity of BPD often causes the person to expose themselves.

On the other hand, guilt arises because during the outbreak we have carried out behaviors that our true self did not want to carry out. That is, we feel sorry.

For example, a BPD patient may yell at her three-year-old daughter because she feels overwhelmed when the child is not obeying. Surely, at other times, she would not have acted in this way, but in the middle of the crisis her impulsivity overcomes her and she ends up behaving in this way with the girl, which later leads her to feel very deep guilt.

The problem with post-crisis symptoms is that they can make the patient believe that “there is no remedy” and lead them to despair.. This helplessness can, in turn, cause new crises and close a cycle. For this reason, it is vitally important that the BPD patient knows the history of the crises and has a structured plan to deal with them. In the same way, your family and immediate environment should also know them.

Conclusions

Although it does not appear as such in the diagnostic manuals, The crises of a patient with borderline disorder are experienced with great hopelessness because, even with treatment, they are very difficult to control. One stops trusting in one’s resources, in one’s possibilities. One day he feels great and the next day, without knowing why, the BPD returns and ends up possessing him.

What can we do? What is essential for a patient with such a disorder is the validation of emotions. It must be taken into account that the majority of patients come from childhoods in which they did not experience this validation; rather, they were reproved. Some were even children who enjoyed rejection more than affection, indifference than affection.

On the other hand, work on regulation and tolerance of emotions is essential. The goal is not to completely eliminate feelings of emptiness or impulsivity, but to reduce them as much as possible, acquiring and training strategies for when they appear.

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