Can Borderline Personality Disorder be cured?
Borderline Personality Disorder (BPD) is a serious diagnosis within the medical field of psychiatry. It is recorded within the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), under the Axis II category, which also contains the other recognized personality disorders. The DSM-IV is a diagnostic compilation of all recognized psychiatric illnesses and it provides the criteria that must be met for each diagnosis.
BPD can afflict both males and females; however, it seems to be found in younger women more often. Possibly 2% of the general population has diagnosable BPD, but it is near impossible to calculate this particular statistic. This is because there is an abundance of individuals that do not seek treatment, as well as those who are misdiagnosed. BPD shares many of the same symptoms exhibited in other psychiatric diagnoses, so BPD patients are commonly misdiagnosed, especially in the beginning of their treatment.
BPD is believed by some mental health professionals to be a hopeless diagnosis due to an apparent perception that successful recovery among those afflicted by this condition simply does not exist. Is BPD really hopeless for those who are diagnosed with it? I do not believe this to be true.
It is beyond the scope of this article to examine all the various symptoms associated with BPD. The focus here is on the possibility that individuals diagnosed with BPD can over time acquire a significant improvement in their previously chronic symptoms. Through years of hard work in counseling, could not some patients technically fail to meet the diagnostic criteria for a BPD diagnosis? If an individual no longer meets the criteria for a diagnosis of BPD, then what happens to this diagnosis that has been correctly recorded for years in their psychiatric records? Is the BPD considered “cured” at that point? Or is it merely a temporary rest from the chaos of BPD’s emotional roller coaster?
I would suggest that BPD is, in fact, a curable condition. However, the healing process is long-term, intensive, and very difficult for the patient to endure for years. Back steps do occur and realistically this should be expected. Some do remain on the path to recovery from the personal enslavement of BPD. Others never quite reach this level of healing and tragedy eventually takes over.
The foundation of my theory, that BPD is actually curable, is based upon the fact that this condition is not biologically based. With the assumption that we are actually capable of retraining our minds, it is then possible for someone to sift through themselves and extract the unhealthy characteristics and habits. This type of self-help necessitates a chemically balanced brain, whether that is natural or medication induced. A chemically imbalanced brain is a sick brain that cannot support a healthy mind. Only a healthy brain can support the work it takes to heal a sick mind.
Unlike biological Axis I mental disorders, such as bipolar disorder and schizophrenia, BPD is not managed with medications that treat a neurological imbalance in the brain. However, some patients are given medications to directly treat BPD's physical symptoms. For example, some patients are prescribed a benzodiazepine, like Ativan, to treat the intense anxiety associated with the emotional outbursts common to BPD. This distinction is very important to understand.
Let’s consider bipolar disorder for a moment in order to demonstrate this critical distinction. As an Axis I diagnosis, bipolar disorder is known by psychiatric medical science to be a chemical imbalance among the brain’s neurotransmitters. Scientists have come a very long way over the past few decades in better understanding psychiatric illnesses on a biological level. This medical research is producing ongoing, potential treatment discoveries for patients with bipolar disorder.
The effects of appropriate psychotropic medications are profound for these patients because this disorder is caused by a physical problem within the brain that is ultimately independent from one’s external environment. Still, the brain is susceptible to chemical disturbances in response to stressful external stimuli. Therefore, a bipolar episode can be triggered by extreme distress or it may occur for no apparent reason. This is because bipolar disorder originates from a physically ill brain.
It is widely agreed upon within the professional psychiatry community that there exists no cure for bipolar disorder. Yet, medications can correct the imbalance among the brain’s neurotransmitters and cause the symptoms of bipolar disorder to lessen or disappear. The patient is relieved, as if it had been cured, but removing the medication(s) will cause the patient’s brain to return to its former ill state and cause the return of clinical symptoms. These patients truly depend upon the appropriate medication(s) to make it possible to manage their condition. Without these medications, patients with bipolar disorder are essentially at the mercy of their own brain.
To the individual suffering from borderline personality disorder, it does feel like they are at the mercy of their brain’s whims, but this is not accurate. Since this disorder originated from an abnormal personality development during childhood, the biological element is not present nor is it a cause of BPD. Any physical symptoms or a chemical imbalance occurring in a patient with a single diagnosis of BPD is the direct effect of an “ill” personality. The stress this patient endures emotionally and mentally will typically trigger worsening symptoms of BPD, which can in turn affect the natural chemical balance in this patient’s brain. It is the cause and effect relationship that differs between the Axis II diagnosis of BPD and bipolar disorder, which is an Axis I diagnosis.
It has been observed that BPD is frequently accompanied by a separate Axis I disorder rendering the patient diagnosable with two psychiatric disorders that are both in a different diagnostic axis within the DSM-IV. Often times there are symptoms present that are found within the diagnostic criteria for both disorders. These two disorders may share the same symptoms, but these symptoms have very different causes.
Instead of a biological trigger, the symptoms found within BPD are produced by one’s dysfunctional thinking and abnormal outlook on life. During a child’s personality development, dysfunctional personality traits & habits become well-ingrained into a person’s identity and thus are very difficult to isolate and undo. To complicate matters further, there are countless forms of dysfunctional ways of thinking, interpreting, understanding, reacting, and behaving that are present in the person whose total symptoms meet the diagnostic criteria for a BPD diagnosis.
To manage BPD disorder, the patient must rely on treatment through the form of counseling, also known as psychotherapy. The focus for the patient is to identify one’s dysfunctional thinking and inaccurate interpretations that have developed over time. Reality is disturbed for the BPD patient as a result of this cognitive dysfunction. A perceived reality that is disturbed will easily lead to disturbed behavior and reactions, which can lead to physical symptoms in the patient. These symptoms can include chronic or acute anxiety and loss of appetite, for example.
Despite all the similarities in BPD and Axis I disorders, it is the cause and effect that is different between the two. Bipolar disorder is caused by a biological disturbance and the effects are the resultant symptoms. BPD is caused by many factors in a child’s environment and their relationships with other people as they naturally develop who they are as an individual. The symptoms are created as a result of nurture and not nature. The distress endured from disturbed and inaccurate perceptions will cause the experience of psychiatric symptoms in an individual with BPD.
Having established that BPD does not originate from a physical illness in the brain, we can set aside this factor in order to further examine its true roots in the personality. Since one’s personality is so strongly connected to one’s own identity, it should be assumed to be a real challenge to separate dysfunctional parts from the healthy parts of one’s own personality. This assumption is proven correct as a BPD patient tries to navigate their way through years of professional counseling.
The mental health professional helps guide the process of recovery, but ultimately it is up to the patient to dig deep and look at themselves with total honesty. The patient must be willing to pick apart who they are and acknowledge where the problems arise that continually lead to the BPD symptoms.
The first determination of success is the patient’s willingness to submit to such critical analysis of themselves by themselves and do it with complete honesty. If the willingness is there, then the next determination of success is the patient’s ability to endure the emotional and mental difficulties that arise during the therapy process. Endurance is essential since the process is so lengthy, taking years of regular counseling sessions. A commitment to one’s recovery is simply mandatory.
The bottom line is that recovery is possible with borderline personality disorder. If recovery occurs and continues, then eventually the symptoms of BPD will slowly vanish. The individual can learn a healthier way of thinking and reacting that was formerly dysfunctional. There will come a point when this hard-working individual can no longer meet the diagnostic criteria for a BPD diagnosis. In my opinion, this means that the BPD has genuinely been cured.
Falling back into the BPD thinking and behaviors after successful recovery is possible, but not as likely. Once the individual, who was previously diagnosed with BPD, begins to see life through a different set of eyes, it is unlikely that they could return to the oblivion they previously had while in the grips of BPD. This person in BPD recovery will not see with such distortion because they have come to know a healthier and more realistic way of thinking and acting. The distortion of reality caused by BPD loses its power over the individual because they have come to know a less painful way of living and seeing life.
In summary, I believe that I have presented a theory that is lived out by some victims of BPD who come to know a new life that finally brings stability and contentment. These individuals have proactively dissected who they are and how they see the world. Such a process must bring a level of wisdom and knowledge of oneself that could not be achieved any other way. It would seem to me that the rewards of recovery from a BPD inflicted life are life changing and lifesaving.
A specific cure for BPD does not have an identity or name itself, as every case and every patient presents differently. Regardless, this cure exists and it saves lives. With a high rate of suicide among those with BPD, it is nothing less than a miracle that these individuals could come to know a life where suicide is never again an option and emotional stability is a continuing reality.