Esther Lopez

English 363

February 2019

Doctor Leslie Bruce

Borderline Personality Disorder

Borderline personality disorder (BPD) is a mental

illness that is distinguished by different degrees of

impulsive behaviors and radical mood ranges and that

creates overall difficulty to function in everyday

activities and interpersonal intimacy, including

Figure 1: Artistic depiction of Splitting. Unknown separation anxiety and antagonization and/ or
artist. http://4.bp.blogspot.com/-
uTHY2KgskMI/VAtKMHlbKZI/AAAAAAAAAcw/IMBJ idealization of an individual/s.
Byp9DYY/s1600/gretel-ella-smith-borderline-
personality-disorder.jpg
Introduction:

According to the National Alliance on Mental Illness, it is currently reported that 1 in 6 individuals

are diagnosed with BPD, although the percentage is thought to be higher1. BPD is officially

categorized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5th Ed.) as a

personality disorder, as its etiology(cause/s) are more prominently based on early life experiences.

Newly found research uncovers patterns in brain activity that are unrelated to social exposure2,

1
National Institute of Mental Health. “Personality Disorders”
https://www.nimh.nih.gov/health/statistics/personality-disorders.shtml#part_155481 National Institute of
Mental Health. (Last updated: November 2017)
2
Ninomiya, Taiga; Oshita, Harumi; Kawano, Yoshihisa; Goto, Chiharu; Matsuhashi, Mai; Masuda, Koji; Takita, Fuku;
Izumi, Toshihiko; Inoue, Ayako; Higuma, Haruka; Kanehisa, Masayuki; Akiyoshi, Jotaro. “Reduced white matter
integrity in borderline personality disorder: A diffusion tensor imaging study” Journal of Affective Disorders,
Vol.225, pp.723-732 (2018)
though as a whole the etiology of BPD is not agreed upon by researchers. Common indicators of

borderline personality disorder are impulsive tendencies, low self-esteem and polarized thinking

which is known as splitting.

Symptoms:

An individual with borderline personality disorder possess insecurities such as having a poor self-

image that can impact their perception of how other individuals view them. This creates a

dysfunction in their own daily living due to a chronic state of self-doubt and therefore disconnect

mentally, also known as dissociate, due to general stress or trigger related stress3. Individuals with

BPD will experience difficulties with decision making, both short-term and long-term, as well as

dramatic shifts in morals which will also have an impact on decisions due to their impulsivity that

may result in destructive consequences for them. Most individuals with BPD present a chronic

feeling of abandonment due to low self-esteem and having no concrete belief in consistency in

relationships due to the splitting view of others in their lives. Struggles with interpersonal relations

are influenced by chronic changes in the way the individual perceives another person, due to

splitting. In a study conducted on relationships of individuals with BPD, it was found that in stress

inducing situations the individuals

(BPD) are more likely to respond

negatively with confrontational

behavior with their partner and it

is speculated by the researchers

Figure 2: Demonstrates the different stages of borderline personality disorder in that this may be due to mistrust
a simple format that a new audience will be able to visibly see. https://cdn-
images-1.medium.com/max/1600/1*TiWwiC0Ua8IhXZxtNLnVmQ.jpeg

3
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Arlington, VA: American Psychiatric Publishing.
and emotional distance4. It is important to understand that Borderline Personality Disorder is a

mental illness that is not brought upon physical injuries and are not triggered by substance abuse

unlike other mental illness such as PTSD (war injuries, car accident) or body dysmorphia5.

Splitting (polarized thinking)

Red or blue pill, black or white, all or nothing, a mindset that only opposite

extremes exist and there is no gray ‘normal’ area of identifying things, this is the

sort of perspective that someone with BPD possess. This mindset makes having

healthy relationships difficult as an individual with BPD view of another person in

one side of the spectrum, ideal and perfect, and at any change in the other person

will antagonize them in the eyes of the individual with BPD. To be able to explain a

non-BPD individual the difference between how they process information gathered

about their interpersonal relationships versus

a BPD individual, a BPD could potentially

think that an individual is the most perfect

and amazing person they have met and they

will forever make them feel secure and happy,

let’s say that other person forgets to respond

to a text message or arrives late to a meeting,
suddenly the BPD individual feels abandoned
Figure 3: Splitting explanation through clip art. Splitting
can be easily expressed through the lack of perception an
individual with BPD may have on the complexity of other
people, being unable to see a dimensional person, instead
seeing them as Good or Evil.

4
Annemarie, Miano; Luna, Grosselli; Stefan, Roepke; Isabel Dziobek. “Emotional dysregulation in borderline
personality disorder and its influence on communication behavior and feelings in romantic relationships” Behavior
Research and Therapy Volume 95 Pages 148-157 (August 2017)
5
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Arlington, VA: American Psychiatric Publishing.
by the person and antagonizes them identifying that they were always evil and

always will be 6.

Impulsive Tendencies (+ dysfunctional emotions):

In the article, Impulsive Behaviors and Borderline Personality Disorder, impulsive tendencies are

listed as activities that can cause dysfunction to everyday living such as overspending, self-harm7.

For example, an individual during a mania episode (feeling ‘too happy’ or overwhelming emotions

that are not depressive) may have a sudden rush to go to Las Vegas and max out all their credit

cards on designer items and once they crash from the episode, they will feel immense guilt and

mental torment. It is often described by BPD individuals as being a back-seat driver to your own

life, and you have no control over what the person on the wheel does8. There is no known etiology

that indicates why individuals with BPD are prone to acting impulsively.

Etiology:

Most research has been aimed at uncovering the social

aspect of Borderline Personality Disorder, such as

studies that survey the effects BPD has in relationships

and obtaining information of individuals that are

impacted by BPD over the course of 20 years. It is

important to note that most of the studies focus on

female individuals with BPD and their relationships,
where sexuality is not disclosed as a possible variable.
Figure 4: White matter in brain, activity through different
tests conducted in research study. In the study the
researchers found some significant changes in matter in
the occipital lobe of the brain that processes visual cues.
https://www-sciencedirect-com.lib-
proxy.fullerton.edu/science/article/pii/S016503271730971
0

6
https://www.elementsbehavioralhealth.com/news-and-research/understanding-borderline-personality-disorder-
relationships/
7
https://www.verywellmind.com/impulsive-behavior-and-bpd-425483
8
https://www.youtube.com/watch?v=xOnNk-8gSe8
In most recent studies that cover BPD, there has been a movement towards researching possible

imbalances and dysfunctions in the brain that can contribute to the possible causes of BPD. The

study, reduced white matter integrity in borderline personality disorder: A diffusion tensor imaging

study, discusses the possible connections that BPD has to other mental illnesses such as ADHD

and depression based on the scans that have been done on individuals with the listed disorders and

therefore theorizing that their etiologies could be similar9. This means that if an individual has

another mental disorder, they may also be in the spectrum of being diagnosed with borderline

personality disorder. In the same study, data showed that there were some visible changes in brain

activity that matches other mental disorders that are affected by less white matter; however it was

found inconclusive, the researchers described some significant change in the occipital lobe which

is known for the visual processing of information located in the back of the brain.9 Unfortunately,

there are no concrete or agreed upon etiology for BPD or risk factors like most other mental

illnesses therefore the behaviors that individuals possess and the psychiatric history of an

individuals’ parents are needed to be monitored for the diagnosis of BPD.10

Figure 3: Shows the percentages of people that have a Personality Disorder v. Borderline that may also have another
disorder. that https://www.nimh.nih.gov/health/statistics/personality-disorders.shtml#part_155481

9
Ninomiya, Taiga; Oshita, Harumi; Kawano, Yoshihisa; Goto, Chiharu; Matsuhashi, Mai; Masuda, Koji; Takita,
Fuku; Izumi, Toshihiko; Inoue, Ayako; Higuma, Haruka; Kanehisa, Masayuki; Akiyoshi, Jotaro. “Reduced white
matter integrity in borderline personality disorder: A diffusion tensor imaging study” Journal of Affective Disorders,
Vol.225, pp.723-732 (2018)
10
Salters-Pedneault, P Kristalyn. “Splitting and Borderline Personality Disorder” VeryWell Mind
https://www.verywellmind.com/impulsive-behavior-and-bpd-425483
Acknowledgements:

Big thank you to Justine for keeping me on high alert on requirements for the paper such as

adding footnotes and changing the tone to fit the audience specifically.

Bibliography:

National Institute of Mental Health. “Personality Disorders”

https://www.nimh.nih.gov/health/statistics/personality-disorders.shtml#part_155481 National

Institute of Mental Health. (Last updated: November 2017)

Ninomiya, Taiga; Oshita, Harumi; Kawano, Yoshihisa; Goto, Chiharu; Matsuhashi, Mai; Masuda,

Koji; Takita, Fuku; Izumi, Toshihiko; Inoue, Ayako; Higuma, Haruka; Kanehisa, Masayuki;

Akiyoshi, Jotaro. “Reduced white matter integrity in borderline personality disorder: A diffusion

tensor imaging study” Journal of Affective Disorders, Vol.225, pp.723-732 (2018)

Annemarie, Miano; Luna, Grosselli; Stefan, Roepke; Isabel Dziobek. “Emotional dysregulation

in borderline personality disorder and its influence on communication behavior and feelings in

romantic relationships” Behavior Research and Therapy Volume 95 Pages 148-157 (August

2017)

Salters-Pedneault, P Kristalyn. “Splitting and Borderline Personality Disorder” VeryWell Mind

https://www.verywellmind.com/what-is-splitting-425210 (2018)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th ed.). Arlington, VA: American Psychiatric Publishing.

Post write:

The most important strategies for my definition were comparing and contrasting borderline

personality disorder to other mental illnesses, because although they may have overlapping

criteria for diagnosis, they also have crucial differences. Short examples of what psychological

terms such as splitting and an example of what impulsive behaviors feels like from a BPD

individual’s perspective. Graphics were difficult to use in my definition as research in BPD that

provides visual representation is scare, illustrations can demonstrate emotions that words cant

convey academically.