How long do bpd episodes last

Bipolar Personality Disorder Feelings - Discovery Mood & Anxiety Program

It’s easy for teens and adolescents with borderline personality disorder (BPD) to feel like they are the victims of a very cruel curse. This personality disorder is often characterized by an intense fear of abandonment, unstable relationships and impulsive behavior that ultimately drives people away. “BPD makes me lash out, allowing some of the cruelest things to tumble from my mouth. And believe me, there are only so many times loved ones will forgive a lack of control,” one person writes. Young people that have this disorder describe what it’s like to live with it, in their own words.

What is Borderline Personality Disorder?

A young woman who was diagnosed with borderline personality disorder at the age of 14 shared her story anonymously in Elite Daily. Describing her battle with BPD, she says, “Relationships feel impossible, my brain never stops running and my stress is magnified. I find it very difficult to distinguish who I actually am and who my mental illness wants me to be.

In a revealing article for VICE magazine, Australian writer Patrick Marlborough offers a personal explanation of BPD: “It is hard to offer a simple medical definition of BPD, but I’ve heard it brilliantly summed up as ‘chronic irrationality.’ Think severe mood swings, impulsivity, instability and a whole lot of explosive anger.”

Borderline Personality Disorder Diagnosis

Because young people with BPD may project symptoms that seem similar to other personality disorders, it is often confused with bipolar, depression, or anxiety disorders. The National Institute of Mental Health offers this description:

“Borderline personality disorder (BPD) is a serious mental disorder marked by a pattern of ongoing instability in moods, behavior, self-image, and functioning. These experiences often result in impulsive actions and unstable relationships. A person with BPD may experience intense episodes of anger, depression, and anxiety that may last from only a few hours to days.

Borderline Personality Disorder Diagnosis Signs and Symptoms

Teens with BPD may experience extreme mood swings and can display uncertainty about who they are. As a result, their interests and feelings about any recent event can change rapidly.

According to NIMH, symptoms include:

  • Frantic efforts to avoid real or imagined abandonment
  • A pattern of intense and unstable relationships with family, friends and loved ones, often swinging from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)
  • Distorted and unstable self-image or sense of self
  • Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving and binge eating
  • Recurring suicidal behaviors or threats or self-harming behavior, such as cutting
  • Intense and highly changeable moods, with each episode lasting from a few hours to a few days
  • Chronic feelings of emptiness
  • Inappropriate, intense anger or problems controlling anger
  • Stress-related paranoid thoughts
  • Severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body or losing touch with reality

Living with BPD

Ordinary events may trigger these symptoms. For example, adolescents or teens with BPD may feel angry and distressed over minor separations, such as vacations, trips or sudden changes of plans, from people to whom they feel close. Research shows that young people with this disorder may see anger in an emotionally neutral face and have a stronger reaction to words with negative meanings than people who do not have the disorder.

Marlborough writes, “I think it’s this erratic oscillation that makes BPD so hard to communicate, particularly to those who are close. Because on the surface, it looks like I’m just being ornery. Like all mental illness, it’s best treated with patience and empathy. And unfortunately, like depression or hypomania, it places the onus on people who are not necessarily in a position to help or understand, no matter how much they may care for you. In a relationship, BPD can leave both parties feeling isolated.”

The Dark Side of Borderline Personality Disorder

Just living with someone that has this personality disorder, or being around them,  can be extremely difficult, Marlborough admits. “It brings out my mean streak something shocking. I’ve always had a devilish way with words, particularly nasty ones, and BPD is like a Terminator vision that highlights the chinks in everyone’s armour. Unlike my mania, which tends to make me charismatic and eloquent, a BPD ‘turn’ or ‘moment’ sees me turn sour and crude.”

Relationships & Borderline Personality Disorder

Due to their impulsiveness, young people with BPD tend to change jobs frequently and abruptly cut ties to people they are close to, the young woman with BPD explains in Elite Daily. “We also have intense and sudden mood changes, and we have severe difficulty regulating our emotions. Unintentionally, we tend to blame others when we make a mistake, which causes us to be manipulative and cruel to those we care about.”

The Disorder that Makes People Seem Out of Order

BPD can make life feel almost unbearable. “It’s a mirage illness,” Marlborough writes in VICE. “You feel like someone without fingerprints. You have no identity. You move between things constantly, people and passions. Onlookers can be tricked into seeing you as boldly transformative. In reality, you are someone without a sense of self.”

The young woman with BPD told Elite Daily, “Long story short, it’s very hard for those with BPD to have successful and healthy relationships and stable confidence levels. Our version of ‘logical thinking’ is most often overthinking. We have a very hard time distinguishing between real issues or imaginary issues. BPD is considered to be one of the most serious mental illnesses, as it causes a great deal of suffering and has a high-risk for suicide.”

Recognizing Red Flags of BPD

If you think that someone you love might have borderline personality disorder, and they are expressing suicidal thoughts and feelings, this should not be taken lightly. Seek professional help immediately. If your friend or loved one is exhibiting any suicidal warning signs, contact a mental health professional, or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Or call 911, or take them to the nearest emergency room. If the person is acting and not willing to accept treatment, call the police, your local hospital emergency department or 911 if you feel that they are in danger. Also take precautions to consider your own personal safety. It is important not to put yourself in harm’s way, experts say.

BPD Recovery is Possible

“Luckily, BPD is treatable with consistent therapy, self-awareness and support. It doesn’t have to be a lifelong chum like depression or anxiety. The ghost can definitely be outed. But like all mental illness, to do that requires some love, from friends, strangers, and yourself,” Marlborough says.

“This is a lifelong battle, but I’m prepared to fight,” the woman tells Elite Daily. “I will never be cured of BPD, but I believe my disorder does not own me. This is my life, and I know it can be beautiful.”

Discovery Mood & Anxiety Program Can Help

We’ve been helping families find their way to lifelong recovery since 1997. Our personalized behavior modification programs are tailored to fit your needs. Discovery Mood provides multi-faceted levels of care for adolescents and teens that struggle with borderline personality disorder, depression, anxiety disorders, bipolar disorder, self-harm behaviors, gender identity, oppositional defiant disorder, eating disorders and other major mental health disorders. Call us at 800-760-3934 today.

Related Articles on

  • Bipolar Spectrum Disorder
  • Borderline Personality Disorder Linked to Drug Addiction
  • What Causes Bipolar Disorder and Who Does It Affect?


  • VICE magazine: How it Feels to Live With Borderline Personality Disorder, by Patrick Marlborough. Retrieved October 20, 2016.
  • Elite Daily: What It’s Like to Live With Borderline Personality Syndrome. Retrieved October 20, 2016.
  • National Institute of Mental Health: Borderline Personality Disorder. Retrieved October 20, 2016.

Symptoms, Causes, and How to Cope

Our personalities are defined by the way we think, feel, and behave. They’re also shaped by our experiences, environment, and inherited traits. Our personalities are a big part of what make us different from the people around us.

Personality disorders are mental health conditions that cause you to think, feel, and behave differently than most people. When untreated, they can cause distress or problems in the lives of people who have them.

One very common personality disorder is called borderline personality disorder (BPD). It’s characterized by:

  • self-image issues
  • difficulty managing emotions and behavior
  • unstable relationships

One key behavior shared by many with BPD is known as “splitting countertransference,” or simply “splitting.”

Keep reading to learn more about splitting in BPD and how to cope with it.

To split something means to divide it. Those with BPD tend to characterize themselves, other people, and situations in black and white. In other words, they may suddenly characterize people, objects, beliefs, or situations as either all good or all bad.

They may do this even though they know the world is complex, and good and bad can exist together in one.

Those with BPD often seek outside validation without considering their own emotions about themselves, others, objects, beliefs, and situations. This can make them more prone to splitting, as they attempt to shield themselves from anxiety caused by potential abandonment, loss of trust, and betrayal.

People with BPD often experience intense fears of abandonment and instability. To cope with these fears, they might use splitting as a defense mechanism. This means they might cleanly separate positive and negative feelings about:

  • themselves
  • objects
  • beliefs
  • other people
  • situations

Splitting often occurs cyclically and very suddenly. A person with BPD can see the world in its complexity. But they often change their feelings from good to bad rather frequently.

A splitting episode can last for days, weeks, months, or even years before shifting.

What might trigger a splitting episode?

A split is typically triggered by an event that causes a person with BPD to take extreme emotional viewpoints. These events may be relatively ordinary, such as having to travel on a business trip or getting in an argument with someone.

Often, triggering events involve minor separations from someone they feel close to and sparks fear of abandonment.

You can identify splitting most commonly through the language of a person with BPD. They’ll often use extreme words in their characterizations of self, others, objects, beliefs, and situations, such as:

  • “never” and “always”
  • “none” and “all”
  • “bad” and “good”

Here are a couple of examples:

Example 1

You’ve been feeling good about yourself, generally. You’re out on a road trip one day and make a wrong turn that gets you temporarily lost. Suddenly, any good feelings you have about yourself disappear, and you get very down on yourself.

You may say negative things to yourself or others, such as “I’m such an idiot, I always get lost” or “I’m so worthless, I can’t do anything right.”

Of course, making a wrong turn when driving doesn’t mean a person is worthless. But a person with BPD can split their perception to avoid the anxiety of others perceiving them as worthless if they do the job first.

Example 2

You have a mentor you deeply admire. They’ve helped you professionally and personally, and you begin to idealize them. They must be without flaw if they’re so successful in their professional and personal lives. You want to be like them, and you tell them so.

Then one day your mentor undergoes turmoil in their marriage. You view this as a sign of weakness. Suddenly, you view your mentor as a complete fraud and failure.

You want nothing to do with them. You completely separate yourself and your work from them and look for a new mentor elsewhere.

Such splitting can leave the person being hurt, annoyed, and confused by the sudden shift in your perception.

Splitting is an unconscious attempt to safeguard ego and prevent anxiety. Splitting often leads to extreme — and sometimes destructive — behavior and personal turmoil in relationships. Splitting often confuses those who are trying to help people with BPD.

Splitting is an unconscious attempt to safeguard ego and prevent anxiety.

Those with BPD often report having intense and unstable relationships. A person who’s a friend one day may be perceived as an enemy the next. Some relationship traits of a person with BPD include:

  • difficulty trusting others
  • irrationally fearing others’ intentions
  • quickly cutting off communication with someone they think might end up abandoning them
  • rapidly changing feelings about a person, from intense closeness and love (idealization) to intense dislike and anger (devaluation)
  • rapidly initiating physically and/or emotionally intimate relationships

Splitting is a defense mechanism commonly developed by people who have experienced early life traumas, such as abuse and abandonment.

Long-term treatment involves development of coping mechanisms that improve your perspective of the events happening in your life. Reducing anxiety can also help.

If you need help dealing with a splitting episode in the moment, here’s what you can do:

  • Calm your breathing. A surge of anxiety often accompanies splitting episodes. Taking long, deep breaths can help calm you and prevent your extreme feelings from taking over.
  • Focus on all your senses. Grounding yourself in what’s happening around you at a given moment can be a good way to distract yourself from extreme feelings and help you better put into perspective what’s happening around you. What can you smell, taste, touch, hear, and see in a moment?
  • Reach out. If you find yourself splitting, consider reaching out to your mental healthcare professional. They may be able to calm you and help ease the split while it’s happening.

It’s not easy to help a person with BPD who experiences splitting. You may feel at the mercy of their symptoms. If you feel capable enough to help, here are some tips:

  • Learn as much as you can about BPD. It’s easy to get offended by the up-and-down behavior of someone with BPD. But the more you know about the condition and how it can affect behavior, the more understanding you’ll have about your loved one’s behavior.
  • Know your loved one’s triggers. Often, the same events over and over again are a BPD trigger. Knowing your loved one’s triggers, alerting them, and helping them avoid or cope with those triggers may prevent a splitting cycle.
  • Understand your own limits. If you feel unequipped to help your loved one cope with their BPD splitting episodes, be honest. Tell them when they should seek professional help. Here’s how to access therapy for every budget.

BPD is a mental health disorder characterized by extremes in the way a person thinks, feels, and acts. Many people with BPD form extreme characterizations about themselves, others, objects, beliefs, and situations during episodes called splitting.

Situations associated with anxiety often trigger splitting episodes. While it may be difficult at times, coping with splitting symptoms is possible.

Getting professional help can best prepare you to cope with your BPD and splitting cycles.

How to live with borderline personality disorder

Daria Batyrshina

lives with BPD

Author profile

I couldn't get a correct diagnosis for several years, and then it completely changed my life.

To describe borderline personality disorder, or BPD, the well-known saying of psychologist Marsha Linehan is perfect: “These people simply don't have 'emotional skin'. Even the slightest touch or movement can cause the most severe suffering.” nine0003

Share my path to getting the correct diagnosis, symptoms, and tips for dealing with people with BPD.

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don't write prescriptions, we make recommendations. Relying on our point of view or not is up to you. nine0003

What is borderline personality disorder

Borderline personality disorder is characterized by permanent changes in mood, self-image and behavior. This can lead to problems in relationships with other people and impulsive actions of all kinds.

BPD - Mayo Clinic

BPD - National Institute of Mental Health, USA

In the International Classification of Diseases 10th Revision, or ICD-10, there is in fact no diagnosis of "borderline personality disorder", there is an emotionally unstable personality disorder, which two types: borderline and impulsive. In ICD-11, this is already a separate diagnosis, which is called borderline personality disorder. nine0003

The disorder has several main features.

So what? 01/12/22

Transition to the new International Classification of Diseases has begun in Russia: what will change and when

Self-injurious and risky behavior. For example, a person may injure themselves or use psychoactive substances - borderline disorder increases the risk of developing various addictions.

Black and white thinking: it seems to a person that there can only be good and bad, there are no halftones. nine0003

Criteria for diagnosing BPD - Medscape

Problems with self-esteem. People with this disorder are overly sensitive to the opinions of others, enter into dependent relationships, have a strong fear of being alone, and may take desperate actions to keep a loved one or get their attention.

The manifestations of borderline personality disorder are similar to those of adolescence: outbursts of anger, mood swings, aloofness, so this diagnosis is made after 18 years. nine0003

What are the symptoms of borderline personality disorder

Alexey Pribytkov

psychotherapist, psychiatrist, Ph.D. It happened.

  • A tendency to intense, tense and unstable relationships, with a slight transition from one extreme to another - from idealization to devaluation of a partner: "I love and hate. " nine0060
  • Fuzzy, unstable self-image: "Who am I?", "What do I like?", "What do I want?" - and pronounced fluctuations in self-esteem.
  • Impulsivity, unexpected actions that carry potential danger, self-destructive behavior: substance abuse, waste of money, sexual excesses, overeating and others.
  • Suicidal thoughts and actions. Repeated self-harm, such as cutting hands, without suicidal intent, "to relieve emotional stress." nine0060
  • Emotional instability, mood swings. Usually these are short, from a few hours to a few days, but intense emotional experiences. Depression and depression can be replaced by an upbeat, euphoric mood. Such drops can occur for no apparent reason or in minimal life situations. For example, the partner did not respond to the message.
  • A constantly experienced feeling of inner emptiness, meaninglessness of life.
  • Excessive manifestations of anger, difficulty in controlling it. nine0060
  • Under stress, suspicion easily arises, there may be thoughts of persecution and bad treatment from other people, as well as a feeling of “unreality” of the environment.
  • Why borderline personality disorder develops

    Why borderline personality disorder develops is not exactly known.


    Biological factors. There is evidence that the development of personality disorders, including BPD, may depend on genetic factors. nine0003

    BPD may also be associated with changes in some parts of the brain responsible for controlling emotions. Its development can be affected by disturbances in the functioning of the system of neurotransmitters - compounds with the help of which brain neurons communicate with each other, in particular serotonin.

    Social factors. For example, unstable relationships with significant adults, lack of love in childhood, neglect by parents, loss of a loved one.

    Emotional or physical abuse, as well as intense fear experienced in childhood, greatly increase the risk of any psychological problems. In this case, BPD can be combined with another diagnosis - post-traumatic stress disorder, or PTSD. It is manifested by constant frightening memories of a traumatic event and increased anxiety. The more unstable the environment around and the more traumatized the child, the more likely it is to get PTSD. nine0003

    How I treated depression and anxiety for several years

    I first saw a doctor almost eight years ago. I had an eating disorder - it often accompanies BPD, but I didn't know about it yet.

    My gastroenterologist at some point realized that my constant pains in the abdomen were most likely connected not with physical problems, but with mental ones. My mother took me to a government clinic, where I came across incompetent doctors.


    How to cure eating disorders

    The psychiatrist said that I have anorexia, I look terrible and I won't be able to find a partner because "men don't throw bones." Then I realized that it was not worth waiting for help from him.

    I dealt with eating disorders myself, having gone through all the stages from anorexia to bulimia and compulsive overeating in two years. After solving the problem with food, depression came. Here, I couldn't manage on my own.

    My days were similar to each other: constant fatigue, apathy, I didn’t even have enough strength to eat and brush my teeth, and there was only fog in my head and no thoughts. My circle of contacts narrowed greatly, because those around me saw only aggression or received no answers at all. So several years passed, then I realized that I needed help. nine0003

    On the Profi-ru website, I found a psychologist who lived next to me. Then I did not yet know how psychiatrists differ from psychologists and psychotherapists, so I did not receive the necessary help.


    How to choose a psychotherapist

    Psychologists usually do not work with mental disorders, besides, in the sessions I just told what was bothering me, there was no other support. Sometimes I couldn't find words and we just kept silent.

    I went to the specialist for about a month and paid 1300 R for each meeting. In total, we held nine meetings. The only thing I got was the fog left my head. Despite my condition and the fact that the psychologist could not do anything about it, she persuaded me to stay in therapy. She said that it helps, although I did not feel any relief.

    11,700 R

    I spent on a psychologist who did not help me

    As a result, I did not want to spend more money on myself and lost confidence in doctors. Then I learned that in Moscow you can get free psychological help at the Moscow Service for Psychological Assistance to the Population. nine0003

    Moscow Service for Psychological Assistance to the Population

    I had to wait there for an appointment, but I had nowhere to hurry. About six months later, I was able to get to a psychologist. I told her what worries me - at that time they were symptoms of depression and apathy. She immediately said that I should talk to a psychotherapist, and I made an appointment with another specialist in the same clinic.

    The psychotherapist referred me to a psychiatrist, suggesting several doctors she trusts. She said that I most likely had depression and needed medication. Psychiatrists are not accepted at MSPPN, so I went to a private clinic, where I had to pay 4000 R for an appointment.

    The amount of free assistance in the ISPP is limited, but it is enough to get started. Source: MSPPN

    A psychiatrist at a private clinic diagnosed me with depression, prescribed an antidepressant and a tranquilizer. I was lucky that my doctor saw not only in a private clinic, but also in a state one, so I went to all subsequent appointments for free.

    The second time I managed to find the right medicines. We fixed the changes not only with the help of conversations. The psychiatric clinic had a simulator on a computer, where the patient was asked to pass several tests: attentiveness, reaction speed, the ability to distinguish faces, and much more. I took tests at intervals of about once a month. nine0003

    This testing is not necessarily and does not always reflect the effectiveness of the treatment, but I liked that the results got better every time. At that time, about 1,500 R per month was spent on medicines.


    8 myths about antidepressants

    During the same period, I tried cognitive behavioral therapy. In a year I started and quit three times, nothing worked out for me. The mood diary was empty, because I do not distinguish between emotions, the diary of situations that concern me and their analysis, too. I did not understand why this or that situation became important to me. In total, I had five meetings with a psychotherapist, the cost of one was 3000 R.

    Diary of emotions to fill out

    At that time, the doctor and I did not yet know that I had more than just depression with panic attacks and anxiety, so we did not follow my emotions and feelings much, which is important in BPD.

    At some point, I abruptly stopped taking the prescribed pills and coped with the withdrawal syndrome for another week. I refused the pills, because it seemed that I could manage without them, besides, they helped for a short time, then everything started all over again.

    /panic attack/

    How to cope with a panic attack: recommendations from a psychotherapist

    A month or two after the withdrawal, I felt fine and even started to exercise. Then anxiety and depression symptoms returned, I suffered for a few more months and went to a new doctor.

    Over the next one and a half to two years, I changed three doctors in one private clinic, I was prescribed different types of medicines in different combinations and dosages. Primary appointments cost 4000-5000 R, repeated - 2400 R. I went to psychiatrists once a month to control my condition. I bought medicines either generics or original ones, they spent about 2000-3000 R per month. nine0003

    The pills made me feel better for a short time, about a month. During this period, I was already diagnosed with "emotional personality disorder", but they did not tell me about it. I later found out from the medical record, which I requested before changing the clinic.

    At the same time, I also turned to Gestalt therapy for help - this is one of the areas of psychotherapy aimed at developing self-awareness. For me, the sessions were an opportunity to cry, acknowledge problems, and receive support. For three months, I called a psychologist every two weeks. One session cost 2000 R.

    107,100 R

    I spent on specialists before I was given the correct diagnosis

    I spent on treatment before the correct diagnosis was made 177,100 R

    Medicines in the last two years of treatment 55 000 R
    Regular visits to psychiatrists 50 400 R
    Drugs in the first year of treatment 15 000 R
    Cognitive behavioral therapy, 5 sessions 15 000 R
    Three initial appointments with the following psychiatrists 14 000 R
    Gestalt therapy sessions, 6 sessions 12 000 R
    Psychologist sessions with "Profi-ru" 11 700 Р
    First psychiatrist appointment 4000 R

    Medicines in the last two years of treatment

    55 000 R

    Regular visit to psychiatrists

    50 400 R

    Medicines in the first year of treatment

    15 000 R

    Cognitive-behavioral therapy, 5 sessions

    15 000 P

    Three initial appointments with the following psychiatrists

    14,000 R

    Gestalt therapy sessions, 6 sessions

    12,000 R

    Psychologist sessions with Profi-ru

    R 11,7000002 Appointment of the first psychiatrist

    4000 Р

    How borderline personality disorder is diagnosed

    Alexey Pribytkov

    psychotherapist, psychiatrist, candidate of medical sciences

    There are no specific studies in psychiatry that would help to make a diagnosis. In the first place is always the clinical picture, that is, manifestations of mental disorders.

    There is an interesting story with borderline personality disorder in Russia. We still use the International Classification of Diseases of the 10th revision, where in fact there is no such diagnosis, which means that for a long time it was out of sight of psychiatrists. But the absence of a diagnosis in the classification does not mean the absence of violations, because more than 30 years have passed since the adoption of the ICD-10 - it was adopted by WHO in 1990 - and the understanding of mental disorders during this period has noticeably changed.

    Now many modern doctors are guided by other criteria when making a diagnosis. They are most clearly formulated in the American classification of psychiatric disorders DSM-5. Similar criteria are used in ICD-11, which is adopted by WHO and should come into force in Russia in 2024.

    The nine criteria that are specific to BPD are listed above. The task of the psychiatrist is to identify them during a conversation with the patient. The basis for the diagnosis of "borderline personality disorder" is the presence of at least five of the nine criteria. nine0003

    How I was correctly diagnosed and treated

    After many unsuccessful attempts at treatment, I decided to change doctors again and went to a new psychiatrist at another clinic. The first appointment there cost 7,000 R, and repeated appointments cost 6,000 R.

    The drug treatment was corrected for me. And with the final diagnosis, they rushed between bipolar affective disorder, or BAD, and borderline personality disorder.


    How much does it cost to treat bipolar affective disorder

    They are similar in symptoms. BAD also occurs with alternating periods of depression and high spirits, but they are usually long and can last several months.

    In BPD, periods of different moods change over several hours, less often over several days, that is, the mood is constantly unstable. Moreover, these two disorders can occur simultaneously in one person.

    As a result, the psychiatrist diagnosed me with borderline personality disorder. Now, once every one and a half to two months, I go to him to monitor the condition. nine0003

    Since that time, I began to go to schema therapy - this is a therapy focused on making a person change their behavior patterns. I go to a psychotherapist every week, one session costs 6000 R. I feel that it helps me.

    BPD - MSD Handbook

    My maladaptive patterns of behavior that my therapist and I identified at our first meeting. In the lower left corner are the schemes to be achieved

    It is difficult to treat BPD. My doctors never know in what condition I will come to them and whether I will come at all. Meetings are held online from time to time. I am often late, I call specialists from different places: it can be a park or my workplace, a stop on the street or someone else's apartment, a noisy highway or a food court. Sometimes I don't want to see my doctor because it seems that he is wrong about everything. nine0003

    I used to feel disgusted and decided that I needed another doctor: I abruptly go from idealizing a person to hating him. For this reason, many doctors refuse patients with borderline disorder. In addition, people with BPD tend to discount their own problems, so many may not seek help for a long time.


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    Over the years, I have developed several rules for choosing a doctor for myself:

    1. At the reception, they listen to me attentively.
    2. Everything that I consider important is important to a doctor. He should not wave his hand and say that there is no point in talking about something.
    3. The doctor speaks honestly about the diagnosis, does not hide anything, describes the treatment regimens.
    4. I am informed about the drug I will be taking. They explain exactly how it works, why it was prescribed, what side effects.
    5. If I don't like something, I change doctors.

    Unfortunately, there are no rules that help fight mood swings. I try to turn to the facts at such moments and tell the doctors how I feel. Psychiatrists, as a rule, treat the frequent change of doctor normally. I have never faced condemnation. nine0003 One of the latest treatment regimens My prescriptions for drugs, there are a lot of them due to different dosages

    How borderline personality disorder is treated

    Alexey Pribytkov

    psychotherapist, psychiatrist, PhD in medicine

    The main method of treating borderline personality disorder is psychotherapy. It is necessary to achieve a stable result. Medications only alleviate some of the symptoms of the disorder.

    Dialectical Behavioral Therapy, or DBT, has the most evidence of effectiveness in treating BPD. Other directions can be applied: schema therapy, transference focused therapy - TFP. nine0003

    However, medications are also prescribed for most BPD patients. Three groups of drugs are usually used:

    1. Mood stabilizers, or mood stabilizers, are drugs that smooth out emotional fluctuations and help maintain an even mood.
    2. Antidepressants - they help reduce the severity of emotional instability. BPD often accompanies depressive and anxiety disorders, obsessive-compulsive disorder - antidepressants are also used to treat them. nine0060
    3. Antipsychotics, or second generation antipsychotics, are prescribed in low doses to correct impulsivity and aggression.

    The choice of treatment regimen depends on the symptoms of the individual patient. Drug therapy usually lasts at least a year, more often several years.

    How do I deal with borderline personality disorder

    Insomnia. I have suffered from sleep problems since childhood. I tried everything: from hot milk at night to being very tired during the day. nine0003

    Unfortunately, I don't have a universal solution to this problem. I only save myself with pills: psychiatrists prescribed tranquilizers for sleep, now I have an antidepressant with a strong sedative effect - or I just don’t sleep.


    How to deal with insomnia

    Anxiety and panic attacks. It often overtakes unexpectedly and at the most calm moments. Just talking to a friend, I can start twitching my leg, nervously breaking my nails, scratching my skin with my nails, or sticking to my phone. This is also manifested by a rapid heartbeat, trembling in the body, a desire to move, and strong fear. nine0003

    To get rid of this feeling, I knit, switch to TV series, listen to meditation practices, start moving more, turn to metaphorical associative cards or Tarot. Metaphorical associative cards are cards with pictures that you can interpret based on your experience.

    I use cards when my anxiety is about the future. I am extremely afraid of uncertainty, and this is a chance to decide at least a little, albeit somewhat irrational.

    Set of mind maps with questions

    Feeling alone and abandoned. Feels like an unfilled hole in the chest. At such moments, I am sure that I have no one to turn to, no one will help. The feeling that I am alone in the whole world.

    Saves background noise such as a movie or TV series. I also have three cats that periodically ask for attention, and I am no longer alone. During periods when I feel very lonely, my friends help, who, if they cannot come, then at least call or write.

    Sometimes, in order to feel that I am not alone, I look for meetings with different men. I tend to dive into the person who gives me attention, as if I'm trying to close the inner "hole". If I don’t get enough attention, then I show aggression, and subsequently I change the “victim”. I'm trying to deal with this with the help of psychotherapy. nine0003

    Mood swings, anger and aggression. In an hour I can experience a huge range of emotions, it is very tiring. Moreover, anything can become a trigger: an incorrect statement on the part of the interlocutor, just an action that seemed wrong to me, or an opinion that is the opposite of mine. I can be aggressive even to banal questions about my well-being.

    I try to warn people about the peculiarities of my behavior, I leave the dialogue if I feel that I am jumping into aggression, I try to distract myself. My psychotherapist advises to live through aggression and give it a way out: tear a sheet of paper, go in for sports, beat a pillow, shout. nine0003


    10 important questions for psychotherapist Sergey Divisenko

    Changes in interests, hobbies and desires. I don't have one hobby, they are constantly changing. I can't say what my favorite movie or music is. Because today I like one thing, and tomorrow I'm already interested in absolutely polar things. I never know in advance what awaits me the next day.

    Suicidal thoughts and destructive behavior. For the first time I thought about suicide at the age of 14. Then these thoughts haunted me throughout my life. Somehow I lived with a gas leak in my apartment for several months, knowing full well about it. I drown my negative emotions in alcohol. I used to cut myself, but then I replaced this ritual with getting tattoos on my body. nine0003

    Such thoughts are difficult to deal with. Medication, mindfulness and constant support from a psychotherapist help a little. I also sometimes go outside in the cold or take a shower: it's sobering.

    Unstable self-esteem. I need a permanent evaluation from the outside. I doubt whether I am doing the right job, whether I look right if I do not receive feedback from people. Every mistake is a tragedy for me, but from praise I can feel capable of anything. I can spend weeks thinking that I did some wrong action, although it did not suffer consequences. nine0003

    To cope with this, I try to compliment myself, remind myself what I'm doing and why, and look at the results of my work. This does not always work, but here you need to take small steps and learn to focus on your feelings, and not just on others.

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    Communication difficulties. I'm thrown from love to hate. I often conflict and change because of this place of work. In no relationship have I lasted more than a few months, and communication with friends is reduced to a couple of meetings a year. If I feel that I may be rejected or denied something, then I do it first to avoid emotions. nine0003

    Everything that happens is always a disaster: vivid emotions, strong feelings of guilt. If I feel like I'm getting less attention, I'm hysterical. I immediately feel abandoned and abandoned. Considering my peculiarities of behavior, I always try to warn friends and relatives about my condition and tell how not to run into even more negativity.

    How to better communicate with people who have borderline disorder

    As with many people with BPD, the SET-UP method works well for me. There is about him in the book “I hate you, just don’t leave me. Borderline Personalities and How to Understand Them by Kreisman and Strauss. nine0003

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    SET stands for support, empathy, truth - support, sympathy, truth.

    It is important that none of the parts can be thrown out of this communication triangle, otherwise the person with BPD will go into conflict or stop communication altogether:

    1. Support should be expressed in the form of concern in the first person: “I worry about how you are you feel." The main thing is to express your own feelings and sensations. nine0060
    2. Sympathy: "You must be feeling upset." It is important to validate the feelings of the person with BPD. Don't try to show pity or talk about how you feel the same way. Most likely, this is not the case. And the phrase "I know how bad you feel" will only cause ridicule and anger.
    3. Truth: you need to rely on the facts about the situation and not go into accusations. For example: “You quit, you have enough money for a couple of months. I can help by preparing your resume, and you will look for a new job.” nine0060

    UP is understanding, perseverance, or understanding and perseverance. These are goals that both participants must achieve.

    A person with BPD must become aware of the causes of his actions and their consequences. Understand that he influences his life and can change it. He needs perseverance in order not to give up treatment, because any changes are difficult.

    For those close to a person with BPD, understanding is the recognition of a person's feelings and emotions. That is, the acceptance that negative statements and aggression are behavioral features. They need perseverance in order to continue communicating with a person with borderline disorder, not to stop reminding him of his readiness to help, to sober him up and help him find the true cause of events, rely on facts, and not let him focus only on emotions. nine0003


    How much does it cost to support a relative with a mental disorder

    Communication with a person with BPD is always stressful, so people around need to take more care of themselves. It will take a lot of patience and strength to withstand sudden mood swings and maintain relationships.

    The main thing is to understand that it is not your fault and you cannot influence BPD. However, if you remain in a stable state and support a person with a disorder, he will eventually cease to see his relatives as a potential threat, which means that there will be fewer outbreaks of aggression. nine0003

    There is a resource center "Borderline Personality Disorder" in Russia. It is designed for Muscovites, but on the site you can find personal stories of people with BPD, literature on the topic and features of this disorder.

    How much does it cost to treat borderline personality disorder? The psychotherapist told me that we would manage in a year.

    I need to visit a psychotherapist every week, an appointment costs 6,000 R. In addition, every one and a half to two months I visit a psychiatrist, whose appointment also costs 6,000 R.


    How much does borderline personality disorder treatment cost? Since I have severe depressive episodes, I need to take pills for a long time: from the moment my condition becomes stable on the background of psychotherapy, it is another 6-12 months.

    Now about 2000 R per month is spent on drugs. I often change pills, so the cost is approximate. nine0003

    Drug treatment can remove symptoms that interfere with a normal life, and with the help of a course of psychotherapy, it will be possible to go into remission and significantly improve the quality of life. Relapses are extremely rare and are associated with affective states.

    I spend 372,000 R per year for the treatment of borderline disorder

    Treatment Expenses
    Weekly psychotherapist visit 312 000 R
    Psychiatric visit every 2 months 36 000 R
    Medicines 24 000 R

    Visiting a psychotherapist every week

    312 000 R

    Visit a psychiatrist once every 2 months

    36 000 000 000 000 2 24 000 24 000 R

    Is it possible to cure a border personality disorder

    Aleksey Profitkov


    psychotherapist, psychiatrist, MD

    We cannot completely eliminate the symptoms of borderline personality disorder. However, its manifestations can be smoothed out: pronounced negative traits can be corrected, some stability achieved, and social adaptation improved.

    At the same time, the essence of personality cannot be changed, the characteristics of a person are preserved. In fact, the task of treatment is not to completely eliminate these features, but to teach a person to live with them, to clearly understand and manage them. nine0003


    1. Borderline personality disorder is characterized by unstable mood, fluctuations in self-esteem, dependency on the opinions of others, and an acute fear of being alone.
    2. The risk of developing BPD is increased by genetic factors, stress and violence in childhood, and poor attitude towards the child by significant adults.
    3. Borderline personality disorder is usually treated with psychotherapy, but medications may also be needed to relieve some of the symptoms and make life easier. nine0060
    4. It is difficult for close people to communicate with a person with BPD, you need a lot of patience to maintain a relationship.
    5. With the help of a course of psychotherapy, it can be possible to go into remission and significantly improve the quality of life.

    borderline personality disorder - The Vyshka

    The Vyshka

    Today, more and more information about mental illness appears on the Internet. About people with borderline personality disorder, or simply "border guards", write publications such as The Village, Wonderzine, "My friend, you are a transformer." The heroine of our material told what it is like to live with BPD, constantly facing bouts of anger, obsession with others and painful searches for your own “I”. nine0543


    Ever since I was a teenager, I thought that something was wrong with me mentally. The topic of mental disorders was already popular on the Internet at that time, and I began to search for information, check the symptoms of obsessive-compulsive disorder, depression. It was strange: I read that depressive episodes last a month or at least a week, and my attack could last literally 15 minutes. As a result, I forgot about the search, I just accepted that I was inadequately reacting to events. But, of course, I didn’t go to a psychotherapist - I thought it was just such a character. The fact that this is a borderline personality disorder, I began to guess at the beginning of last year. I accidentally saw an article about the symptoms of BPD and just realized that my life was described there - everything coincided. nine0003

    Red mist

    Anger has always felt very strange to me, and when I explained it to others, they did not understand. It’s as if pleasant, like a red mist that fills your head - and you begin to do what anger tells you to do. On the one hand, this leads to terrible consequences. Well, on the other hand, you seem to enjoy this complete madness with some part of your personality, which takes possession of you for some short time. Sadness, grief and shame come much later. nine0003

    Emotional swings

    One of the signs of borderline disorder is severe emotional instability. When it suddenly becomes bad, the picture of the world changes in a second. I can go in a good mood, remember that one of my friends looked at me the wrong way, and come up with a whole story about how they secretly hate me. It just seemed that life is beautiful, but now I already hate myself and others. It's hard to contain, I'm shaking, my pulse quickens, I want to hit someone. This state is called "split". At such moments, I yell at everyone, I want to break off relations with everyone and destroy my life. And then I just see a message from a friend, for example, and it goes away - I generally forget about anger. And so all my life, these jumps are very exhausting. nine0003


    I went to a psychologist when, after some events in my life, outbursts of anger intensified, there were more suicidal thoughts. I literally stand in the subway every day, look at the rails and think: “I wish I could jump now.” Naturally, in my case, you need to go to a psychotherapist, but it’s difficult to get to a free one. Yes, and if I go to a psychiatric clinic, it seems to me that they will immediately say that I have depression, they will prescribe pills and let me go home. Therefore, I decided to enroll in the HSE Psychology Center, since there is an opportunity to do it for free. In the end, it helped - I felt better. I told the psychologist about my childhood, about the symptoms that prevent me from living. And she realized that it really, most likely, borderline disorder. We outlined a plan for the next meetings, but the psychologist advised me to still go to a psychotherapist in order to rule out neighboring diseases and get a prescription for antidepressants. But I don't have a good idea how to do it. I even thought about going to a psychiatric hospital to take a break from everything and get treated, but it's useless. Well, I will lie down, take pills, how will this help me? nine0003

    Reaction of loved ones

    When I said that I had BPD, my friends took it calmly, but still, since it was a self-diagnosis, no one took it seriously. It was more difficult with my mother: she simply did not believe that there could be something wrong with me: “I have a healthy child, I could not give birth to an unhealthy one!” Already when the psychologist confirmed that I really had BPD, I sent her several articles about this diagnosis. She did not comment on this in any way - I think she is now in the stage of denial. nine0003

    Acquaintances often discount my frustration: "Get up, start doing something, and it will pass!". In principle, the attitude towards people with mental illness in our society is not very good. They do not believe, they say that we all come up with boredom.

    Without past

    It is very common for people with BPD to have a vague sense of identity. It's like you have a bunch of disparate 'I's, and you feel different every moment

    You literally don't know what you like, what orientation you are, what you generally want from life. You easily adopt other people's habits, behavior, interests. It is a huge stress for a border guard to choose something, even if it is just ordering food in a cafe. At such moments, I do not feel connected to the past, I just do not remember what I liked ever before. I get stupor, and I take the same as others. nine0003

    For example, I'm still not sure what exactly I want to do professionally. I may like a teacher, and I immediately think that his subject is my destiny. Then, for some homework in this subject, I get a six and see no reason to continue doing this. Sometimes this uncertainty arises right in the middle of a lecture: “What am I? What am I doing here?". Thoughts about expulsion can be a daily routine, and here it is not clear whether it is necessary to be expelled or just calm down and wait it out. Who will tell me? I should know this, but I don't know myself. nine0003

    Favorite person

    BPD is when you are like an empty sheet, and every person who comes into your life can write something there, whether he wants it or not. There is also the term favorite person, which is used in the English-speaking Internet space. This is the person that the border guard is obsessed with in the first place, whose reaction is most important. In a sense, we rely on such a person as a mirror in which we look for our reflection, we adjust our behavior to his expectations. It doesn't have to be a romantic partner. I once had three such people at the same time. When one of them left me, I got hysterical, and I was afraid that the rest would also leave


    The first person I told about my borderline disorder was my ex-girlfriend. It was pretty funny - she said she suspected him too. As I have seen, border guards are often attracted to each other. Therefore, I got the motivation to learn more about BPD, about how to save relationships, because when you are both border guards, it's generally chaos. You can throw a tantrum over the same bullshit that your partner gave you a tantrum a while ago. And if then you reassured him that these were irrational thoughts, then now you yourself are freaking out because of this. nine0003

    From the outside, it just looks like an idiot, so it is believed that border guards have bright, intense, but short relationships. We usually leave people first because of the constant fear that they want to leave us


    When the emptiness is felt in the chest directly physically, I want to fill it, and I am unhealthy fond of people, I behave abusively towards them. For example, to be jealous of girlfriends for their relationship for me is generally a normal practice. I understand that this is wrong, that it is impossible for a person to have no other life than you. But emotions say otherwise. With romantic partners, this is even more pronounced. nine0003

    The fact that there is no answer to the message “good night” with a heart can cause thoughts that they have stopped loving me, that at this very moment they are cheating on me, and in general, all our relationships are lies

    Plus constant paranoia that they don't really like me, namely they use me. Sometimes it seems to me that my girlfriend really has someone special, and with me she is just taking time or being treated for an injury.

    Self-harm and curiosity

    A very common sign of a border guard is self-harm when they cut themselves. This helps to release aggression, physical pain drowns out the mental. I have never had such urges, and two close friends did it. And I decided to try it too, because it was interesting - I started cutting myself, but in the end I only ended up with a scar for life. But I didn’t get involved in self-harm so much, and it didn’t come to suicide attempts. In general, I did a lot of things in my life simply because others do it. nine0003


    In my teenage years, when I was in a difficult condition due to life circumstances, I became addicted to alcohol. I drank to get away from problems - it seemed that alcohol gave me the right to throw out emotions. It was a tradition: I came to the reception, got drunk with the thought that today I would cry all night, locked myself in the toilet and sobbed out loud.

    Ways to express emotions

    Border guards are more dedicated fans than healthy people - they can forget about themselves by going to other worlds, so they often have an obsession with books, TV shows, various fandoms. Due to the fact that we are often unable to directly talk about our feelings, we do this with the help of imaginary worlds, we associate ourselves with some characters. You need someone to rely on, to express your emotions through others. Many more are prone to creativity - they write poems and songs, because it is unrealistic to keep emotions in oneself. nine0003

    Tips for border guards

    Before, I had no control over the jumps from apathy to anger. And now I'm trying to calm myself rationally, and the thought that helps me is that emotions are temporary. I try to mentally yell to myself that in half an hour my mood will change, I will think about something else. You need to force yourself to be distracted, the simplest thing is to sleep. Or chat with friends on whom the emotional state does not depend much. It helps me a lot that I live in a hostel, and I can talk with balanced people at any time. When I get sick, I ask what happened at the lecture today, we discuss it, and I calm down .

    Such conversations with their normality seem to make me normal

    I also want to advise border guards to save screenshots with nice messages from important people: “I love you”, “I care about you”, and so on. When you freak out, open them and remember that you were not always abandoned and unhappy - there were moments when you felt loved.

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