Identifying Episodes Intense angry outbursts. Suicidal thoughts and self-harm behavior. Going to great lengths to feel something, then becoming increasingly avoidant and withdrawn. Paranoia, feeling as if there is someone out to get you.
Someone with BPD may go to great lengths to feel something, as well as becoming increasingly withdrawn and avoidant during an episode. Paranoid thoughts of everyone being out to get them and hating them are also common during these times. Episodes can also be extreme highs, bursts of euphoria and positive emotions.
Recognizing a BPD Episode
Intense outbursts of anger are indicative of an episode of BPD as are bouts of depression and anxiety. Eighty percent of those suffering from BPD experience suicidal thoughts and behavior while in the throes of an episode as well.
For many folks with BPD, a “meltdown” will manifest as rage. For some, it might look like swinging from one intense emotion to another. For others, it might mean an instant drop into suicidal ideation. Whatever your experience is, you're not alone.
“This can look like poor self-image and excessive self-criticism, feelings of emptiness and instability in goals, values and opinions.” Individuals living with quiet BPD may have decreased levels of empathy, high conflict relationships, clinginess and fear of abandonment, adds Dr. Lira de la Rosa.
While there are no specific causes that would result in quiet BPD vs. typical BPD, it's likely that one's personality or temperament influences how the disorder manifests in terms of outward symptoms or inward symptoms.
When stressed, people with borderline personality disorder may develop psychotic-like symptoms. They experience a distortion of their perceptions or beliefs rather than a distinct break with reality. Especially in close relationships, they tend to misinterpret or amplify what other people feel about them.
Instead, they see something as completely good or completely bad, and their assessment may switch back and forth rapidly. A person typically splits unconsciously or without realizing it.
Lashing out in anger, a hallmark of BPD, often stems from one basic yet intense and overriding fear — the fear of being alone. People with borderline personality disorder often go into a panic or rage when they feel that they are being abandoned or are left alone, whether that abandonment is real or imagined.
Intense episodic irritability or anxiety lasting a few hours or more than a few days). Recurring feelings of emptiness. Frequent intense, inappropriate anger or issues controlling temper. Severe dissociative symptoms or stress-related paranoia.
Auditory hallucinations and paranoid delusions seem to be the most common psychotic symptoms in patients with BPD. Much effort has been made to better distinguish between psychotic symptoms in BPD and those that occur in psychotic disorders, most notably schizophrenia.
Individuals with Borderline Personality Disorder (BPDs) become overwhelmed and incapacitated by the intensity of their emotions, whether it is joy and elation or depression, anxiety, and rage. They are unable to manage these intense emotions.
Separations, disagreements, and rejections—real or perceived—are the most common triggers for symptoms. A person with BPD is highly sensitive to abandonment and being alone, which brings about intense feelings of anger, fear, suicidal thoughts and self-harm, and very impulsive decisions.
People with borderline personality disorder may experience intense mood swings and feel uncertainty about how they see themselves. Their feelings for others can change quickly, and swing from extreme closeness to extreme dislike. These changing feelings can lead to unstable relationships and emotional pain.
A person with BPD may experience intense episodes of anger, depression, and anxiety that may last from only a few hours to days.”
While people with BPD feel euphoria (ephemeral or occasional intense joy), they are especially prone to dysphoria (a profound state of unease or dissatisfaction), depression, and/or feelings of mental and emotional distress.
There's also a lot of anecdotal evidence from other people's experiences that suggest 2-4 years is more common. So, if you want to know how long your relationships might last if you have BPD, it really does depend on the intensity of your condition.
BPD is a very different diagnosis than schizophrenia, though the two can co-exist. While BPD is characterized by a pattern of instability in interpersonal relationships; schizophrenia is characterized by a range of cognitive, behavioral, and emotional dysfunctions.
Between 50% and 90% of patients with BPD report hearing voices that other people do not hear (Yee et al., 2005; Kingdon et al., 2010). Importantly, such auditory verbal hallucinations (AVH) are a risk factor for suicide plans, attempts, and hospitalization (Miller et al., 1993; Zonnenberg et al., 2016).
Approach them very gently when they are in a stable mood. Don't specifically mention BPD if you can help it—just tell them their behavior is worrisome to you because you love them and want them to be happy. Offer your support every step of the way.
To evaluate crying behavior, we used a set of specially designed tools. Compared to non-patients, BPD patients showed the anticipated higher crying frequency despite a similar crying proneness and ways of dealing with tears.
What others perceive as a simple mistake to be brushed off, people with BPD might perceive as a serious wrongdoing. You might hold onto a grudge for days, or until the person has apologized sufficiently.
Dating someone with borderline personality disorder can be challenging. Your partner may have major difficulties with strong emotions, drastic mood swings, chronic fear of abandonment, and impulsive behaviors that can strain your relationship with chaos and instability.