Most people first encounter borderline personality disorder (BPD) on screen: It’s the condition behind Glenn Close’s character in Fatal Attraction. It’s what Winona Ryder’s character was diagnosed with in Girl: Interrupted. It’s what Jennifer Lawrence may have had in Silver Linings Playbook, in which her character’s specific mental health condition went unnamed. The largely unfair stereotype that has emerged of BPD—partially because of some Hollywood portrayal—is that of a crazed, manic, uncontrollable woman.
To learn more about the condition, I spoke to Dr. Barbara Greenberg, who treats BPD, Thomas*, a 32-year-old who dates someone with BPD, and Karla*, a 29-year-old recently diagnosed as borderline.
*Names and details have been changed
VICE: So what is BPD?
Dr. Barbara Greenberg: It’s a personality disorder that’s really all about having very intense moods, feeling very unstable in relationships, and seeing the world in black and white—things are either all good or all bad. People with borderline feel empty, and they are always trying to fight off what they perceive as rejection and abandonment, so they see abandonment and rejection where it doesn’t necessarily exist. They’re so afraid of being alone, abandoned, or left, or people breaking up with them, that they sense it where it doesn’t exist and they need tons of reassurance. I think it’s one of the hardest personality disorders to have. And what’s really unfortunate is that there are males with borderline personality disorder too, but it’s the women who tend to get the label more frequently. I’ve always had an issue with that.
Do more women actually have it? Or is it a cultural stereotype that leads to more women being diagnosed for their emotional behavior?
I think it’s both. I think it’s primarily that women get the diagnosis because when women are upset, they get sad, depressed, and worried. When men have intense feelings, they act it out. They act it out in terms of anger, or hitting a wall, or drinking, or smoking. Women are wonderful torturers of themselves.
How does the fear of abandonment affect their romantic relationships?
When they are in relationships they get very intensely involved way too quickly. Men or women, whatever their [sexual preference] is, tend to really like [people with BPD] at first, because they are very intense, and very passionate. Everything they do is very intense—who is not going to be attracted to that? But then what comes along with it, a couple of weeks later, is: “Why didn’t you call me back immediately?” “Are you out with somebody else?” So [people with BPD] get attached very quickly, give [the relationship] their all, but then get disappointed very quickly. They start out thinking, “I love this guy, he’s the greatest,” but if he does a minor thing that disappoints them, they get deeply disturbed. Everything is done with passion, but it goes from being very happy and passionate to very disappointed and rageful.
How can that behavior affect someone without BPD?
Terribly, because most people aren’t trained to deal with it. They don’t even know that it exists. So eventually [people with BPD] do get rejected by partners because they’re just too intense. And it’s very hard for their partners to focus on other things in their life if their relationship is so demanding.
“Everything is done with passion, but it goes from being very happy and passionate, to very disappointed and rageful.” —Dr. Barbara Greenberg
Is there treatment available for BPD?
Absolutely. There is treatment and usually the women [seek] treatment because of relationship problems leading to depression or maybe self-harm behaviors. Dialectical behavior therapy has a tremendous success rate in treating borderline personality disorders because it basically teaches them a set of skills for them to handle their emotions. [Those with] borderline somehow have the message that every feeling needs to have an accompanying behavior. If [non-BPDs] are mad, maybe they’ll keep it to themselves. We sit with it. But borderlines initially can’t sit with any emotion that is uncomfortable. They have to act on it. So that’s one of the things they learn [to manage]. They learn in DBT how to deal with and sit with negative emotions without acting on them. It’s a very Buddhist zen-like treatment. They’re also taught to “walk the middle path,” like don’t look at a person as all good or all bad, a person is shades of gray. Bad people have good qualities and good people have bad qualities.
What advice would you give to someone who is dating a borderline and wants it to work?
If they want it to work they need to either be prepared to give reassurance: “I’m not leaving you, you’re safe with me.” Or they have to suggest that that person gets some therapy before being in a relationship. Or if it’s too much for them they should get out of there sooner rather than later.
So do you think there’s any hope for the borderlines after therapy to have a successful relationship?
Oh yeah, oh yeah. I really, really do. I’ve seen a lot of them get so much better, I love working with borderlines. Because their emotion is all there, and acting that way is all they know, and then when you show them an easier way to be, and to act, they see how much easier life can be. Absolutely. There’s hope.
VICE: When did your girlfriend tell you she had BPD?
Thomas: My girlfriend didn’t receive an official, medical diagnosis for BPD until a number of months in to our relationship, and the scenario surrounding the diagnosis itself was particularly unpleasant—as had some events which occurred in the months prior to the diagnosis which, considering things now, led to the diagnosis in the first place.
Before you knew the diagnosis, was there behavior that made you wonder if something was amiss?
Before her diagnosis with BPD, I understood my girlfriend to have some form of depression as well as social anxiety, which I believe she still may have in some capacity in addition to her BPD. She had grown up in—and was still living in—a particularly volatile and negative family atmosphere where she was treated quite badly. Frankly, witnessing that firsthand, I believe that if my girlfriend didn’t have some mental illness as a result of it then she’d be a true anomaly. However, many of her mood swings (which of course I can now link and identify with her BPD) before the diagnosis were difficult for me to understand, and for the most part, I assumed it was something to do with me being difficult for her to be with. I didn’t know anything about BPD before my girlfriend was diagnosed with it and certainly had no awareness that my girlfriend had it. I had no real idea of what BPD was before then.
“I see Borderline Personality Disorder as an illness about pain, fear, and struggling to cope with all of that.” –Thomas
How have you educated yourself on BPD?
Since my girlfriend’s diagnosis, I have done some considerable research on BPD, mostly as a means to better understand and to protect her. I’ve done research on the internet and read various articles.
What do you find to be the biggest misconceptions about BPD?
I think BPD is entirely misunderstood (if people are even aware of it at all) and sufferers are seen as “crazy” more than anything else. As a personality disorder, I think it’s seen in much the same vein as Antisocial Personality Disorder or even sociopathy and the likes of that, where it really isn’t comparable to those. There are a lot of nuances, complexities, and lines to be read through with BPD, but mostly I see Borderline Personality Disorder as an illness about pain, fear, and struggling to cope with all of that. It’s almost like a wounded animal, as I see it. But the common conception is just [that they are] crazy, which is an extraordinarily damaging misconception to those who suffer from it. They aren’t crazy, they’re hurting.
VICE: How have romantic partners reacted when you’ve told them you have BPD?
Karla: I am a picky girl when it comes to romantic relationships. I usually only have flings here and there, so I did not deem it necessary to let them into my mental world. One, however, did stick around. During these years I had suffered BPD unknowingly, and then knowingly. We dated on and off for about four years. He knew about my anxiety and mood depression disorders, diagnosed back in 2013 into 2014. When I told my ex-boyfriend Aaron* about borderline, he had zero clue of what it meant, or what it means to live with it or be close to someone who suffers in it. He did hours of research on borderline. Even before this, a year or two ago he had researched anxiety disorders to get a better understanding. It was impressive that instead of him running away in fear, it shed light on many aspects of the not-so-great parts of our relationship. Aaron helped himself comprehend how difficult it must be, and reiterated multiple times that was is in full support of whatever I needed at the time, as long as I was open with him, which I always was—perhaps to a fault.
How do your BPD symptoms affect your relationships?
My BPD symptoms affect my relationships with family, friends, and lovers almost all the time. It would be impossible for me to explain all of the ways my symptoms do, so I’ll give an example. One of my friends was having a get-together before we went to our favorite pub. It was a small party of about four girls and six guys. When I feel as though someone is secretly attacking me, I will get on the defense, become overly emotional, moody, and dramatic, and perhaps will call them out on it. In reality, [they] may have just not been aware whatsoever. In this case, I acted on my symptoms. It was not so much of a big deal as it was an embarrassment for me, to me. I doubt my friend had any idea. Some people with BPD label people as “good” and “bad” friends (black vs. white) when one small thing happens. I have unfortunately done this in the past.
Are you in treatment? Is it helping with your relationships?
I am currently in DBT therapy treatment. When it comes to relationships, I have certainly seen progress, but I cannot wait to see and feel more.
If you suspect you or a loved one is suffering from Bordering Personality Disorder, learn more about treatment options here.
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This piece was originally printed on Vice.com