What does ‘Borderline Personality Disorder’ mean?

Borderline Personality Disorder (BPD) has meant a number of things since the ’70s.

BPD – A brief history

It was first brought to light in 1938 by Adolph Stern. He called those with the disorder “the border line group” – on the border of neurosis and psychosis.

In the 1940s it was described as a ‘mild version of schizophrenia’. Helene Duetsch described it as having an ‘as-if personality’ – that it involved having a ‘plastic’ personality based on ‘mimicry’.

The first research was carried out in 1968 by Roy Grinker. He used 50 hospitalised patients. He concluded that there were different subtypes of the disorder.

Bear in mind, this means that most of the knowledge gained was about hospitalised patients and not those who had not been hospitalised.

BPD wasn’t included in the DSM until DSM-III in 1980; until then it was a ‘mild schizophrenia’. Only at this point was it officially separated into ‘borderline personality’ and ‘schitzotypal personality’.

Around this time there was also lots of research into medications for borderline patients – specifically MAOIs and antipsychotics – and how best to diagnose the disorder.

Interestingly, there was also research relating vivid, realistic and grotesque dreams to borderline patients. I, for one, can relate to this.

Treatment came in the form of Dialectical Behaviour Therapy (DBT) in the early 1990s, introduced by Marsha Linehan. Now, I am probably going to sound old here, but to me 1993 is very recent (in the grand scheme of things).

BPD – what it means today

Since it’s arrival in the DSM in the ’80s, the criteria for BPD is continually updated in the DSM-IV and (most recently) DSM-5.

The DSM-IV, for example, has the widely quoted 9 characteristics of a person with BPD, which can present in any combination.

The DSM-5 is much more comprehensive and removes a lot of subjectivity. I, personally, much prefer this over the 9 characteristics in the DSM-IV (although they do fit nicely in an Instagram picture).

Unfortunately, BPD remains one of the most stigmatised mental health disorders, with some health professionals limiting or refusing BPD patients.

I read recently that it’s been described as the ‘leprosy of mental illness‘. This stuck in my mind as it *so accurately* describes the reaction I’ve received when I revealed my diagnosis.

unstable personality

Stigma stays around BPD as it’s usually used to describe people who are ‘crazy’ – you’ll see this a lot in television and cinema.

This results in a lot of Google searches for things like:

  • Is borderline personality disorder bad?
  • Is borderline personality disorder evil?
  • Is borderline personality disorder dangerous?
  • Is borderline personality disorder manipulative?
  • Is borderline personality disorder selfish?
  • Is borderline personality disorder attention seeking?

Sad face.

Fingers crossed, this will reduce with more research, better definitions, possibly renaming (although not a massive fan of the new option – Emotionally Unstable Personality Disorder) and general open discussions around the disorder.