State of Mind: Living with borderline personality disorder

WAUSAU, Wis. (WSAW) -- Personality is inherited and molded by our experiences.

A stack of books about borderline personality disorder (WSAW photo)

"Our thinking patterns, our emotional patterns and our behavior," explained North Central Health Care Psychiatrist Dr. Richard Immler. "We gradually develop a pretty stable sense of who we are."

But, borderline personality disorder skews that.

"Folks with borderline personality difficulties can really struggle with that consistent sense of who they are," he added.

BPD affects about one in 50 people, or 2% of the population, but unlike mood or anxiety disorders, BPD deals with the way you think and feel about yourself and others. These emotions are extreme, impulsive and unstable.

"It's like not having an emotional shock absorber."

Dr. Immler said it can be difficult to return to an emotionally stable baseline. It's something Laurie Lanala knows all too well. She's been diagnosed with borderline personality disorder for five years. Before that, there were some diagnoses that didn't seem to fit.

But because BPD tends to co-occur with other mental health conditions, like anxiety, depression and post-traumatic stress disorder, it's one of the most misunderstood and misdiagnosed mental health disorders.

"I started doing better after I got the right diagnosis. It was actually like a breath of fresh air," Lanala said.

There are key symptoms associated with borderline personality disorder. They include extreme emotional swings, impulsive or self-destructive behavior, explosive anger, self-harm or suicidal thoughts, unstable relationships and fear of abandonment.

Lanala said that whenever she gets close to somebody and they go away, she feels like her life is over.

"The anxiety, often around relationships, can be really extreme," Dr. Immler said. "That relationship is so idealized, and then it's as if the bottom drops out. There's a slight disappointment, but intense pain around that."

Lanala described her emotional capacity as that of a 7 year old.

"When I try to describe my feelings, I don't know how to describe them and they are way off the wall."

That's where dialectical behavior therapy can make a difference. It works to identify negative thinking patterns and teach skills to manage painful emotions.

"It's a foundation in validating that the person is doing their best, because often there's a level of criticism of the individual because of their difficulty," said Dr. Immler.

For Lanala, DBT has led her down a positive path and has even helped bridge a support system with her children.

"So my kids know that helps, and it also helps them learn a little bit how to deal with their own feelings."

Dr. Immler said it is difficult to struggle with features of borderline personality.

"But, the hope is that with these evidence-based interventions that people can do so much better. That gives me hope in working with folks, and having seen people relieved of some of that suffering."

Lanala said she has hope for healing each day and that she's never been happier.

"I want to live a better life. And, that's what I'm going to do."

While medication, like mood stabilizers, can be helpful, Dr. Immler said a combination with dialectical behavior therapy is the best approach.