Fooling Most of the People, Most of the Time.

July 28, 2010

People who suffer from Borderline Personality Disorder are some of the best actors in the world. They have to be in order to function in the real world. You can’t really blame them. Their fear of rejection/abandonment drives them to keep up the charade. One that includes lies and re-writing history. A BP tells so many “stories” sometimes they don’t know what the truth is.

Therefore it is up to loved ones and those who have intimate knowledge of the BP to determine what is fact and what is fiction.  Remember: the BP always puts their best foot forward. If you go to their Facebook page, they will litter it with photos showing how happy there are. They will blog about how great life is. In public, they will have the most boisterous full-body laugh you will ever hear and see. That is not to say these happy moments aren’t real. But they are only a small part of the picture and are usually exaggerated for dramatic effect.

But if you spend any good amount of time with the BP, you will eventually see the darkside. If not angry outbursts, you will see the deep depression. This is why BPs cycle through friends and go through lovers so quickly. Most people are unprepared for such drama. And any attempt to help is met with hostility. If that helpful person doesn’t leave, the BP will show them out the door.

But if a BP threatens suicide, it should be taken seriously. Especially, if that person has a history of “cutting” (a common BPD trait) or repeated threats. These are cries for help. The following info is issued by the American Psychiatric Association:

  • Monitor patients carefully for suicide risk and document this assessment; be aware that feelings of rejection, fears of abandonment, or a change in the treatment may precipitate suicidal ideation or attempts.
  • Take suicide threats seriously and address them with the patient. Taking action (e.g., hospitalization) in an attempt to protect the patient from serious self-harm is indicated for acute suicide risk.
  • Chronic suicidality without acute risk needs to be addressed in therapy (e.g., focusing on the interpersonal context of the suicidal feelings and addressing the need for the patient to take responsibility for his or her actions). If a patient with chronic suicidality becomes acutely suicidal, the clinician should take action in an attempt to prevent suicide.
  • Actively treat comorbid axis I disorders, with particular attention to those that may contribute to or increase the risk of suicide (e.g., major depression, bipolar disorder, alcohol or drug abuse/dependence).
  • If acute suicidality is present and not responding to the therapeutic approaches being used, consultation with a colleague should be considered.
  • Consider involving the family (if otherwise clinically appropriate and with adequate attention to confidentiality issues) when patients are chronically suicidal. For acute suicidality, involve the family or a significant other if their involvement will potentially protect the patient from harm.

The actual chance of suicide is slim. But if you care about the person, it’s probably better to air on the side of caution. At the least, a diagnosis is warranted. It should be noted that even if a BP threatens suicide, it is not uncommon for them to deny it days later. Friends are often reluctant to pursue such matters for fear of losing their friendship and family often try to keep such things under tight wraps. But both are doing the BP a great disservice by enabling the BP’s denial. Telling them everything is fine and they are OK is the worst thing you could do for a BP. BPD is a serious mental illness and needs to be regarded as such. No joke, people.

Confronting BP about lies.

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