Personality Disorders: Struggling to Be Yourself? Overwhelmed by Internal Chaos?
By Ashwini Anand (Ash), Clinical Psychologist, Chethana Psychology, Melbourne
Introduction
If you’re reading this, you may feel lost or unsure how to make sense of your emotions and relationships. Misinformation about personality disorders is common, especially about borderline personality disorder (BPD) and narcissistic personality disorder (NPD), which are frequently mentioned in the media. However, personality disorders are varied, and experiences differ for each person. I’ll briefly talk about personality disorders and then focus on BPD, the most diagnosed and often misunderstood.
What Are Personality Disorders?
We all have personality traits, but they become a “disorder” when they cause significant distress or dysfunction in our daily lives, affecting our relationships, work, or self-esteem (American Psychiatric Association, 2013). Personality disorders are long-standing patterns of thinking, feeling, and behaving that are inflexible and differ from what’s expected in your culture. Many people with personality disorders, including BPD, have experienced trauma, especially early relational trauma, which can shape how you see yourself and connect with others (Zanarini et al., 2016; Ford & Courtois, 2021).
Living with Borderline Personality Disorder
If you have BPD, you may have heard people describe it as “emotional instability.” But this label doesn’t capture just how overwhelming and exhausting it can feel. Your emotions might swing rapidly, and what seems minor to others can feel earth-shattering to you. You may long for closeness yet fear abandonment so deeply that even small changes can trigger intense pain. This can make relationships both essential and terrifying, and sometimes your actions done in the moment to protect yourself end up pushing others away. It’s important to know this isn’t about being “difficult” or “manipulative”, it’s about struggling to survive intense feelings and a desperate need for connection (Agnew-Blais et al., 2021; Lieb et al., 2020).
For many, the roots of BPD lie in trauma, neglect, or unstable relationships early in life. This history can make it hard to trust, and even when you want closeness, your fears can make it difficult to let others in. You might find yourself stuck in patterns of wanting connection but worrying you’ll be rejected or hurt, leading to behaviours that unintentionally drive people away (Buchheim & Diamond, 2018).
The Weight of Loneliness
Loneliness can be a profound struggle for people with BPD, leading to a sense of isolation even in the presence of others. Research links this loneliness to emotional pain, self-harm, and difficulty trusting. Reaching out may be hard due to fears of rejection, but remember that loneliness is not a personal failing and deserves compassion (Liebke et al., 2017; Beeney et al., 2019).
The cycle of intense emotions, fear of abandonment, and unstable relationships often causes behaviours that unintentionally push others away. This "push-pull" dynamic intensifies loneliness and makes seeking support harder (Beeney et al., 2019; Liebke et al., 2017).
Stigma Related to Diagnosis and Treatment
You may have felt misunderstood not just by friends or family, but sometimes even by clinicians. Sadly, stigma is common with personality disorders, especially BPD. Some clinicians hesitate to diagnose BPD out of fear of reinforcing harmful stereotypes, and the label “difficult” or “hard to treat” may have been used. This stigma can lead to underdiagnosis, misdiagnosis, or reluctance to seek help, which only deepens feelings of isolation (Aviram et al., 2006; Sheehan et al., 2016). If you’ve had these experiences, know that you’re not alone and you deserve understanding and support.
Overlap and Comorbidity:
When It’s Hard to Find Your Box
If you sometimes feel your struggles don’t fit one neat label, you’re not alone. Many with BPD also experience anxiety, depression, or trauma-related symptoms. These overlaps can make getting the right diagnosis and support tricky (Cavicchioli et al., 2021; Ford & Courtois, 2021). For example, women with autism or complex PTSD are sometimes misdiagnosed with BPD because of similar patterns like overwhelming emotions or trouble in relationships (Loomes et al., 2017).
Treatment and Recovery
You might have heard that BPD is “hard to treat,” but research shows recovery is possible. Therapy, especially Dialectical Behaviour Therapy (DBT), can make a difference in your symptoms and quality of life (Stoffers et al., 2020). Medication may help with mood or anxiety, along with therapy, and especially building secure, trusting relationships, is central to healing. Recovery can be a long road, but you are not alone, and change is possible with the right support.
References
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American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.
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Beeney, J. E., Hallquist, M. N., Stepp, S. D., & Ringwald, W. R. (2019). Borderline personality disorder, loneliness, and social networks: A longitudinal analysis. Personality Disorders: Theory, Research, and Treatment, 10(4), 376–385.
Buchheim, A., & Diamond, D. (2018). Attachment and borderline personality disorder. The Psychiatric Clinics of North America, 41(4), 651-668.
Cavicchioli, M., Movalli, M., & Maffei, C. (2021). The associations between borderline personality disorder, eating disorders, and obsessive-compulsive disorder: A systematic review. Borderline Personality Disorder and Emotion Dysregulation, 8, 13.
Ford, J. D., & Courtois, C. A. (2021). Complex PTSD, affect dysregulation, and borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 8(1), 24.
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Liebke, L., Bungert, M., Thome, J., Hauschild, S., Cording, C., & Bertsch, K. (2017). Loneliness, social networks, and social functioning in borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 8(4), 349–356.
Loomes, R., Hull, L., & Mandy, W. P. (2017). What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 466–474.
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Sheehan, L., Nieweglowski, K., & Corrigan, P. W. (2016). The stigma of personality disorders. Current Psychiatry Reports, 18, 11.
Stoffers, J. M., Völlm, B. A., Rücker, G., Timmer, A., Huband, N., & Lieb, K. (2020). Psychological therapies for people with borderline personality disorder. Cochrane Database of Systematic Reviews, 5, CD005652.
Zanarini, M. C., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G. (2016). The role of childhood adversity in the development of borderline personality disorder. Harvard Review of Psychiatry, 24(2), 104-112.
Disclaimer: This blog post is provided for general information and psychoeducation purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. If you are seeking mental health support or assessment, please consult a qualified health professional.