The term borderline personality is highly evocative, suggesting someone living life on the edge. In reality, borderline personalities are characterized more by volatility than by risk. Emotional dysregulation and impulsivity are at the disorder’s core. Sufferers swing from happiness to despair to fury, often in minutes, and each feeling is vastly disproportionate to its trigger. “Life is like a ship in a stormy sea without a keel,” says New York psychiatrist Frank Yeomans.
If interacting with a borderline is confounding, the condition is highly disruptive to borderlines themselves. During her worst flare-ups, says Debbie Corso, a San Francisco author who also blogs about her disorder, her emotions became so overwhelming they gave rise to physical symptoms. “My head would feel like it was spinning. My breathing would become shallow and my muscles tense. I would get what I describe as a flush of cold adrenaline flooding through my body. The urge was to curl up in the fetal position and cry until I was so exhausted that I wanted to sleep.”
Although BPD has long been ascribed to problematic parenting, scientists now believe that the borderline personality develops out of a neurobiological flaw. Borderlines exhibit a highly reactive limbic system in conjunction with a decreased capacity for cortical control of it, reports Mayo Clinic psychiatrist Brian Palmer. Vulnerability to the disorder appears to be inherited in the form of a tempestuous temperament, although early caretaking in some way seems to activate it.
The condition may not manifest until adolescence—often with self-cutting, burning, or frank suicidal behavior—but it begins long before. “As children, they are hard to parent,” says Palmer. In the absence of exceptional parenting, they never achieve self-regulation or a stable sense of self and never learn to tolerate any distress.