A Basic Guide to Borderline Personality Disorder

Thrive • June 1, 2021

UNDERSTANDING BPD

Borderline personality disorder (BPD) is typically explained using the Biosocial Model because the condition is influenced by a person’s biology and environment. Individuals struggling with BPD have a biological predisposition that causes them to experience their emotions much more intensely and for a longer period of time than the average person. Their environment can further exacerbate this biological predisposition by being unable to provide the support necessary for them to learn how to manage their emotions.

To people on the outside, it may seem like these intense, prolonged emotional experiences are overly dramatic outbursts. In reality, the individual suffering from BPD is experiencing their emotions at an extremely intense level. If the environment (i.e. family) doesn’t understand what is happening on a deeper level, they may provide invalidating responses like, “I need you to calm down,” or, “Just be patient.”

These interactions can lead to the development of an unfortunate dynamic where the individual understands that their responses are ineffective, but they don’t know how to manage their emotions. Unfortunately, because the environment is struggling to understand the experience of the individual, they tend to oversimplify the solution without actually teaching the individual how to tolerate their emotions.

THE SYMPTOMS OF BPD

Individuals with BPD may:

Become intensely upset by seemingly small causes and stay upset for a long time.
Struggle to maintain relationships. They feel caught between loving and hating a person, but not wanting them to leave.
Feel great one minute, then feel the worst they’ve ever felt in their life the next minute while struggling to remember that emotions are transient.
Engage in extreme behaviors to try to get relief from their emotional pain. Sometimes they may even resort to self-harm as a way to alleviate their pain.
A preoccupation with suicide can also be a symptom of BPD. For example, they may start the day feeling great, then resort to considering suicide because they broke their favorite coffee mug. Oftentimes, suicide becomes the answer to any and all problems that are encountered throughout the day, especially if they are harboring the belief that they are ineffective at managing their own lives.
Engage in a rigid way of thinking called ‘black-and-white thinking’ or ‘all-or-nothing thinking.’ They become trapped between opposites like, “This always happens to me, every single time,” or, “I can’t do anything right.”
Suffer from pervasive self-invalidation of their emotions. In other words, they hide their inner turmoil, fearing judgment or being misunderstood due to their emotions.
BPD can co-occur with other mental health concerns including but not limited to: eating disorders, depression and bipolar disorder.

DIAGNOSING BPD

If you or someone you know is in constant emotional pain and is engaging in problematic behaviors in an attempt to manage or distract from the pain, a mental healthcare provider can offer a screening to determine if a full assessment is necessary.

Because BPD has similar symptoms to other disorders, such as bipolar disorder, it’s important to have a thorough assessment done by a mental health provider. Additionally, BPD can occur in addition to bipolar disorder. For this reason, assessment and diagnosis of BPD can take some time.

Here are some of the differences between BPD and bipolar disorder:

BPD is an issue of how one’s brain is physically wired or formed, while bipolar disorder results from a chemical imbalance in neurotransmitters.
Bipolar disorder can be treated with medication that addresses the chemical imbalance; whereas, individuals with BPD must change their behavioral responses which eventually results in a physical change in the brain. Because BPD is the result of how the brain is structured vs a chemical imbalance, medication is ineffective long-term.
The emotional intensity experienced by people with bipolar and BPD differs in the length of time and co-occurring symptoms. Bipolar results in periods of elation that can last days with a diminished need for sleep, usually followed by an emotional “crash” where the person experiences depression for a week or more. Emotional intensity in BPD is usually shorter in duration and fluctuates more frequently. Bipolar is often fairly cyclical and predictable in that periods of elation, or mania, are followed by periods of depression. BPD can include any combination of all or some of the emotions within a relatively short period of time and is usually related to an environmental trigger.
And… BPD and bipolar can also be co-occurring in which case both conditions need to be addressed.

TREATING BPD

When someone is diagnosed with BPD, usually the next question is, “Okay, so what do I do with that?”

The answer is that BPD is manageable. Attending a Dialectical Behavioral Therapy (DBT) program, which is designed to treat the cluster of behaviors and co-occurring issues that are associated with BPD is the most ideal form of treatment. A DBT program includes attending weekly group therapy sessions to learn DBT skills, as well as working with a therapist individually to finetune and apply the skills.

At its heart, DBT treats emotional dysregulation and the problems that tend to come with it. DBT was developed in the late 1980s by Marsha Linehan. Linehan later disclosed that she, herself, suffered from BPD. At the time, no one really knew what BPD was, let alone how to treat it. After years of hospitalizations and lack of effective treatment options, she began to consider how to pursue life differently which led her to explore how effective people live their lives.

Linehan found that there are four parts of life that are necessary to master, which are taught in a DBT program.

The four modules of DBT are:

Mindfulness: Linehan borrowed from different spiritual and religious practices to teach individuals how to quiet their minds, so they can reside fully in the present moment.
Interpersonal effectiveness: The goal of DBT is to figure out what your life worth living looks like and how to get there. In everyone’s life that is worth living, there are other people involved. This section teaches individuals how to form supportive, loving relationships and how to troubleshoot those relationships when necessary. It also helps individuals realize what relationships are damaging and how to end them.
Emotion regulation: All effective people can regulate their emotions. Regular practices can help keep emotions in a more manageable range, including sleeping enough, incorporating movement, avoiding mood-altering substances, and caring for your physical health. Incorporating pleasant events in your life and actively doing things that challenge you are also important practices that reduce vulnerability to negative emotions. This section also includes information that helps individuals understand what their emotions are, where they come from, and what they are telling them about their environment.
Distress tolerance: After blowing a tire on the freeway, how do you survive the situation without making it worse? This section teaches individuals how to respond to distressing, unplanned events in a way that doesn’t add to the crisis. The distress tolerance section also teaches the skill of radical acceptance which allows us to move on from hard realities, so we don’t get stuck ruminating about whether it should have happened or whether it was fair.

HEALING FOR FAMILIES

One of the unfortunate hallmarks of BPD that often contributes to the development of the disorder is an invalidating environment. An invalidating environment can be dismissive, neglectful, and abusive. An invalidating environment can also be a warm and loving family that doesn’t understand how to support their loved one.

Families with a loved one who is struggling with BPD would likely benefit from professional help. Professional support and DBT skills training can help teach family members how to understand what their loved one is experiencing and ways to reduce unintended invalidation.

For example, a child may suffer from extreme tantrums that have no obvious cause. As a result, parents can feel confused and frustrated with the intensity of the emotional reaction and feel helpless in attempting to stop it. Professional support can help parents to understand what is happening and offer ways to help their child to manage these intense emotions while also managing their own anxiety and frustration. With early intervention, parents can also reduce unintentional invalidation and likely reduce many of the symptoms of BPD over time.

BPD is an interwoven condition. The problems tend to exacerbate themselves, but the solutions also tend to expand on themselves.

LIVING A FULL LIFE WITH BPD

While it is understandable that you would want to “cure” or get rid of BPD initially, this goal is unrealistic and often leads to approaches that prove unhelpful. Adjusting or adopting the mindset of management can be more effective and eventually lead to a positive outcome. BPD does not have to be an overwhelming burden. With treatment and support, BPD can bring a sense of richness to life that would not be possible without it.

Experiencing emotion on such an intense level can be like a superpower. Superpowers can be painful if you don’t know how to manage them or control them. When you experience emotion on a deeper, more intense level than the average person, you also tend to be more attuned to the emotions of others. With time and practice, it is highly likely that you will be able to accurately identify what those around you are feeling, sometimes better than them! And with all the skills and strategies you learn from treatment, you can help others to manage their emotions, too. This emotional intelligence can be an asset in several fields including mental health, social work, management, public outreach, etc. Once you have the skills to manage and regulate your emotions, you can take back control of your choices and be free to pursue your life worth living!

About the Author

SHANNON SERVI, MSW, LCSW — Clinical Lead and Therapist at Thrive

Shannon Servi completed her master’s in social work at the University of Nevada, Reno. Shannon has worked in the mental health field for over a decade, helping people heal from eating disorders. In addition, she has experience working with individuals struggling with anxiety, depression, trauma, intense emotional dysregulation, grief, and substance use. Shannon has training in Dialectical Behavior Therapy, Cognitive Behavioral Therapy, Exposure Response Prevention, and Motivational Interviewing.

It is one of Shannon’s beliefs that our pasts do not have to dictate our future and we are often stronger, more resilient than we realize. Recovery is possible. Healing is possible.

Shannon is a homegrown Nevadan and enjoys sunshine, stand-up comedy, poetry, and quasi-competitive board games. And dogs. She loves dogs.

The post A Basic Guide to Borderline Personality Disorder first appeared on Thrive Wellness.

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The Power of Community: 5 Benefits of Support Groups

January 16, 2025

Support groups serve as a critical resource for those seeking a sense of community while navigating life's challenges. The benefits of support groups extend beyond the mere sharing of experiences; these groups provide valuable emotional support, foster a sense of community, and enhance mental wellbeing. In this blog post, we will explore what support groups are, how to find the right one for you, the various benefits they offer, and specific options available here at Thrive Wellness. What is a Support Group and How Can It Help Me? A support group is an organized gathering of people who share similar experiences or challenges, providing a space to find mutual support and understanding. These groups are safe and confidential spaces where participants can express their feelings, share personal stories, and receive emotional support from others who understand their unique struggles. Support groups are also powerful tools for reducing the feelings of isolation that can come with a challenging or traumatizing experience or being diagnosed with a mental health disorder. When you come together in the clinical setting, you can share experiences and gain unique insights from others. This sense of belonging often leads to improved mental wellbeing, as participants feel less alone in their struggles. Through the shared wisdom of the group and a therapist, members can learn important skills like coping strategies, gain encouragement, and develop a stronger sense of community and support. The collective strength that can come from these shared experiences contributes to personal growth, allowing attendees to thrive in their everyday lives. How Do I Find a Support Group That is Right for Me? Finding the right support group for you is essential to getting the most out of your experience. You can begin by researching local groups that align with your specific support needs and interests. Consider the focus of a group and whether it fits with the challenges you face. Healthcare professionals, therapists, or counselors can provide tailored recommendations and guide you to potential options. It's also important to consider logistical factors such as location, meeting frequency, and whether the group meets in-person or virtually. At Thrive, our admissions process for groups involves a 30 minute meeting with a group leader prior to joining to ensure that you are a suitable fit. What Are the Benefits of Support Groups? Support groups provide a multitude of benefits to help improve your emotional, mental, and social wellness. 1. Safe space for expressing emotions Support groups offer a safe environment where you can express your feelings and share experiences with others facing similar challenges with the assurance of confidentiality. This sense of emotional support is crucial if you are working though complex emotions, hardships, or trauma. 2. Sense of belonging and community Support groups help you to build a stronger sense of community. Through joining, participants can experience reduced feelings of isolation, knowing they are not alone in their struggles. 3. Exchange of advice and strategies Groups are great avenues for sharing knowledge, allowing members to exchange practical advice and coping strategies specific to their shared situations. In addition, therapists guide growth and provide practical strategies to help deal with challenges as they lead support groups. 4. Enhanced coping mechanisms Regular participation in groups can significantly improve your coping skills, enhancing your ability to manage anxieties and challenges associated with your experience or condition. Therapists are trained in teaching their groups effective coping skills specific to their needs. 5. Motivation for personal goals Groups provide a network of support, encouragement and motivation where attendees can cheer each other on in achieving their shared goals. Other group members can hold you accountable in pursuing your personal goals and staying on track with your treatment plan. What Support Groups Does Thrive Wellness Offer? Thrive Wellness offers a variety of support groups tailored to people's unique needs, ensuring comprehensive emotional and mental health support. Each support group is facilitated by experienced professionals offering guidance over the course of a group session. Groups being offered now at Thrive include a Perinatal Mental Health Support Group , a Social Anxiety Skills Group , a Body Image Skills Group , and a Teen Body Image Skills Group . Our admission process for groups is as follows: An individual therapist will submit a referral, then our client experience team will reach out to you to schedule a 30 minute group intake meeting with the group leader to ensure that you are an appropriate fit for the group. From there, you are admitted and scheduled to the group. All groups cost $50 for cash pay, however copays are collected when insurance is billed. Finding Strength Through Connection Support groups offer powerful benefits, making them a vital resource for those seeking emotional and mental support. Whether you are exploring what a support group is, searching for the right one for your needs, or looking into our specific offerings here at Thrive Wellness, the impact of these groups is real. By connecting with those who share similar experiences as you, you can find comfort, strength, and a renewed sense of hope, empowering you to face life's challenges with a team of people on your side.

Winter Blues and Seasonal Affective Disorder: Why Winter Days Can Darken Your Mood and Ways to Brighten Your Outlook

January 9, 2025

Even if you look forward to the ski season all year, can't wait to read a good book by a crackling fireplace, and count down the days until you can frolic through fresh snow, you can also experience seasonal affective disorder or the winter blues. Dreary winter days stuck indoors can make it difficult for many to summon their natural cheerfulness, gratitude, and enthusiasm for life. This shift in mood may be confusing, especially if you're typically captivated by wintertime wonders. As the nights lengthen, days shorten, temperatures drop, and storm clouds block the sun, your mood can darken too. Essentially, the changing patterns of sunlight can disrupt your circadian rhythm (a kind of biological clock that influences your sleepiness and wakefulness patterns) and hormonal balance. Two conditions commonly develop during the winter: the winter blues and seasonal affective disorder (SAD), recently designated Major Depressive Disorder (MDD) with a Seasonal Pattern . Below, you can explore the differences between the winter blues and SAD, and find strategies to boost your mood and reclaim your motivation during the winter season. What Are the Winter Blues? Individuals struggling with the winter blues generally experience feelings of sadness, fatigue, and loneliness attributed to bleak winter weather. Although not considered a mental disorder, the winter blues may cause you to feel like a gloomy, less motivated version of yourself, while still being able to participate in and enjoy daily activities. Symptoms of the Winter Blues Feeling sad or down during the winter months Decreased motivation or energy Changes or difficulty with sleeping Causes of the Winter Blues Cold weather Shorter days, longer nights Decrease or change in exposure to sunlight and vitamin D production Risk Factors for the Winter Blues Lack of connection to community and social interactions History of depression or anxiety Environmental considerations (such as living in a climate that experiences particularly long or harsh winters) What is Seasonal Affective Disorder (SAD)? Also known as seasonal depression, SAD or MDD with a Seasonal Pattern is a subtype of major depressive disorder that interferes with a persons ability to engage in everyday life and find pleasure in activities that typically spark joy. In most cases, a person struggling with SAD will experience depression that begins in the fall or winter and ends in the spring. Less commonly, individuals may experience SAD in the summer, possibly brought on by exposure to too much sunlight that can cause sleeplessness, agitation, and anxiety. Symptoms of Seasonal Affective Disorder Depressed mood or sadness Decreased motivation or energy Hypersomnia (or excessive sleepiness and oversleeping) Eating beyond fullness Weight gain Loss of interest in hobbies or activities that usually evoke happiness Social isolation and withdrawal Increased feelings of agitation or irritability Difficulty concentrating Sense of hopelessness Suicidal thoughts Causes of Seasonal Affective Disorder Decrease or change in exposure to sunlight and vitamin D production, resulting in: Changes in circadian rhythm (disruption to your body's internal clock) Hormonal fluctuation, including imbalances of serotonin and melatonin Risk Factors for Seasonal Affective Disorder History of depression or anxiety Genetic factors Environmental considerations (such as living in a climate that experiences particularly long or harsh winters, resulting in decreased social interactions and activity) Ways to Boost Your Mood During Wintertime You can fight the winter blues and wrap yourself in warmth by incorporating some of the self-care strategies below into your wintertime routine. Eat intuitively. The way you nourish your body is directly connected to your mental health , but shorter days may disrupt breakfast, lunch, dinner, and snack time routines. By listening to your fullness and hunger cues, while also eating an array of foods consistently and adequately, you can promote your well-being including your emotional health. Move mindfully. Allowing yourself the time and space to move intentionally can do wonders for your mind-body-spirit connection. Research shows that mindful movement can help lower stress and anxiety in addition to relieving depression and improving overall mood. Commit to a consistent sleep and wake routine. By going to bed and waking up at the same times every day, you can practice good sleep hygiene , which can help you regulate your emotions effectively and promote overall well-being. Spend time outdoors in the sun. Sunlight promotes the body's vitamin D production and vitamin D is believed to affect the regulation of the feel-good hormone serotonin. By doing your best to soak up the sunshine when it graces the sky, you can help foster feelings of happiness. Maintain connections with family and friends. Loved ones can infuse dismal winter days and long winter nights with laughter, companionship, and a sense of belonging. Participate in service projects and other community activities . Offering your time to individuals in need and enveloping yourself in your community can bring you a sense of purpose, meaning, and connection. Your presence can light up the lives of others, making you feel good in turn. For more habits that create a well-balanced lifestyle and improve your mental and physical health, download our free guide "How to Thrive." Clinical Treatment for the Winter Blues and SAD If your sadness, lethargy, or other depressive symptoms begin to impair your daily functioning or extend beyond the season, we encourage you to speak with a healthcare provider. Licensed professionals can guide you in developing coping skills, reducing your depressive symptoms, and increasing your resiliency and motivation. In some cases, you may be prescribed light therapy or antidepressants to ease symptoms. You deserve to feel wonderful any time of year, and through outpatient therapy , Thrive can help you embrace the winter season with joy. Reach out to us to learn more. This blog post was originally posted December 22, 2021

Instead of Setting New Year's Resolutions, do this

January 2, 2025

Ah, New Year’s resolutions. The moment January 1 rolls around, it feels like everyone is armed with a laundry list of goals: lose weight, save money, drink more water, learn to play a new instrument. While these aspirations might look great on paper, the truth is they often come with a side of unnecessary pressure—and let’s be real, most of us abandon them by February anyway. This year, let’s flip the script. Instead of piling on more goals, how about taking a breath and reflecting on everything you’ve already accomplished? Trust me, there’s a better way to approach the new year without the stress of rigid resolutions. Why Resolutions Often Fall Flat The tradition of setting resolutions can feel exciting, but it’s easy to fall into the trap of overdoing it. We create lists of lofty goals, expecting ourselves to magically transform overnight. But what happens when life gets messy, work gets busy, or we simply don’t have the energy to crush it every day? The result is usually guilt, frustration, and a sense of failure—not exactly the motivational vibe we were aiming for. The problem with traditional resolutions is that they often overlook the importance of realistic planning and self-reflection. Instead of motivating us, they can pile onto the stress we’re already carrying. Give Yourself Permission to Pause Let’s start 2025 differently. Instead of asking yourself what you need to do, take a moment to consider what you’ve already done. Acknowledge the challenges you’ve navigated and the wins—big or small—that brought you here. This shift isn’t about giving up on growth or change; it’s about embracing a more compassionate, flexible approach to your well-being. Reflect on Your Wins From 2024 Before you set any intentions for 2025, pause and reflect on the year that’s just passed. Here are some questions to guide your thoughts: • What were my biggest wins from 2024? Celebrate the moments that made you proud. Maybe it was a professional milestone or simply surviving a tough season. Wins don’t have to be monumental to be meaningful. • What relationships were most meaningful to me? Think about the people who supported you, made you laugh, or helped you grow. How can you nurture those connections in the year ahead? • What surprised me most about 2024? Life has a way of throwing curveballs. Reflecting on how you adapted can help you appreciate your resilience and prepare for the unexpected. • What should I say “no” to? What would I like to say “yes” to? Sometimes, the key to growth is learning what no longer serves you. Saying “no” to draining commitments makes space for the things that truly light you up. • What am I most proud of and grateful for? Gratitude is a powerful tool for shifting perspective. Take time to appreciate the moments, people, and experiences that enriched your life. Start 2025 With Intention The beauty of reflection is that it allows us to set intentions that feel authentic and achievable. Instead of chasing resolutions rooted in perfection, focus on growth, gratitude, and balance. This year, let’s give ourselves permission to start small and prioritize what truly matters. Take a Self-Care Step With Our “Breathe Easy” Guide If you’re looking for a gentle way to begin 2025, our free Breathe Easy guide is the perfect place to start. It’s packed with simple breathing exercises designed to help you reduce stress, refocus your mind, and find a sense of calm—no matter how chaotic life feels. Download it today and give yourself the gift of a fresh start, one deep breath at a time. Let’s make 2025 the year we breathe easier, live more intentionally, and celebrate the progress we’ve already made. You’ve got this!