Keywords: Borderline personality disorder, unstable personality, mood instability, deliberate self harm.
Introduction.
The Fear of Abandonment in Relationships. Is this a form of mental illness to fear being abandoned? How do people with borderline personality disorder (BPD) behave? Do people with BPD have good aspects? What causes borderline personality disorder? How many people have this problem? What are the complications of BPD? Can BPD be treated?
Some people have the problem of forming stable relationships with other people. This instability becomes apparent more during love relationships. So such people may end up marrying and divorcing many times. Many a times this could be due to fear of abandonment in relationships. This is an irrational fear.
This irrational fear of abandonment does not only occur in love affairs, but also in ordinary friendships among same gender. The person is afraid of being abandoned by the people they care about. So they keep changing friends because of this fear. This means that their friendships do not last.
What actually happens is that they would prefer to abruptly end the relationship with the people they care about. They prefer this than to take the chance of the other person abandoning them. So they would rather say ‘I left the person and not that the person left me.’
The fear of being abandoned is it a form of mental illness?
Every human being fears being abandoned because we are social in nature. Even children fear being abandoned by their mothers.
But there are certain people that the fear of being abandoned is so extreme that it affects their social functioning. That is the fear of abandonment in relationships. This occurs more in people with borderline personality disorder which is a mental disorder. It is also known as emotionally unstable personality.
How do people with borderline personality disorder (BPD) behave?
Borderline Personality Disorder (BPD) is a personality disorder that is chronic and pervasive. It is pervasive in the sense that it affects the person in all aspects of life.
Problems with loyalty:
These people have problems with keeping a relationship stable. This is because they have this irrational fear that their friend or partner will soon abandon them.
The fear is there even when the partner or friend shows all the signs of loyalty. So when this fear creeps in they will quickly end the relationship, rather than to be abandoned.
It is important to know that such a person falls easily into and out of love. So they can fall in love with someone they just met and go into a serious relationship with the person. But as easily as they fall in love, they also fall out of love at even an imagined excuse.
Mood instability:
This means that such people have mood instability. The mood instability can also present as depression, anxiety irritability, with all these lasting only a few hours to a few days and change to another mood. So they have mood swings.
Identity problems:
Such people don’t know who they really are and what they actually want in life. So they have poor self image and actually feel empty inside.
Impulsivity:
These people are impulsive in nature. They can get involved in excesses like engaging in risky sex, doing risky driving and abuse substance or do binge eating. They can also do certain actions without thinking, which they may end up regretting.
Suicidality:
People with BPD are at risk of recurrent deliberate self harm and suicide. Deliberate self harm include cutting self with a sharp object like razor blade to allow blood flow out. It is done to reduce tension.
Psychotic symptoms:
Occasionally such a person will hallucinate, especially auditory hallucination.
There also can have paranoid delusions against the partner or friend. The paranoid delusion is where the person has the erroneous believe that the friend or partner is against him/her.
The person can also feel depersonalized. This means that he or she feel not being real.
All these usually occur during times of great stress.
Anger issues:
Persons with BPD easily get angry at the flimsiest or no apparent provocation. And easily go physical with physical aggression and violence.
Do people with BPD have good aspects?
Those with BPD are not all bad. Despite their shortcomings, they also have their good qualities.
Trustworthiness:
Because they know what abandonment feels like they are ready to go that extra mile for a friend. They do this because they don’t want others to feel betrayed.
Therefore, when they make friends they are loyal to their friends through thick and thin, while the friendship lasts.
This means that sometimes, instead of cutting off the relationship abruptly, they will go the extra mile to show loyalty. In so doing, they can easily become dependent on the partner to the point of idealizing the person. But of course this doesn’t last for too long, before they will devalue the person and cut off the relationship.
Compassionate:
Such people with BPD are compassionate and empathetic because they feel what the other person is going through.
They can easily pick up how the other person feels through the person’s body language.
And they are good in listening to other people.
Bold and strong:
Having gone through traumas in their lives, people with BPD turn out fearless and bold. And when they speak, they do so with boldness and directness.
Happiness:
Even though such people can easily get depressed and angry, but when they find a trusted friend they are elated. And they appreciate little acts of kindness.
Creative and resourceful:
In order to keep themselves calm, they are very creative. They enjoy music, arts, cooking, etc. And they have the gift of being able to solve some complex problems because they think outside the box.
What causes borderline personality disorder?
Borderline personality disorder is due to the interaction between biological and psychosocial factors that affect the developing brain.
Biological factors.
Genes:
The risk of getting BPD is due to a combination of inherited genes from parent(s).
But that a parent has BPD does not mean that the child must have it.
Brain structure:
Certain parts of the brain of persons with BPD are smaller in size than in those without the disorder. For example, the hippocampus, amygdala, and medial temporal lobe are the areas of the brain affected. The hippocampus is for memory. The amygdala is for emotions which is hyperactive and not responsive to the inhibition from the prefrontal cortex.. The temporal lobe is for processing information, language, face recognition, etc. Even the hypothalamus becomes enlarged and not functioning well.
Neurotransmitters:
There is shortage of the serotonin receptors at the brain cells. Even the serotonin gene is mutated or has polymorphism. So serotonin neurotransmitter function is affected.
Other neurotransmitters like dopamine and noradrenergic transmissions are negatively affected. Also the enzyme COMT that degrades these neurotransmitters has also the mutated version.
These problems in the brain, causes the irrational fear of abandonment in relationships.
Psychosocial or environmental factors.
Adverse childhood experiences:
These are some of the predisposing factors in BPD. This can include sexual abuse, physical abuse and neglect, verbal abuse, and early parental separation or loss. Also having parents that abuse substances or that are mentally ill is a risk factor to BPD. Adverse childhood experiences are adverse experiences one has while living with the parents.
In short, coming from a dysfunctional home or from a family where there is poor communication are risks factors.
Poor attachment:
Having poor maternal attachment and poor parenting methods, contribute to the development of BPD.
Peer victimization:
Any form of peer victimization during the early years is a risk factor for BPD. These include bullying in primary school years. This is more probable in chronic bullying.
How many people have this problem?
Globally, approximately 6% of the population has BPD. But for patients in psychiatric hospital settings, the prevalence can be as high as 20%.
What are the complications of BPD?
People with BPD have difficulties in forming stable relationships and if married, they can be a high risk of divorce. Even if they remarry, the risk of subsequent divorce is present. They have problems with parenting, also.
Comorbid psychiatric issues are common in people with BPD. So they are predisposed to suffering from depression, anxiety disorders, and post traumatic stress disorders.
There is the risk of abuse of substances such as cannabis, alcohol, cigarette, etc. Also common with such persons are deliberate self harm and suicide.
Can BPD be treated?
Actually, as the person gets older into the late 40s, 50s and above, in age, some of the symptoms starts to disappear. For example, impulsivity will be much reduced. Overall the person seems better because he/she finds ways to avoid some of the troubles that provoke the symptoms.
The first line treatment and the most effective treatment for BPD is psychotherapy. There are different types of psychotherapy methods that can be used. So it is important to first consult with the clinical psychologist.
There may be need for the psychiatrist when a comorbid mental illness is seen. Medications are then used.
Learning parenting skills can also be an advantage to help prevent the offspring getting BPD.
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