Living with Borderline Personality Disorder: the Truth, the Stigma, and the Path to Healing

Borderline Personality Disorder isn’t just a checklist of symptoms—it’s a nuanced condition shaped by both genetics and environment. From a biological standpoint, we know that people with BPD often have increased sensitivity from a young age. That sensitivity isn’t imaginary—it’s observable even in the brain.

Research shows structural and functional differences in key brain areas for individuals with BPD. The amygdala, our brain’s emotion processing center, may be more reactive. The prefrontal cortex and hippocampus—essential for decision-making, emotional regulation, and memory—may be smaller or less active. These neurological differences mean someone with BPD might feel emotions more intensely and struggle to regulate them.

But biology doesn’t act alone. A major environmental factor is what we call an “invalidating environment”—essentially, a mismatch between a highly sensitive child and caregivers who lack the tools or understanding to support that sensitivity. Maybe you were told “you’re too sensitive” or “there’s nothing to cry about.” Over time, hearing that message again and again teaches a child that their emotions are shameful or wrong.

Without emotional coping skills, that sensitivity can be displaced and misdirected—leading to intense reactions when triggered. People may turn to substances, aggression, or even suicidal thoughts simply to manage what feels unbearable. At its core, BPD is often about trying to cope with trauma and emotional dysregulation without having the tools to do so. That’s why treatment often means learning those foundational skills from scratch.

My own journey with BPD didn’t start with a diagnosis. Like many, I spent years trying to find the right words and labels to explain what I was experiencing—social challenges, emotional overwhelm, identity confusion. Receiving a diagnosis of BPD gave me clarity, a sense of direction, and, perhaps most importantly, community.

That’s the message I bring to my own clients: your emotions aren’t wrong or bad—they just need care, patience, and skill to manage.

I’ve been in therapy for over a decade, and each day I continue to learn about myself. The most meaningful part of this journey has been working with clinicians who see me not as “difficult” or “too much,” but as a human navigating deep emotional pain and learning how to sit with it. That’s the message I bring to my own clients: your emotions aren’t wrong or bad—they just need care, patience, and skill to manage.

If you’ve ever googled BPD or spent time on social media, you’ve likely encountered a lot of misinformation. Let’s set the record straight:

1. “BPD is overdiagnosed.”
   Not true. In fact, BPD is significantly underdiagnosed. Many clinicians hesitate to assign a personality disorder diagnosis due to stigma or misunderstanding. And because BPD is defined by long-standing patterns, it often gets missed or misdiagnosed early on. It’s especially underdiagnosed in men, who may show different emotional or behavioral patterns. So no, we’re not just slapping labels on people—we’re actually trying to catch what’s too often overlooked.
2. “People with BPD are manipulative or just seeking attention.”
   This is one of the most harmful misconceptions. Let’s talk about “attention seeking” first—because what does that even mean? As humans, we all want connection. We want to feel seen, valued, and loved. That’s not pathological. That’s human.

   The word “manipulation” is also loaded. It implies malicious intent. But in my experience—both personally and professionally—what gets called manipulation is often a desperate attempt to be understood. The emotional pain people with BPD feel is real, physical, and intense. If you haven’t been taught how to express that pain in healthy ways, it often comes out in maladaptive behaviors. But the intention? It’s often: “Please, see what I’m going through.”

   I tell my clients, “Your feelings are valid. The behavior might be hurting you—but the feeling is real.” From there, we work on finding new, safer ways to express distress.

3. “They don’t really mean it when they talk about suicide.”
   This is another deeply dangerous falsehood. BPD is associated with one of the highest suicide attempt rates of any mental health condition. And yes, some people with BPD may express suicidal thoughts or behaviors frequently—but that doesn’t mean it’s not serious. Every expression of suicidality reflects pain and deserves compassionate attention.

   I tell clients, “We’re not going to overreact, but we’re also not going to underreact. We’ll find the middle ground.” The idea that someone must be “faking it” only increases shame and discourages people from asking for help when they need it most.

4. “It’s just your personality—you can’t change.”
   

   Yes, your emotions may always run deep. Yes, you may be more sensitive. But you can build the skills to work with those emotions instead of feeling consumed by them.

   This might be the most disempowering misconception of all. Having a personality disorder doesn’t mean you’re doomed. It doesn’t mean this is “just who you are.”

   The truth is, with treatment—especially Dialectical Behavior Therapy (DBT)—people with BPD can change how they respond to their emotions, how they relate to others, and how they see themselves. As Dr. Marsha Linehan, the creator of DBT, teaches: healing lies in walking the middle path—balancing acceptance with change.

   Yes, your emotions may always run deep. Yes, you may be more sensitive. But you can build the skills to work with those emotions instead of feeling consumed by them.

So how is BPD treated? I can’t speak for every clinician, but I believe an integrated, trauma-informed approach is best. First, you need to build safety—both in your surroundings and in your body. Processing trauma requires that you also know how to re-center yourself afterward. That means learning emotional regulation skills, improving sleep and nutrition, moving your body, and developing patience and compassion for yourself.

DBT has been a major part of my healing and my practice. It offers a set of skills across four domains: mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness. But it’s more than just worksheets and acronyms. It’s about slowing down and figuring out which skills actually work for you. Not every DBT tool is right for every situation or person. And for those who first encountered DBT in a hospital setting, it may have felt rushed or surface-level. But when you work with a provider who truly understands BPD, DBT becomes something you can personalize and internalize.

Other modalities can help too. I often integrate:

• Mindfulness-based therapy for cultivating awareness
• Mentalization-based therapy, which aims to help clients take the perspective of others and reduce emotional reactivity
• Somatic therapy to address trauma stored in the body

An integrated approach is appropriate because BPD affects every part of us—thoughts, behaviors, nervous systems, relationships. It also often coexists with eating disorders, cardiovascular issues, and autoimmune conditions. It’s never just one thing we’re treating.

Yes, there is struggle. But there is also beauty.

Some of the most compassionate, creative, and emotionally intelligent people I know have BPD. When you feel everything so intensely, that includes joy. My clients often describe a kind of profound gratitude and awe in their moments of peace and connection. BPD forces you to be aware, to reflect, to find meaning in small victories.

My final takeaway? Shame does not serve healing. Many of us with BPD have developed coping mechanisms in response to trauma. That doesn’t make us broken. It makes us survivors.

As Dr. Marsha Linehan so beautifully says: “You deserve a life worth living.” No matter what you’ve been through, that life is possible.