Disclaimer: Some people may find some of the content of this article distressing. If you are struggling to keep yourself safe, please contact your local ER or a trusted mental health professional.
There is a high correlation between personality disorders and substance abuse disorders. Borderline Personality Disorder (BPD) is one of the most commonly encountered disorders and its key feature is attempted suicide and/or acts of self-harm. While substance abuse is a form of self-harm, it leans more towards self-sabotaging behavior and is not as directly harmful in most cases as overdosing or cutting. Anyone who has a substance abuse disorder can be viewed as self-destructive but it is still different from the self-harm and para-suicide of borderline personality disorder.
Self-harm takes many forms: cutting, burning, self-punching, head-banging, hair-pulling, bathing in bleach (or other caustic substances), overdosing—these are just some of the most common ones. There are many ways that people with BPD harm themselves. Not everyone with BPD will self-harm nor does everyone who self-harm have BPD, but it is common enough for it to be associated with the disorder.
For those who do not self-harm, or who have never felt the urge, these acts can appear bizarre and disturbing. We may want the person to stop or think that they are being attention-seeking. However, for the person with BPD, they may feel that this is the only way they have to communicate their inner pain.
Some people with BPD describe a sense of relief when they cut or a feeling that they’re more alive, rather than the “deadness” or numbness that they normally feel. Others find it difficult to put their distress into words and so they resort to self-harm in order to convey how upset and alone they feel.
People who are diagnosed with BPD have often been brought up in “invalidating” environments. They may have experienced abuse, trauma, neglect or abandonment as infants and so have never fully learned the way to communicate their feelings. They may feel so worthless that they think they deserve the pain that they inflict on themselves.
A significant number of people with BPD will go on to commit suicide, but the self-harm is not always about wanting to end their life. It is more about wanting to end their inner pain, to let others know the extent of their inner damage and to ask for help.
Mental health professionals often find it difficult to understand why someone would inflict such injuries upon themselves. They can then inadvertently re-traumatize the person with BPD due to a lack of adequate training and understanding. But there is hope. Given the right treatment and therapy, there is a good chance of recovery and people with BPD can go on to live more stable and productive lives.
It is important to recognize that self-harm can seem like the only option at times for someone with BPD. This may be the only way that the person thinks they can manage their overwhelming emotions. If you know someone suffering with BPD, all that is required is listening and being there for him or her. Acknowledge their communication for what it is: a way of asking for help.