Is BPD An Attention-Seeking Disorder?


Borderline Personality Disorder (BPD) is much more than an extreme attention-seeking disorder. It’s a genuine psychological disorder with many symptoms, some of which involve attention-seeking behaviors. Like all mental health disorders, BPD causes significant problems that prevent a person from having a satisfying life. For this reason, among others, people with BPD are often seen in a less sympathetic light by others.

BPD impairs all areas of life, particularly interpersonal relationships. It’s a wide-ranging condition that involves an inability to control one’s behavior and emotions, highly volatile and unstable relationships, and problems with self-image. People with BPD usually have other mental health issues, like depression and anxiety.

 

What is Attention-Seeking Behavior?

Attention-seeking is common in children and younger adolescents, but in adults, attention-seeking behavior is troublesome and indicative of poor coping skills. In adults with BPD.  

Attention-seeking involves behaviors such as:

  • Bragging and embellishing one’s accomplishments, or making up accomplishments.
  • Saying inflammatory or rude things to provoke a reaction—even if it’s a negative or hostile reaction.
  • Annoying others deliberately or starting fights.
  • Pretending to not know how to carry out a task.
  • Constantly bringing conversations back around to themselves.
  • Often posting one’s troubles on social media, particularly exaggerating their severity.
  • Self-harming behavior or suicide attempts.
  • Inappropriate flirting, inappropriate sexual displays.
  • Manipulating others to get attention.

 

Why Do Borderlines Need Attention?

Attention-seeking is a prominent aspect of BPD, but it’s only one symptom of borderline personality disorder in adolescents and adults. Attention-seeking in BPD is often dramatic and disruptive and originates from a deep need to be validated constantly.

BPD’s attention-seeking originates from the traumas they create. It’s not a character flaw on the part of the sufferer, and although sufferers from BPD are aware of their behavior and its effects on others, they lack the insight and ability to change their ways of behaving.

 

Symptoms of BPD

BPD can begin in childhood, although it typically emerges during adolescence.  Typical symptoms include:

  • A consistent pattern of intense, unstable relationships, often idealizing the desired person, then believing that person is victimizing them, planning to leave them, or is cruel to them.
  • Extreme and unrelenting fears of abandonment. These fears often lead the individual to take drastic steps to avoid rejection.
  • Risky, impulsive behaviors, such as promiscuity, drug abuse, binging, and overspending. People with BPD may sabotage themselves when they’re succeeding, such as doing well at work or cheating on a loyal partner.
  • Self-injuring behaviors, suicidal threats, especially in response to rejection.
  • Chronic feelings of emptiness.
  • Abrupt changes in one’s self-image and identity. Values and goals may change rapidly and individuals lack a set of core beliefs beyond staving off abandonment.
  • Suicidal threats or behavior or self-injury, often in response to a spiking fear of separation.
  • Intense anger or rage with no appropriate cause. Sarcasm, extreme negativity, and physical fighting are common.
  • Rapid and extreme mood shifts.

Manipulative behaviors are plentiful and complex in borderline personalities. Borderlines tend to categorize people in their lives as victims, rescuers, or persecutors, with them typically in the victim role. They manipulate people to rescue them by portraying themselves as the victim of unfair treatment—when they’ve in reality experienced no such treatment. People with BPD most often create disagreements with someone they designate as a persecutor, who is usually innocent of wrong-doing.

Borderline individuals have a profoundly unstable view of reality and other people, seeing situations and individuals in terms of stark black and white. A person they idealize as their best friend, the most kind and caring friend or family member imaginable, can within hours become their most despised enemy.

 

BPD’s Causes

BPD’s causes are not completely understood, but there are many consistencies in the family histories and experiences of people with BPD.

  • Genetic inheritance. Studies of fraternal and identical twins raised separately indicate that there is a much higher likelihood of close relatives having BPD, regardless of how or by whom they were raised. 
  • Neurological conditions. Brain scans of people with BPD show unusually high levels of activity in the amygdala.
  • Traumatic childhood. Many people with the disorder report being sexually or physically abused or neglected during childhood. Further, children who were not abused but were separated from their caregivers traumatically, in situations such as being orphaned or entering the foster care system, also have an increased incidence of borderline personality disorder.

 

BPD’s Effects and Concurrent Disorders

Complications of BPD are serious. The disorder interferes with a person’s ability to have good relationships of any sort with others. Other harmful issues include:

  • Trouble holding a job or establishing a career
  • Legal issues, including jail or prison sentences, from aggressive or violent acting out
  • Inability to get a good education
  • Constant stress in relationships
  • Stress from conflict with others
  • Physical issues related to self-injuring behavior
  • Conflict-filled relationships, marital stress or divorce
  • Abusive intimate relationships
  • Self-injury, such as cutting or burning, and frequent hospitalizations

The incidence of people with BPD to have another psychological disorder is high compared to the normative population. Common co-occurring disorders include:

  • Histrionic Personality Disorder (HPD)
  • Anxiety Disorders
  • Depression
  • Eating Disorders
  • Post-traumatic Stress Disorder (PTSD)
  • Substance abuse disorder
  • Alcohol abuse disorder

 

Treating Borderline Personality Disorder

People with BPD can benefit from psychotherapy (talking therapy). Medication can be useful, but only in conjunction with individual and family psychotherapy. One mode of therapy, dialectical behavior therapy (DBT), is particularly useful for treating BPD.

Dialectical behavior therapy (DBT) helps people redirect their attention to the present moment, a core feature of mindfulness. DBT also teaches people concrete skills to manage their emotions, particularly how to soothe and still anger, fear, and paranoia. For those with BPD, learning how to control intense, overwhelming feelings and irrational beliefs also sets the stage for learning helpful new coping skills.

 

New Approaches to Treating the Symptoms of BPD

TMS is an FDA-approved treatment for depression, in which a physician or clinician uses a magnetic pulse to gently stimulate the areas of the brain that are responsible for mood and emotional control. It’s a rapid, non-invasive treatment that’s carried out in a clinic, requires no hospitalization, and has no systemic side-effects. It requires no sedation and is medication-free.

Studies have shown that the symptoms of Borderline Personality Disorder may improve when treated with TMS.

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.

 

Works Cited

 

Borderline personality disorder. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/Borderline-Personality-Disorder/Overview. Accessed August 24th, 2021.

Herman, J. L., Perry, J. C., & Van der Kolk, B. A. (1989). Childhood trauma in borderline personality disorder. The American Journal of Psychiatry, 146(4), 490–495. https://doi.org/10.1176/ajp.146.4.490

Mattocks, N. (2019, October 11). Borderline personality disorder myths and facts. NAMI. Accessed September 23, 2021, from https://www.nami.org/Blogs/NAMI-Blog/October-2019/Borderline-Personality-Disorder-Myths-and-Facts.

Reyes-López, J., Ricardo-Garcell, J., Armas-Castañeda, G., García-Anaya, M., Arango-De Montis, I., González-Olvera, J. J., & Pellicer, F. (2018). Clinical improvement in patients with borderline personality disorder after treatment with repetitive transcranial magnetic stimulation: preliminary results. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999), 40(1), 97–104. https://doi.org/10.1590/1516-4446-2016-2112

Skoglund, C., Tiger, A., Rück, C. et al. Familial risk and heritability of diagnosed borderline personality disorder: a register study of the Swedish population. Mol Psychiatry 26, 999–1008 (2021). https://doi.org/10.1038/s41380-019-0442-0

Young JQ. Chapter 26. Personality Disorders. In: Feldman MD, Christensen JF. eds. Behavioral Medicine: A Guide for Clinical Practice, 3e. New York: McGraw-Hill; 2008. Accessed September 24th, 2021.





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