Thriving Amidst Co-Occurring Borderline Personality Disorder and Depression: A Journey of Resilience

Borderline personality disorder is a mental health condition and personality disorder. Like other personality disorders, BPD affects how you see the world, how you view yourself, how you relate to others, and how you behave and react. BPD specifically causes:

• Difficulty creating a self-identity, even feeling empty inside or as if you don’t exist
• Intense fear of being abandoned by loved ones
• Threats of suicide or self-harm
• Unstable personal relationships
• Paranoia and loss of touch with reality
• Impulsive and risky behaviors
• Intense mood swings
• Emotional outbursts

With BPD, you have a hard time being alone and figuring out who you are. Emotional outbursts, inappropriate reactions, and anger make satisfying relationships difficult. You may often feel empty or lost, as if you’re a bad person and that others will abandon you.

Depression is also a serious mental illness. It causes persistent feelings of sadness and hopelessness along with anhedonia, the inability to find pleasure in anything. During episodes of depression, you may also have changes in sleep and how you eat, feel anxious or restless, and have difficulty concentrating. Depression can make you feel worthless and guilty and drain your energy.

BPD is a disruptive, difficult condition, and it often occurs along with other mental health disorders. Many people with BPD also have depression. The co-occurrence complicates each condition and can make symptoms worse.

The experience of depression with BPD has some significant differences as compared to depression alone:

• Earlier onset of symptoms
• More severe symptoms
• More persistent episodes and symptoms
• Episodes more often triggered by interpersonal relationships and conflicts
• An increased risk of suicidal behaviors
• An increased risk of self-injury
• Greater impairment in social skills

Researchers have also found that people with depression and BPD respond less well to medications to treat depression. Treatment for depression is more effective when the BPD is under control or being managed with effective treatments.

3. Reduce and Manage Stress.

Stress only makes symptoms worse, so anything you can do to keep it to a minimum will help. It’s not possible to eliminate all stress from your life, so also practice strategies for coping with it. Find what works best for you: meditation, breathing exercises, progressive muscle relaxation.

Another way to better cope with stress is to practice healthy lifestyle habits. When you feel good physically, you will better tolerate stress and difficult emotions. Get daily exercise, spend time outdoors, get adequate sleep each night, eat well, and avoid drugs and alcohol.

4. Practice Controlling Your Impulses.

Impulsivity is a common characteristic of BPD. You may engage in risky behaviors or lash out at people with little forethought. Impulsive behaviors that you later regret can also trigger depressive episodes. If you can learn to control impulses, you’ll feel better.

Many people with BPD act impulsively because they feel overwhelmed by difficult emotions. To get relief, you may do something you know you shouldn’t. To manage these impulses, you need to learn how to deal with and tolerate the bad feelings.

When emotions build to an intolerable level, pause and assess them. Name your feelings and accept them. It also helps to ground yourself in the moment. Focus on your senses and breathing to calm down. If these strategies fail, try a distraction: Watch TV, call someone, do chores around the house, or anything else that will take your attention away from the emotions you’re feeling.

5. Work on Improving Relationships.

Social support is a powerful tool against depression and other mental health issues. But maintaining positive, mutually beneficial relationships with BPF isn’t easy. Anger, emotional outbursts, threats, and neediness often drive people away.

Be proactive in developing better interpersonal skills and maintaining relationships with the people closest to you. Relationship therapy is useful. It will teach your loved ones about your conditions and how to communicate with you more effectively. You’ll learn practical skills in treatment for questioning your assumptions, not projecting negative emotions onto others, and managing how you interact with people when emotions are high.

6. Plan for a Crisis.

When you’re in the middle of a storm of emotions, you may struggle to do what you know will help or to tell others what you need. Make a plan with loved ones for how to deal with this situation, so they know what to do.

The plan should include a mental health first-aid kit with strategies, coping mechanisms, and objects that calm you and help you bring your feelings back under control. It could include a list of your proven stress busters like a scented candle you like, a favorite book, or sayings that you take comfort in. Whatever triggers calm for you will be ready and waiting if you experience a crisis.

Coping with this difficult dual diagnosis isn’t easy. Living with BPD or depression alone is hard enough, but the two interact and trigger and worsen symptoms. You can live well with complicated mental health issues, but it takes work. Keep up with treatment, even after a residential stay. Use coping mechanisms and the support of loved ones to live your best life.