Emotionally unstable personality disorder (EUPD)

Emotionally unstable personality disorder, EUPD, or Borderline Personality Disorder as it is also called, describes the problems you experience if you are emotionally unstable, anxiety-ridden and have a pattern of self-destructive behaviour. If you have EUPD, you may get into a borderline psychotic condition where you experience extreme doubt in yourself and others. You cycle rapidly between moods, and may move from despair to euphoria in a very short time. It’s common for you to feel extremely bad, and to feel a great deal of shame if you have these problems. But you are not alone, and there are specialised treatments for EUPD. There is also a lot that you can do on your own to feel better.

When you have EUPD, it is very difficult for you to manage feelings of abandonment, anxiety or anger, and it is common for you to harm yourself in various ways, either physically or mentally. Your self-confidence may be okay sometimes, only to plunge into deep self-hatred the next minute. Many people with EUPD describe a feeling of emptiness and identity problems.

If you have EUPD, you may have difficulty trusting and feeling secure in close relationships, and you may frequently swing between admiration for the people closest to you at one minute and contempt for them at the next. This can make it difficult to maintain relationships in the long term.

It’s common for you to “self-medicate” with alcohol or drugs, or to develop eating disorders or engage in self-harm.

How do I know that I have EUPD?

According to the criteria, you should have at least five of the following symptoms:

• An intense fear of abandonment.
• A recurring feeling of emptiness.
• A confused or unstable self-image.
• Sharp fluctuation between different moods: Strong irritation, fear or depression that may last from a few hours to a few days at the most.
• Stormy relationships that swing between intense admiration and extreme contempt.
• Intense, heated anger that is disproportionate to whatever triggers it.
• Short-lasting, excessively suspicious ideas or temporary feelings of detachment from reality.
• Impulsiveness that leads to abuse of drugs, sex, food or money, for example.
• You harm yourself, have suicidal thoughts, talk about or plan to take your life.

Even if you feel these symptoms apply to you, it’s not certain that you have EUPD. You need a professional evaluation to find out whether you have EUPD. It’s important to rule out other causes for your symptoms.

What is the cause?

Many people with borderline have had an extremely traumatic or chaotic childhood. Some have been abused. But you may have EUPD even if you had a secure childhood without any clear traumas.

What sort of help can I receive?

If you have EUPD, you may receive treatment in the form of group or individual psychotherapy. There are several forms of therapy that have proven to be effective for EUPD. Dialectical behavior therapy (DBT), Mentalisation based therapy (MBT) and Schema therapy are some examples. You may also receive treatment through medication.

You have the right to receive information about existing treatment alternatives, and to have the chance to actively participate in your treatment. It’s important for you to be motivated and to feel trust in your therapist.

If you have sought professional help in the past but didn’t think that it worked, don’t give up. Seek help again. Research has shown that the type of therapy is not what determines whether a treatment is effective; rather, it is the trust you have developed in your therapist.

It often gets better

It’s not uncommon for you to have other diagnoses in addition to EUPD, such as ADHD or bipolar disorder. As with these other diagnoses, life often improves over time as you understand yourself better and can explain