Hi, I'm Dr. Tracey Marks, a psychiatrist,
and I make mental health education videos.
Today I'm answering a viewer question
about what triggers the mood swings
that you can see in borderline personality disorder.
One of the features of borderline personality disorder
that make it look like bipolar disorder
is having wide mood swings.
I compared borderline personality disorder
to bipolar disorder in this video.
But the jist of it is, with borderline personality disorder,
you get quick shifts in moods
that can last hours, or even a day,
whereas with bipolar disorder,
you get shifts in mood states that last
for a minimum of four days for hypomania
and two weeks for depression.
So Parissa asks:
"I have a questions about mood swings in BPD,
"is it always a reason behind it?
"Because my psychologist said to me that there is.
"But most of the time seems like it comes from nowhere."
Thanks for the question Parissa.
I agree with your psychologist,
that with borderline personality disorder
the shifts in mood from high to low,
to irritable to elated, are triggered in some way.
The catch is, the trigger may not always be conscious.
That is, it may not always be identifiable to you
what's triggering you.
Remember, one of the symptoms
of borderline personality disorder
is having a very high sensitivity to feel abandoned
or rejected in some way.
So one of the most common triggers
is something that goes on in a relationship.
For example, a friend can say
"Hey I went to lunch with this friend from work,
"and it was a really great restaurant,
"I think you'd love it."
And you may say
"Yeah, thanks for telling me, maybe I'll go."
But after you get off the phone,
you feel really down, and think
"Yeah, I'd like to try that restaurant,
"but I guess I'll have to go by myself.
"I don't have anyone who wants to take me to lunch.
"How many friends do I really have anyway?
"Why don't people think about me when they wanna go out?"
You start imagining everybody doing stuff together,
and not really thinking about you,
so you spiral down into this self-loathing,
no one cares about me state.
But in reality,
while your friend was out having lunch with someone else,
she was thinking about
how her friend would like this restaurant,
so she's thinking about you,
even when she's having fun with someone else,
but you were threatened by that one statement
that seemed innocent on the surface,
but it made you spiral into negative thinking.
Another symptom of borderline personality disorder
is feel empty, and this an internal vulnerability
that can make you unravel
in the settings of stress, boredom,
or any kind of frustration,
and these are factors that can happen while you're alone,
and does not involve a relationship dynamic.
With borderline personality disorder,
you can experience dissociative symptoms,
like depersonalization and derealization.
With depersonalization, you feel disconnected from yourself.
You can look in the mirror and not recognize your own face,
or you can feel like you're watching yourself
go through the day.
With derealization,
you can look out of a window and see a tree,
and the tree seems like it's moved further away now,
kind of like tunnel vision.
And this can be very disturbing and unsettling.
And these dissociative episodes can just happen,
and then when they happen,
they can make your mood flip from feeling peaceful
to suddenly fearful.
And as a dissociative experience goes away,
you could start to feel better,
and you're back to your usual self.
So within a matter of hours
you went from feeling fine, to panicked.
Another big trigger is memories of trauma.
Many people with borderline personality disorder
have been abused in the past,
maybe in childhood, or young adulthood,
or you may have had a series of
emotionally abusive relationships.
So you can be sitting outside enjoying some sun,
and have a memory of sitting on the beach
with an abusive partner,
and that two-second memory
can make you feel overwhelmed with despair.
There are times that you have a memory of something
that flashes across your mind so quickly
that you don't make the connection
between the behavior and the emotions
that you're currently experiencing,
and something that happened in the past.
Therapy is something
that can help you make these connections,
so that you don't have to be as overwhelmed by the emotions
that seem like they're coming out of nowhere.
If you start by understanding
that the intense emotions do come from somewhere,
then you can learn to accept the emotions,
process them, and let them pass without overwhelming you.
In dialectical behavior therapy,
you learn to do this with lessons on distress tolerance
and emotion regulation,
and there's a lot of strategies that are taught
in dialectical behavior therapy.
Take a look at this video
that I did on managing negative emotions.
Thanks for watching, see you next time.