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Welcome back to You’re Not Alone: A mental health series where we aim to highlight mental health conditions that affect people’s day-to-day lives, and what products, apps, and services they use to make their every day easier. This month, we hear from Clare Mohan, a communications associate who has borderline personality disorder (BPD).
This article mentions depression, suicide ideation, post-traumatic stress disorder (PTSD), and psychosis.
If you’re thinking of hurting yourself or are having suicidal thoughts, please call the National Suicide Prevention Lifeline at 800-273-8255.
You can also call 911 in the case of a mental health emergency.
The woman I am now is not the woman I thought I would grow up to be. I am calm, chirpy, and — I hope — grounded. I live in the English countryside with a small flock of chickens, a rescue cat, and my wife. I work in communications, which isn’t quite fulfilling the dream I had of being a famous poet, but it’s close enough.
The other part of that dream was my underlying belief that I wouldn’t make it to 30. I’m about to turn 31. By the age of 13, I had already experienced emotions at a higher intensity than most of my friends. I contemplated suicide frequently, in a slightly abstract way. Because of these suicidal ideations, I was pretty sure I would never see my 30th birthday.
In hindsight, these were the early signs of borderline personality disorder (BPD). However, I managed to hide the worst of how I was feeling from the people around me. I was relentlessly bullied at school and experienced a traumatic sexual assault when I was 14, but because I maintained a really high-performing facade, I flew under the radar.
It wasn’t until after a mental health crisis in my early 20s that I finally received a diagnosis of BPD. From there, I started accessing the professional support I needed to begin making sense of myself.
I was on a high dose of antidepressants for most of my 20s. It’s taken 2 years, but I’ve been able to slowly wean off of them. I mostly manage my moods and symptoms well, though certain anniversaries tend to trigger “flare-ups.”
These “flare-ups” include symptoms of dissociation and derealization, flashbacks, and strong mood swings, but I’m better equipped to cope now.
Sometimes, I’m still surprised that I’ve gotten to where I am today.
BPD is a type of personality disorder where people have difficulty managing or processing the intensity of their emotions. It’s characterized by mood, identity, and relationship instabilities.
People living with BPD often have an unstable sense of self. That may consist of experiencing a sense of chronic emptiness or having a distorted self-image. This can often lead to impulsive and risk-taking behavior.
The instability associated with BPD means that it can be all-encompassing for people living with it, along with their close friends and family members. It’s often harder to maintain stable, long lasting relationships and friendships, and the intense variations in mood that come with the condition can be exhausting and overwhelming.
For me, it feels that BPD is one of the more stigmatized mental health conditions. Even some mental health professionals view patients with BPD in a negative light, and some even refuse to treat patients with the condition.
But there are various treatment options available that are very effective for those who have BPD, including dialectical behavioral therapy (DBT), an approach that helps people develop key coping skills like:
- distress tolerance
- emotional regulation
- relationship skills
I’m thankful to be at a place in my life where BPD no longer affects my day-to-day life in the way that it used to. That doesn’t mean it’s gone entirely. I often say I live with BPD, or I manage it.
At its worst, though, BPD was my day-to-day. It was all-consuming. My relationship with my wife (my then-girlfriend) was often dominated by my emotions. If she came home late, she’d find me sobbing myself to sleep, convinced she’d decided to leave without telling me.
She once jokingly asked me why I was obsessed with minimalism and decluttering, and if it reflected how I felt about myself. As a result, I spent the entire day in floods of tears because I felt like I didn’t know who I was.
I had a deep, abiding sense of emptiness as if I was fundamentally hollow. It’s very hard to explain, but I felt like I was a shell of a human, not really real.
The best (and oddest) way to describe it is I felt like a chocolate Easter egg: They look solid from the outside but when you crack the surface, there’s nothing underneath. It’s a very alienating thing to experience.
I used to joke that being asked “how are you?” was a tricky question. First of all, I had to figure out who “you” even was.
Throughout my late teens and early 20s, I knew something wasn’t quite right. I was diagnosed with depression and anxiety while I was in university, but I figured I also probably had post-traumatic stress disorder (PTSD) after the trauma I experienced in my early teens.
It was only after a second, deeply traumatic event when I was 22 that I started to seriously think that I might have something beyond clinical depression.
In the immediate aftermath of this event, I went through a short but very dramatic deterioration in my mental health. I experienced disturbing visual hallucinations and started feeling as if I didn’t really exist, or that if I did, I was being remote-controlled by giant robots.
Eventually, I was admitted to an acute mental health unit for a short stay. It was after this that I was finally diagnosed by a psychiatrist.
He was cautious about the diagnosis because many people with BPD often reject the label. It has a strong stigma, and being told that your personality is “disordered” can feel quite shocking. But when I read up on BPD, it was a relief. I had an explanation for what was happening to me, and with that explanation, I could finally get adequate help.
The biggest key to helping me manage my condition was when I started a program called Systems Training for Emotional Predictability and Problem Solving (STEPPS). This is a ‘psycho-educational’ approach that helps participants recognize the underlying triggers behind flare-ups and outbursts. The goal is that you identify the warning signs much quicker and can act on them before you reach a “boiling point.”
After starting STEPPS, I began to adopt a more active approach to managing my symptoms, rather than feeling like I was being led by them. However, I’d definitely still describe myself as “highly strung.” I feel things very intensely, but I’m also fiercer about protecting my own emotional needs and boundaries in ways I never was before.
I would say that I always have my symptoms in the back of my mind. They exist with me, but they don’t rule me. I generally try to be watchful of my emotional state so that I can stay in control. My BPD hasn’t gone away in any sense, but my life is so much smoother than it used to be.
Here are some of my favorite products and apps that help lessen symptoms associated with BPD.
- $ = under $13
- $$ = $13—$50
- $$$ = over $50
This is an alarm clock that helps you wake up more naturally by gently increasing the amount of light in the room, mimicking sunrise. It can also help you wind down before bed with the sunset function, where the light will gradually decrease over a period of about 30 minutes.
I found this on my own after some research. When I am in crisis, my sleep cycle feels pretty nonexistent. I would wake up at 3 a.m., on the dot, feeling wired and anxious, and although I’d be exhausted most of the day, I couldn’t sleep because of my racing thoughts.
The makers of Lumie claim that their lamps help to stimulate the natural production of melatonin to prepare the body for sleep. They also claim to help you to wake up more naturally. With the use of this sunrise alarm, I definitely feel like I wake more gently than I used to, although that can definitely vary!
More recent Lumie models also have different noise settings. When I’m trying to fall asleep at night, I often deal with repetitive, negative thoughts. If you do, too, you may want to opt for a newer version — in fact, I love my current one so much that I may purchase one of the more updated ones. (It’ll probably help me shut my mind off more gently than the true crime podcasts I listen to at night.)
Headspace is a mindfulness and meditation app. it has a range of guided programs and meditation courses on all kinds of topics to help you embrace mindfulness. In addition to guided meditations, the app now includes focus tracks for working or studying, guided workouts, and meditations for exercise and housework, as well as other routine tasks.
I know meditation doesn’t click for everyone; it can be hit or miss. However, I’ve found it to be incredibly rewarding. Even when I’m totally failing to focus, just the act of sitting down every day for 3, 5, or 10 minutes gives me a moment to check in with myself and see how I’m doing. If I can’t concentrate because my mind is racing or my emotions are high, guided meditations can still provide a sense of calm.
Many therapeutic programs for BPD incorporate some element of mindfulness, even if that’s just trying to gently increase your awareness of your emotional state. I find that when I’m in a bad patch, I don’t notice the intensity of my feelings increasing until I reach a point of overwhelm. When I regularly practice mindfulness, I’m often aware of the warning signs much earlier.
With all that being said, it should be noted that mindfulness doesn’t work for everyone. People with a history of trauma can experience distressing symptoms when they explore meditation. If you have any concerns, it may be worth discussing these with a mental health professional before exploring mindfulness.
This is a fairly straightforward step counter. It tracks how much you’re walking during the day to encourage you to be active. It has other features, although I don’t tend to use them. My favorite is the pedometer function.
My therapist recommended that I try to keep active as a way to help regulate my mood. So I try to meet a target of around 10,000 steps a day. It keeps me moving and means I have to get out into the fresh air at least once a day, which tends to boost my mood.
Early on in my journey, I decided to take up running as well, so I used the Couch to 5K program from the U.K. National Health Service. I used to find that I was regularly dissociating and felt disconnected from my body, but walking and running forced me to pay attention to how I physically felt. It’s hard to focus on anything else when you’re trying to get through a 3-mile run.
Running is a coping mechanism that I use as a way to come back to myself. If I’m starting to feel dissociated, putting on my trainers and getting out the door — even if I only manage a mile — brings me back to myself again. It was vital to me when I was struggling to get on top of my symptoms, and it’s even more important now that I use running to help me maintain my mood.
Something I struggle with is the way I consume social media. I have often used it to deal with low moods or feelings of emptiness by being very provocative and aggressive with people online. I wish I could say I don’t do that anymore, but that’s not quite the case.
However, I’ve found that having some displacement activities available can be helpful. I prefer to have a tactile distraction on hand, anytime I need it.
Something like cross-stitch, knitting, or another simple craft can be fun to pick up, and most importantly, once you’ve figured out how to do it, it can be deeply absorbing. I have to concentrate on what I’m making, so I find that my mind slows down and focuses on whatever I’m trying to complete.
If I take even 10 minutes to pause and put in a few stitches or knit a few rows, by the time I return to whatever had upset me before, I’ll feel calmer and more levelheaded about it. And that can often be a good “circuit-breaker” to prevent me from saying or doing something I might later regret.
One of the most common assumptions about people with BPD is that we are likely to be abusive or manipulative. And while people with BPD can — and do — act out in ways that are toxic or damaging, it’s not the case that every person with the condition will automatically act like that. There are a number of horror films and thrillers in which antagonistic characters are revealed to have BPD, which certainly doesn’t help its reputation.
So although it’s not uncommon to find problematic and harmful behavior coming from people with this condition, there’s a lot more to it than that. People with BPD are often living in severe emotional distress.
If you have a loved one with BPD and are struggling to cope with their behavior, hurtful outbursts can be one of the hardest things to deal with. When approaching the person, I encourage you to try being conscious of your own boundaries.
While BPD symptoms might be an underlying explanation for someone’s behavior, it’s not an excuse for treating others poorly. I’m always grateful that my wife felt confident enough to be firm with me about what was appropriate.
I would also advise people to try and be patient and help de-escalate when things are most intense. When my emotional intensity was at a 10 out of 10, that was not the time to discuss whether my reaction was reasonable. With a bit of time, I was often able to reflect, and that was a better time for my wife and me to have deeper conversations about whatever had triggered my emotions.
So, if you’re finding it difficult to cope with a loved one’s behavior and they have BPD, it might be best to wait until they’re calm. From there, you can talk with them about what they might find most helpful when they’re in an intense state. It’s OK to be frustrated or hurt, and it’s important to communicate that to your loved one so they can find ways to handle their own distress without hurting you.
If you’re living with BPD, I hope this article and some of the recommendations I’ve made are helpful. For years, borderline personality disorder has had a reputation as being “incurable,” but that’s far from the truth.
There are powerful therapeutic programs and tools out there that can help make the symptoms manageable again. Many of those programs are hard work and can feel draining — but the tools and lessons learned from them are invaluable.
In the meantime, the best answer I found in the worst of times was to try and find the small things I could do to self-soothe and find some peace for myself.
From grounding techniques to exercise and good sleep habits, if I could keep myself feeling a little healthier and more in control of my daily routine, then that helped me find the energy and resilience to cope with the tougher struggles.