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Impulsivity and Borderline Personality Disorder


Continuing my series of Mental Health Monday and BPD DSM IV diagnostic criteria posts today we look at Criteria 4

4. impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

source: BPD Today

*Warning* Do not read this post if you are disturbed by discussions of sexual promiscuity!

I have covered many of the elements of this criteria my earlier post about self-harm (What is Self-harm?) where I listed a number of self-harming behaviours to demonstrate that ‘cutting’ is just one of many forms of self-harm, and not necessarily the most dangerous of them.

Now I’m going to look in more detail at impulsivity and how I am affected by this particular criteria…

The DSM criteria explains that to meet this criterion an individual will exhibit at least 2 areas of impulsive self-damaging behaviour NOT included in criterion 5 – which refers to suicidal intentions and self-mutilation.  So to be diagnosed with BPD someone could be exhibiting any combination of two or more of the following (although this list is not exhaustive, there are other impulsive behaviours one could be exhibiting that are not listed here)

  • gambling
  • substance abuse
  • driving recklessly
  • irresponsible spending
  • engaging in unsafe sex
  • binge eating

For me the impulsiveness has touched on a number of these and other behaviours. Examples of how it has affected me in it’s simplest (least harmful?) forms are:

Behaviour Results
Binge Drinking Hangover, hospital/paramedics
Spending Same item (clothes) in EVERY available colour, large credit card bill
Binge Eating Weight gain, nausea
Substance Abuse Seizures

But by far the largest impact has been with engaging in unsafe sex.

To be honest I kind of expect a few hate mail/nasty comments as  result of this post as I know how a lot of people feel about people who cheat in relationships.

Of course this is a difficult subject for me to talk about, as it has involved other people (who shall not be named) and it has impacted on relationships.  The truth of the matter is that my BPD impulsivity has made me cheat in relationships and clearly talking about that, never mind any of the other implications, proves awkward and brings old wounds to the surface…

Still, the whole point of this blog (in particular the BPD) posts is to be honest and provide information that may help people understand BPD better; so talk about it I must.

Now let me just point out that not all BP’s will cheat on their partners, and also cheating on a partner is not a wholly BPD experience – people do it all the time without BPD as an excuse/reason.

For me it is about several things

  • An unusually high sex-drive
  • Abandonment issues (criteria 1)
  • Craving inappropriate attention, excitement
  • Crisis – especially triggered by boredom phases, abandonment and many other emotional triggers (criteria 6)
  • Feeling unworthy, unwanted and general low-self esteem that makes any level of attention so much more than it may really be (criteria 2)
  • Self-harm (criteria 5)
  • Identity (criteria 3)

I’m sure that is not an exhaustive list, but those things are part of why I can go off the rails with impulsiveness. As you can see they mainly relate to other BPD criteria as well – as all these things that make us BPD are a package that is hard to separate into it’s constituent parts…

Most of all though I think it’s about filling the emptiness that I have in me (the subject of the next of my DSM IV criteria posts, criteria 7 ).

Okay I can see I’m struggling with this as I haven’t really explained much yet have I!?

Let’s try to get this down…

So, whatever the underlying cause (another of the BPD symptoms) I will be feeling high levels of frustration; with myself or my partner or both, or I will be feeling bored, numb, empty.

These feelings, unchecked, will grow creating a desire to ‘do something’ anything to relieve the intense feelings – or to ‘feel’. This may lead to self-harming, but that may not be enough.

What starts as an innocent night out (as many are) can be overwhelmed by these feelings and knowingly or not ‘crisis mode’ will have kicked in with a massive desire to be outrageous, ‘have fun’ and indulge cravings for excitement. Reckless behaviour begins, heavy drinking and heavy flirting – with people I know or strangers – begins.  This can still be harmless, nothing has to happen, no harm need be done… but sometimes things go to far…

Nothing but an empty house to return to, now feeling sexually needy, the flirting grows. Like a teenager with no ties, obligations or concerns, all that matters is here and now.

Pubs and clubs close, not wanting the night to end an invitation is extended – ‘let’s go back to mine, drink some more’. People dwindle away until eventually there’s just the two. Me and this guy (he may be a friend or a guy I’ve met that night), we go back to my place. The thrill is everything… desire, feelings, passion all heightened to extremes.

The inevitable occurs – no consideration of protection, ‘hell,’ the mind says ‘It’s not like you can get pregnant’. Sometimes it can be wild, rough and dirty, which just increases the level of enjoyment – things that you shouldn’t enjoy, wouldn’t normally do, hurting and being hurt – all part of the self-harm cycle.

Next morning, everything is the same as it was before – you need more, that was awesome but again, again, but that isn’t happening, it’s over done. Then the guilt, self-hatred and feelings of abandonment kick in again – a vicious circle. You may or may not want to see this guy again, but that experience – the excitement of the ‘first time’ is something you want, need to relive time and again.

But life goes on, you have to return to reality, and nothing has changed – all that has been achieved was a brief reprieve; on top of which you now have the concern’s of discovery. Sometimes you just outright admit what you have done, other times you just leave it, say nothing and hope it will never be questioned. You know that if asked you would admit it straight away, lying is not something you are capable of (except by omission) so if questioned you spill you guts, that’s what you do. Until then it’s another dirty secret in your closet. Until the next time…

Such behaviour can be addictive, hence the repetition. It may be about needing to feel ‘good’ about yourself or to ‘get even’ with your partner for real or perceived injustices, mistreatment or abandonment of you.

There may be warning signs that precede an impulsive episode – extremes of emotion, separations in a close relationship (perceived as abandonment) or there may be none. Either way it can be very destructive and make a crisis period worse as more emotions (the very thing we were struggling with in the first place) are triggered. Then it can also lead back to other criterion, such as unstable relationships – idealizing the ‘one-night stand’ guy, becoming the obsessed freak chasing a repeat performance; devaluation of your partner who is no longer your idol.

Regardless of the outcomes; which are almost always negative for the BP, the whole cycle begins again…

According to everything I have read about BPD to date impulsivity is one of the strongest markers of a poor prognosis for recovery from BPD – not a good sign for someone like me, for whom impulsivity is a major factor in her diagnosis and ongoing problems. Yet, even promising myself to fight it is not enough, like with other forms of self-harm – the compulsion is just too strong to ignore sometimes :( I guess that is why I have this diagnosis! And of course then that plays into my feelings of being undeserving of my partner – unable to reassure him I will not cheat again; I told he as fairly and honestly as I could I will try but I will not make a promise I cannot necessarily keep – what more can I do? I gave him plenty of opportunity to break it off, especially given the weight of this burden – why would anyone want to stay with someone who may repeatedly cheat on them? :’(

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40 comments on “Impulsivity and Borderline Personality Disorder

  1. Thought that you would want to scan Brodie’s book, Virus of Mind
    In many cases, we were hypnotized on our thinking……it is interesting reading.

    I will read this when I have more time. When I worked at a homeless shelter, I had discovered that many mh residents DID NOT attend discussion goups. I thought that would help someone.
    The mental health programs seem to have money, but not much success with patients. Am I wrong?
    Hello World!
    Tenn Man…

    • Thank, I will look up that book! I don’t have access to any MH support, groups or otherwise, but would gladly attend if I did so long as I was finding it helpful. I’m not sure how successful these programs are due to not having accessed any, but I suspect they are not very successful for a variety of reasons… :/

    • My boyfriend may have BPD and I am really trying to understand. Do research, and be helpful and understanding. I give credit to people whom do have the disorder, ALOT!!! I’m hearing of very Strong and Amazing people who have been treated rotton and shouldn’t have ever had to endure it. I honestly think he has cheated on me already. I’m hurt, but I dont know and I dont want to assume or blame. I myself used to abuse my self sexually, sleeping around and I did it because I was empty. I never did so in relationships, but def put myself in harms way with drinks and out of control flirting. But point being, I hope I can ask-I want him to feel safe. I wont leave if he did, I just need honesty and trust between us. Any advice or reccomendations? Two Doctor’s mentioned to him, that he has it.

      • Hi Lindsey, sorry to hear of your concerns about your relationship. I think that the best thing you can do is try to talk to him without, like you say, assuming or blaming. You say he has been told he has BPD – does he accept this and want to get help and deal with it? or does he not agree and not want to sort it out? His attitude towards BPD will have a big impact on how things will be, both for him and your relationship. If he does not accept the diagnosis and wont get help it will be very difficult for you both, it will be difficult even if he does get help but if he does get help at least there is more of a chance of things being okay. I wish you both all the best and hope things work out okay for you x

  2. I know that you know, but just felt like reminding you that you are not alone in this, I obviously struggle with this a lot as well. Toast and I actually had a conversation last night that included my saying pretty much the same thing, I can try, but I dont know that it will never happen again. Anyway, my thoughts are with you.

    • Thanks Gypsy, I know there are probably lots more of us with this issue, but very few seem to talk about it – it’s more ‘taboo’ than all the physical self-harm stuff; strange but I guess people don’t like ‘cheats’ and by writing about this we are admitting to being exactly that – with the added point that it is likely to happen again (proving the old saying ‘once a cheat always a cheat’) a sure fire way to make people dislike us :( xx

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  4. This article does a really good job of describing the life of BPD patients. If BPD patients are interested in learning more about treatments such as passive response choices which can help you better communicate with others I suggest they visit http://OnlineCEUcredit.com/edu/BPD-tf. Hope the site is helpful.

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  9. yet again right on the button
    with me as you are aware probably it is my stepdaughter who has bpd and i can at least 3 of the six impulsivity issues you list she has done

    identidy issues
    feeling worthless/useless
    abondoned
    partly living in a non reality world or though to her it was real enough
    self harming
    attention
    it goes on and on but again you are spot on
    mike

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  14. This article is a spitting image of what i have gone through and what i have done over the last couple years.. nice to know im not alone. for the longest time i thought i just had commitment issues alone but realized i have many other symptoms of borderline personality disorder..recent drug therapies failing, doctor not wanting to refer me to a psychologist right away is only making matters worse. This is going to be one long road to recovery because this is obviously a very misunderstood disorder in society, people think im just coming up for excuses for all my self harming and impulsivity/cheating. it hurts but i know i will soon get the proper help i need..i was just wondering what steps you have been taking to help with the empty/abandonment feelings that cause this?

    • Hi, thanks for your comment. To be honest I still have a long way to go myself, mainly I have been talking about the issues in therapy, but it takes a long time to move from recognising them to being able to deal with them either in the moment or plan in advance how to handle things likely to stir up these feelings. I hope you get the help you need, I am still waiting…! :/

  15. I have been studying BPD for a little while now and more than certain my wife has it. We are currently separated and she is dating other guys if not more. It has been hell on me to say the least. She constantly lies about it among other things. Do I need to bite my tongue because I’m ready to just be straight forward with her as it is not ok? A non-BPD partner should not put up with this.

      • Thanks Showard76! I tried to tell her, but she was looking at me with empty eyes and after blamed me in everything: that she don`t want anything between us, that I should find other girl, that she doesn`t understand me and can`t talk with me at all (will call you when I can).
        I love my ex, but after this I understand that should just move on. Without therapy – she will not change (she doesn`t want to hear about it)!

      • I think moving on is the best course of action, while it may be difficult to do so in the long run it will be best for you. I hope one day she will get the help she needs (and want it!)

  16. My ex girlfriend has BPD and she told me: I need you in my life, you are very important to me, I like you so much, and I think you are great – but I don`t feel anything… When we went out I saw her trying to hit on other girl…
    What would you think?!

  17. I am not sure but I am starting to really think I have BPD. I just recently had an “episode” just like this article describes. I sometimes get these high intense feelings to flirt and I don’t think of the consequences after. First it’s a few drinks and some innocent flirting.. I have taken a bunch of tests online for BPD and they all come up that I have it. I’m married and this flirting kind of behavior, and many others of BPD, have been going on for a long time. Now that I think I know what is going on with me, I feel lost in my marriage and not sure what I want to do. I’m afraid of my husband leaving me if he knows what I truly am. Thank you for writing this article. At least now I feel I am not a lone.

    • Hi, thanks for sharing, if you feel you need help with your problem it may be worth talking to your doctor and asking for a referral for therapy to help you learn to control the emotions better. You are not alone that much is certain! Good luck whatever you decide :)

  18. Thank you very much for this very honest and open article. I can understand how hard it could have been to write. I have only recently had a BPD diagnosis but reading the above account I recognise 15 years of regrettable behaviour. Thank you for this as I have found it useful in understanding and coming to terms with my own behaviour

  19. Thank you for sharing. That was highly informative.

    I have been married to someone with BPD for 14 years. We have two young girls (age 7 & 8) At first it was not so bad but over the last 6-7 years it became horrible. Her drinking became so bad that she was convicted twice for child neglect / abuse.

    We separated several times over the last 3 years, with me getting the children each time. Each time she would make amends and we would try again. And each time she would do somthing that would cause our split — the last time she attempted suicide ith our children nearby and was involuntarily institutionalized). Each time this has happened I have reached out to her and tried to help her get on her feet and be a productive functioning member of our family.

    In the last year-and-a-half she cheated on me with at least a dozen different men and each time promised it would stop. We have quarreled about this and I have let it go saying to myself that’s its only sex and that it would eventually stop (or hoping it would)/

    About 2 months ago however she informed me that she no longer wanted to try to make our relationship work and wanted to move on in order to “find herself”. She even told me that if this meant she could not see the kids again, so be it. Or as she put it “I wish to find myself so I can be there for the kids in the future”.

    After she told me this she began to date like crazy. Within a one month period I counted like 10-12 men she had been intimate with. Not only was she engaging in risky unprotected sex (anal etc) she also told me that she had begun to do things like rape role play and heavy BDSM. After 3 weeks she met someone and told me that they were exclusive and serious. However no sooner did they become “exclusive” then she began to cheat on him as well. It was like she wanted to self destruct. Now he has supposedly left her to be with his ex and she is bummed. But not enough to stop being intimate with others. By my count she has slept with over a dozen different men this month alone! Even worse is that we live in a small town and some of her behavior (ie aggressive flirting, intoxicated and acting very inappropriately in public etc) is giving her a very bad reputation (and me and our kids by association). She tells me that some of the issues that trigger her behavior are boredom, a recently re-discovered high sex drive, feelings of loneliness and inability to deal with rejection, huge impulse control issues and finds the dangers involved in he risky behavior to be exciting.

    What’s even worse is that during this whole time all she does is demonize me to all of these strangers. Just two months ago she was telling me that I was the most important man in her life and she would love me till the day she dies. Now she calls me abusive and controlling. And she is so venomous towards me whenever we speak on the phone. I have just had to break off all contact. For the record though I have a masculine exterior I am a firm pacifist and have never abused or hurt her in any way.

    I think part of my problem with her was that I actually tried to get her help for her BPD and substance abuse issues. I learned the hard way that if you try to help someone with BPD with issues of self-image and impulse control even though they will tell you that it is appreciated and thank you, inside they will feel resentment towards you. in the end they will lie and deceive others about your actions to justify there behavior. For me this constant lying and manipulation was the absolute worse thing emotionally.

    And for the record she was severely abused as a child. She has a history of self harming herself. Has attempted suicide on two separate occasions.

    I want to make clear that people with BPD are not evil or horrible. Rather they are decent human beings who have some type of chemical / behavioral imbalance that makes them act in horrible ways. Some like my wife know what they are doing is wrong (as she has told me countless times in the past) but just don’t know how to turn it off. When they are sober and sane they are actually wonderful human beings.

    So now I am at a crossroads and don’t know what to do for her. Because I have two children with her its not as easy as just getting up and leaving. Presently she cannot see the children unsupervised and it is highly unlikely (like zero chance) that she will ever get to see the children unsupervised. Anyone have any suggestions as to what I should do?

    • Thank you for sharing Jay, I can see some similarities with your description of your wife and my own behaviour. I have at times described the out-of-control aspects as being like a passenger in a speeding car you know is going to crash but you don’t have control of the wheel to stop it someone else does, I am just along for the ride even if I don’t want to be there, watching and waiting for the crash to happen unable to do anything about it! I don’t even need to be drinking to engage in these behaviours just the right (wrong) place where it can occur…
      To be honest I’m not sure there is much you could do for her now, she needs professional help and to ‘want’ to stop these behaviours enough that she is willing to make a real effort to do so. If she is working to get better then being ‘there’ at arms length is probably the best you could do, but don’t let her become too close or dependant on you as while she is like this she will just repeat the cycle over and over, whether she wants to or not. You need to not be involved with her relationship wise, but as the father of her children I can see how you don’t want to and can’ walk away fully. Trying to maintain a ‘civil’ relationship for the children is the best plan.
      Myself, I’m single now and plan to stay this way because then I can’t be hurt but also can’t hurt a partner with my sexual behaviour (which is the main similarity I have with your wife although not as many men in such a short time!) and I fully agree with the things she says trigger this!

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  21. I don’t know if this blog entry is too old for you to comment on, but I couldn’t find another way to contact you. Your notes hit several notes for me that made me want to ask you a bit more. After years of being confused and wondering what the heck is up with my fabulous soulmate (in the first few years anyway) husband, I realized he has many of the markers of BPD.

    He has a very high sex drive as well and when he is home it’s rare for us not to have sex at least once per day, even after 7 years. He has a high profile job that requires him to travel overseas several times a month and he is good looking and extremely well-built. He does have some degree of social anxiety as well in personal (not business) situations though. He likes porn a great deal, but this is the case with many men, so who’s to say where that line is. He doesn’t look at it daily or anything though.

    I caught him last year in a rather innappropriate conversation with someone on Craigs list although he was using a pseudonym and was in a foreign country at the time in a hotel room. On confrontation, he did something that felt exactly like what you were talking about (and it’s not the first time)..he spilled his guts or it seemed that way to me. He told me of other instances that this had happened and that it was about getting admiration and to fill time and emptiness, but he was never going to go through with it. I do believe his many years in the military and what he does now for a living precludes too much unbridled impulsivity though..he would never have made it this far.

    Now, however, whenever he goes on a trip my quality of life and general productivity goes in the dumper, as I’m worrying what he is up to for 3 days? We had a Hepatitis B scare with him recently, although it turns out he was vaccinated military years ago, and not something he’d actually had. Anyway, I’m a bit confused as it seems everyone tells you that BPDs are compulsive liars, and yet it seems to me (and this would be very reassuring to think or know) that the only time he lies, is by omission as you said. Up til now, I’ve been wondering if he is really that tricky and telling me some other stuff is basically a red-herring? OTOH, there have been times when I asked him some unpleasant things that would have been easier for him to lie about and he seemed almost compelled to tell me everything even though it might have made him look bad.

    I also wonder if you treated/treat your husband a whole lot nicer after a transgression, since he is sometimes so sweet and kind with me after returning, and is a complete a-hole others. The incident I’m referring to above, he was being really nice to me before this came to light and now I’m wondering if that’s a sign he’s been up to no good? I know you can’t answer for him, but this ‘do you act better or worse after cheating’ is my second question.

    • Hi Deb (first I just wanted to say I have edited for privacy as requested :) )
      Obviously, I can’t diagnose BPD from this alone, and no matter how much information I have I’m not a professional so still could not do so I just want you to be aware of that… anyway to answer your questions. It could well be that he is lying by omission, but he may also be telling the truth, if only we could read minds hey!? Compulsive lying is actually more of a trait of narcissists, but there is a lot of overlap in symptoms between BPD and narcissistic personality disorder. So, this is probably not very helpful to say but the stuff he says could be a red-herring, or it could be the full truth. Very specific questioning can help rule out lying by omission, e.g not asking ‘did you sleep with someone else?’ but instead being more detailed ‘did you have any sexual activity with anyone else?’ …while you were away… is more likely to result in a true answer if like me he is unable to lie directly, but if he is able to lie then this will not produce a better answer than he would give anyway… As for your second question, personally I am not aware that I treated my partner better or worse after a transgression, to be honest I think most likely I was exactly the same as normal because I would be detached from the two experiences being in any way connected, so that probably doesn’t help much either?

      • Actually it does help, and I appreciate your answer very much. I think you are so brave and as weird as it sounds, listening to what BPD people or recovering BPD people have to say, is in many ways far more helpful than what therapists have to say for me. I don’t know what ‘normal’ cycles are in all this (if it’s anything like most everything else about this thing, it’s probably all over the map) but my husbands cycle’s seem to run anywhere from 4-8 weeks without any problems, and then 1-2 days of ‘issues’. Being extremely tired and/or alcohol will make this worse. Me hanging on to resentment and anger definitely makes an episode last longer.. and me setting firm limits seems to help shorten things.

        As for the therapists I’ve spoke to, I’ve been pretty much advised that I will need to leave him eventually, and to be prepared because he’s bound to get worse with age. This from people who say they are BPD trained therapists! It’s not helpful. Aside from this once-in-a-while craziness, we have a great life and just telling someone to leave the person they love and have committed to seems irresponsible at best to me.

        I asked the last therapist I spoke with if she would recommend I leave him if he came home with a cancer diagnosis or was paralyzed in a car accident? (She had made a comment that ‘No one should have to put up with this’).. I have watched 2 people I loved die long lingering deaths from cancer. No one should have to put up with that either, but if we love people we don’t abandon them because they have become inconvenient. There is lip service to this being not the BPD person’s fault and yet, we are told it is hopeless and to run? (I’m going to qualify this by saying this is only my perception of my situation..not judging someone for doing what they know is right for them!)

        We’ve been together for 8 years and finding out this diagnosis (I have no doubt that he has at the very least strong BPD ‘traits’) has been a relief for me in many ways.. to know that I’m not crazy and that this follows a pattern. I believe there IS hope here and once again, thanks for your thoughtful reply. Deb

      • Glad to help :) I guess therapists can be a bit too clinical and detached at times, as they have not really experienced things for themselves. I think you are right that there isn’t really a normal cycle, it’s different for everyone. Yeah, your experience with therapists is pretty much typical from what I’ve heard, most of the so-called professionals are to blame for the stigma and discrimination around BPD, labelling us as dangerous, untreatable and basically writing us off as a lost cause (when in truth it is poor, inappropriate treatment that is the problem). Things can and do get better, so long as the person wants to get better and can find some good help (not a therapist who will treat them like garbage).
        It’s lovely to hear how you feel about this likening it to not giving up on someone dying with cancer, if only more people could see things this way it would be a better world! and yes, everyone has to do what is right for them, no-one should have to put up with things that make their lives a misery, but some of us care enough to see beyond the problem and have faith in a solution one day coming about :)
        good luck and best wishes to you both x

  22. I’m the exact same way. When I’m not stuck in a downward spiral I’m even actually uptight/prudish, but when I get the slightest hint of uneasiness or discomfort I feel like I have to react. The dangerous consequences just attract me even more. You’re not alone, that’s all.

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