Unstable Moods in Borderline Personality Disorder

The pervasive pattern of mood instability is the 6th criteria for a BPD diagnosis in the DSM-IV where it states:

6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

source: BPD Today

The unstable moods cut across all the other criteria for a BPD diagnosis as they both cause and are caused by each of the other elements.

Dysphoria is often the baseline state for many BP’s, in other words we are often in a basic state of depression, discontent and indifference.

This state can be disrupted by intense emotions or situations which trigger other moods, even periods of relative stability are actually a shift from the basic state of being for a BP.

For me and probably most BP’s this is difficult to cope with as it is unpredictable and the effects and be devastating.

Most non-BP’s can regulate their emotions, and as such if they are feeling down they can do something about it, if something upsets them they can do something about it, if they get angry they can do something about it…

Having BPD however, we do not have that ability to control and regulate our emotions in the normal sense.

Sometimes the very existence of the mood swing is irrational, with no rhyme or reason for switching from happy, smiley one minute to one foot off the bridge suicidality.

You feel like Jekyll and Hyde and others may feel like they need to walking through a field of land-mines around you forever in fear of tripping off a sudden explosion of uncontrollable intense emotion.

Moods and emotions are overwhelming. The sudden onset of some emotions can spark a spiral out of control… let’s examine how this can happen with an example from my own life.

It started with a text message.

Before the text message I was in a relatively stable state laughing with my partner about something that had happened that day.

Because we had been having a lot of problems with a particular person’s text messages and behaviour in general at the time as soon as I heard the unmistakable beep of his phone receiving a message anxiety kicked in.

I could feel a wash of panic rush through me, my heart was racing, I was physically shaking.

Then the confirmation, it was this person and as usual what they had to say was disturbing and annoying.

Fury raged through me know, why can someone behave like this? how can they say these things?

I went outside for a cigarette, it didn’t help calm me at all, now I was feeling desperate, hurt and like I must deserve this, I must be to blame, everyone would be better off without me. Thoughts of self-harm and suicide, running away anything and everything that would take me out of the equation. Banging my head against the wall tears streaming down my face just minutes before I had been happy, hadn’t I?

How could I go from that to this so quickly?

My partner tries to console me but the text conversation continues and for a rare moment my anger starts to head outward rather than inward as I scream for it to stop and how I want to kill this scum that dares to interfere with our life this way. But still I take it out on myself the door and walls get a few kicks and punches.

But most of all overwhelmed with self-loathing, guilt and shame – although I have no reason to, it’s not me that has done something wrong! But you cannot fight the feelings, the emotions, they control you not the other way round.

I collapse in a heap on the ground just moaning ‘let me die’, this period does not abate quickly even though the incident has come to an end. I slip into a state of dissociation, nothing and no-one can connect with me, I don’t hear them, don’t feel them, just rocking and crying and moaning, incomprehensible, unreachable.

When I come back (hours later?) I am numb, empty, devoid of feeling I do not know what happiness is. I can see that earlier point in the day, but it is not me I see smiling and laughing, it is a reflection of me, someone I maybe could be in another life…

So you can see, even little things like a text message can trigger a switch or swing in mood.

We are easily triggered, upset and irritated by little things.

Every emotion is amplified, reactions intensified.

What to others is just a scathing remark that can be brushed off with a shrug is like a knife in the back to us.

We are more easily upset

Unable to reign in an emotion once it starts to tailspin, for example someone apologizes for having said something very nasty, anyone else would be able to accept the apology and move on, but the original comment is still cutting through us and burning up inside like an avalanche that cannot be contained once started, leaving us unable to come back to a stable level with the apology.

Thus emotional dysregulation is the underlying key to each of the other BPD criterion and if we are to have any hope of recovery the steps we must take begin with learning to recognise these emotional states.

Once we recognise them we can begin to understand them.

Once we understand them we can begin to learn about how they work.

Once we learn how they work we can look at ways of controlling or changing them – but that is when we reach the most difficult stage towards recovery, changing ones nature, especially something as complex as this is very difficult, and while only we can do it, we need a lot of help to be able to do it, need that is where we need you – our family, friends, therapists, colleagues (or whatever your relationship to us). Your help, love and understanding is vital to the process of recovery, we need a reason to recover as much as we need help to recover…

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