6 Tips for Managing BPD Symptoms During the Holidays
Editor's Note
If you or a loved one is affected by addiction, the following post could be triggering. You can contact SAMHSA’s hotline at 1-800-662-4357.
Living with borderline personality disorder (BPD) is hard enough throughout any time of the year, but seasonal holidays, including end of the year holidays and summer breaks, may exacerbate symptoms.
During holidays, people with BPD may struggle with impulsive spending in the midst of sales and gift giving, substance misuse and distress related to social gatherings. While there are many reasons the holidays may exacerbate BPD symptoms, holidays often involve sudden changes from school, work or treatment schedules. Changes in routine or structure more generally are a main BPD trigger.
To explain BPD, the American Psychiatric Association (APA) highlights “The perception of impending separation, rejection or the loss of external structure, can lead to profound changes in self-image, affect, cognition and behavior. These individuals are very sensitive to environmental circumstances.”
The APA further highlights the significance of structured work and school arrangements, which can severely impact performance and BPD symptoms. Structure is even highlighted and built into treatment models for BPD.
Borderline personality disorder (BPD) is a mental health condition characterized by emotion dysregulation and extreme emotional hypersensitivity. People with BPD tend to experience intense emotional reactivity for long periods of time, with a slow return to a stable emotional baseline.
Just a few of the main symptoms include chronic emptiness, hourly mood-swings (e.g., intense anger to idealization to anxiety all within a few hours), recurring self-injury, suicidal ideation and impulsivity. Other symptoms include transient stress induced dissociation, paranoid ideation and hallucinations.
One of the most notable symptoms of BPD are the extreme reactions and preoccupations to real or perceived abandonment or rejection. Mundane events, such as brief separations, may trigger panic or paranoia. Overall, the symptoms impact major areas of functioning, including emotion, behavior, interpersonal, cognitive and a distorted sense of self and direction.
For those of us with BPD, these symptoms may be intensified during the holidays. It is important to address and be aware of this concern, whether you have a loved one living with BPD or live with the condition yourself.
Changes in structure from the holidays may signify abandonment and separation. Throughout the semester, I see my friends and classmates on a regular basis for months, only for that schedule to abruptly change and come to an end. Family members and friends may also travel during the holidays. Will they come back? Will they be safe? Will they replace me while they are gone? Will they realize I am not needed in their life?
The structure and meaningful activities that keep me engaged and facilitate adaptive coping and social connection may also temporarily pause or interfere with holiday plans. College has provided me with meaningful activities, professional goals and a learning and social environment.
With the holiday changes, I often feel increasingly disconnected, abandoned and left out with a thwarted sense of belonging and purpose. I struggle with amplified emotion dysregulation and a distorted sense of self.
It feels like everything compounds. For example, one way people with BPD may idealize someone or respond to abandonment fears is by showering people in lavish gifts, even when they do not have financial capability. Impulsive spending, the holiday season and gift giving may compound.
Likewise, when I fear abandonment, I may repeatedly contact friends to ensure they will not abandon me. Yet, the holidays are a busy time of the year for everyone. They may not have considerable time to socialize or return phone calls, which can confirm the fear in my mind.
My days seem to go by with little to no structure or direction. I may sink into depression, panic, back to depression then rage. I reflect back on the holidays and often feel like a failure and a waste of time. Out of an attempt to regulate emotions and gain a sense of structure and control, people with BPD may be at risk for impulsive behaviors or self-injury.
When COVID-19 was declared a pandemic in March, I wrote an article describing “Why The Coronavirus is Triggering my Fear of Abandonment.” Now, the holidays add more stress that may prove to be especially difficult if you live with BPD.
Structure is emphasized in BPD given that it has a regulating effect on behaviors and emotions. To me, events may seem more predictable, and I may feel better equipped and prepared to handle the day. I feel overall more safe, secure and comfortable. It forms a foundation, adaptive patterns and may ease abandonment fears. By focusing on the task, structure helps me remain mindful and stay in the present moment.
The following strategies may help create structure for people with BPD during the holidays.
1. PLEASE Skill
The Dialectical Behavior Therapy (DBT) PLEASE skill aims to reduce emotional vulnerability by focusing on the way physical and emotional health overlap. Poor sleep structure can increase our vulnerability to anger and sadness. When we are hungry, we may be easier to anger. The PLEASE skill reminds me to create a healthy structure. PL = Treat Physical Illness, E = Balanced Eating, A = Avoid Mood Altering Drugs, S = Balanced Sleep and E = Exercise. For a description of the skill, click here.
2. Activities
Writing, word games, reading or audiobooks, exercising, going outside, studying, painting, video games, movies or something you are passionate about can help occupy your mind and process your thoughts and emotions. Activities can be an effective way to create structure and routine, and maintain a sense of meaning.
3. Be patient and flexible with yourself.
While structure is critical if you have BPD, if it is too rigid, it may actually worsen symptoms. We are prone to periods of intense frustration, shame, restlessness or boredom, all of which may worsen under rigid environments. Structure does not mean disallowing yourself to naturally pursue the day and remain flexible. If a routine adds too much pressure and stress to meet demands, it may be too rigid.
4. Create flexible, realistic structure.
To do lists, a schedule or an intentional morning routine can help return some feelings of consistency and form structure. Yet, the above point is why I tell myself to create flexible structure or a flexible routine. Be careful not to use the importance of structure to create unrealistic expectations or shame. I learned quickly that if I attempted to do yoga each day at exactly 3:00 PM, I became frustrated or painfully bored of an activity I once appreciated. If I missed the exact time, even for a good reason, I felt ashamed. Instead, I learned I need to establish a window of time. Or, I may establish a to do list for that day or that week. Do whatever approach works better for you and the context.
5. Remember it is not your fault.
BPD is not your fault. I understand what it is like to quickly internalize feelings of isolation and abandonment. Self-blame may be perpetuated by low self-worth or a false belief in being able to control and solve every situation. Taking responsibility when appropriate is not the same as blame either. It may help to focus on your strengths.
6. Maintain contact.
Because of the pandemic, most of our options may be virtual right now (e.g., video chat, message or call family and friends). Safe social connections and pets may help restore feelings of connectedness and alleviate feelings of abandonment. Other resources for social connections in the BPD community include the Twitter hashtag #BPDChat and bpd support group
For more articles about BPD and the holidays from The Mighty, check out the following:
Photo courtesy of Getty Images
I am a psychology MA student, research coordinator, BPD support group facilitator, and part of a specialized SCN Program here at The Mighty where I write select paid pitches. I focus broadly on emotion regulation, BPD, accessible care, and health related issues (e.g., disease, disability, and chronic illness). I facilitate various live events/webinars for The Mighty and have gotten involved in ways I couldn’t imagine. I believe these stories will shape the outlook and discussions on a broader level and contribute to social change. Diagnosed with and write about: borderline personality disorder, major depressive disorder, and persistent depressive disorder/dysthymia, Amelogenesis Imperfecta, auditory processing disorder, POTS, fibromyalgia, Sjögren’s syndrome, some hearing loss, and platelet storage pool disease. Views are my own.
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