Understanding Borderline Personality Disorder:
Three Voices, One Conversation
May is Borderline Personality Disorder Awareness Month, and this year, we wanted to mark it differently.
Instead of a single perspective, we went looking for three. That of a psychologist, a psychiatrist and someone with lived experience.
So we spoke with Samriti Makkar Midha, a clinical psychologist, psychotherapist, and co-founder of Equilibrio Advisory LLP, whose work spans emotional regulation, workplace mental health, and inclusion; with Dr. Jyoti Sangle, a Mumbai-based psychiatrist with over 25 years of clinical experience and with someone who has lived with a BPD diagnosis for several years, bringing the kind of knowledge that no qualification can fully capture, to respond to the same three questions:
Q1: What do people need to understand about BPD?
Samriti Makkar Midha:
“From a CBT lens, BPD is best understood as a pattern of intense emotional responses, unhelpful thinking styles, and coping behaviours that developed for a reason but no longer serve the person well. Many individuals experience rapid shifts in mood, strong fear of abandonment, and difficulty returning to baseline once activated.
In therapy, we often see core beliefs like “I will be left” or “I am too much,” which shape how situations are interpreted. These beliefs then drive emotional and behavioural cycles. The focus in CBT is on identifying these patterns, building awareness, and gradually developing alternative ways of thinking and responding. Importantly, change is very possible with structured support and practice.”
Dr Sangle:
“Borderline personality disorder is highly stigmatized, and often misunderstood to just be about frequent mood fluctuations and suicidal ideations or attempts. However, one must understand that it is a condition rooted in emotional vulnerability, attachment disruptions, trauma, and difficulties regulating emotions. Individuals living with BPD often experience intense fear of abandonment, unstable self-image, emotional pain, and impulsivity. Importantly, many are highly sensitive, empathic, and psychologically insightful. With evidence-based treatments such as Dialectical Behaviour Therapy and consistent relational support, prognosis is far better than commonly assumed, and many individuals achieve meaningful recovery and stable functioning. Often , psychological trauma and overwhelming environment are underlying factors for this personality disorder.”
Person with lived experience:
“When two different people diagnosed me with Borderline Personality Disorder, it felt surreal. The very name made it sound like something is wrong with me as a person. The psychiatrist I was going to kept giving me relationship advice as if she was sure I’d cheat on my partner. It felt very confusing and alienating.
Only after I changed therapist a few years later, did I see there was nothing ‘wrong’ with me. This diagnosis was just a part of me. That with the right support I could manage, instead of feeling like there was no hope for me.”
Q2: What myth should we drop, right now?
Samriti Makkar Midha:
“That people with BPD are manipulative.
What looks like manipulation is often a combination of intense emotional activation and limited coping tools in that moment. In CBT terms, it is a behaviour that has been reinforced because it works in the short term, even if it creates problems later.
When we shift from blame to understanding the function of the behaviour, we are better able to respond in ways that actually reduce distress and build healthier patterns.”
Dr Sangle:
“Three myths that we urgently need to discard is that people with Borderline Personality Disorder are “manipulative by nature”, “attention-seekers” and “dangerous”. What may appear manipulative is often a desperate attempt to cope with overwhelming emotional distress, fear of rejection, or perceived abandonment. These individuals have often experienced chronic invalidation to their traumatic struggles. Labelling individuals in this way damages therapeutic alliances and increases stigma.
Another misconception is that BPD is untreatable. In reality, long-term outcomes are often positive when individuals receive structured psychotherapy, validation, boundaries, and continuity of care from informed professionals and support systems.
The other myth that one needs to be realistic about is that it can be FIXED- it is a product of an interaction of trauma, need for acknowledgement and emotional dysregulation- and hence requires long term therapy”
Person with lived experience:
“When my partner got to know about my diagnosis, they started calling me “manipulative”, and “over-emotional”.
It really made me question my own self. I wish they would read up a little more about before making these snap judgements about me, that not only hurt our reationship but further harmed my mental health.
It was hard to face that while struggling with suicidal ideation. Later my new therapist, helped me see that people living with BPD are at more risk of self-harm than actually hurting others.”
Q3: And what's worth keeping in mind when we think about BPD in the workplace?
Samriti Makkar Midha:
“Consistency and clarity help reduce misinterpretation. Keep communication direct, predictable, and boundaried. Avoid personalising emotional reactions and instead respond to the situation at hand. Brief validation can help de-escalate. Teams should stay aligned and avoid getting pulled into extremes. Where possible, encourage access to professional support while continuing to recognise the person’s strengths at work.”
Dr Sangle:
“In workplaces, it is important to remember that psychological safety and predictability significantly influence emotional functioning. Individuals with traits of emotional sensitivity may struggle more in environments marked by invalidation, inconsistent feedback, humiliation, or interpersonal volatility.
Also the trauma induced neurodivergence features- sensory overload and trauma responses need to be acknowledged and accommodated
Supportive supervision, respectful communication, clear expectations, and mental health awareness can make a substantial difference. Employers should also recognise that many individuals with BPD are creative, committed, and resilient contributors. A compassionate workplace culture benefits not only those with mental health conditions, but organisational wellbeing overall.”
Person with lived experience:
“At my last place of work I hardly ever spoke about my mental health. I once heard a colleague make a very crass remark about “Bipolar, borderline, yeh sab naya chal raha hai market mein”.
I was afraid people would look at me and treat me differently if I ever shared my diagnosis at work. Casual callous comments that hold harmful inaccurate stereotypes can be deeply hurtful. If someone shares their BPD diagnosis with you, remember they are already struggling, please treat them with respect and dignity.”