Understanding and Managing Mood Swing Triggers in Borderline Personality Disorder

This episode by Dr. Tracey Marks addresses a common viewer question regarding the triggers behind the intense mood swings characteristic of Borderline Personality Disorder (BPD). Dr. Marks clarifies that while BPD mood shifts can resemble bipolar disorder, they are distinct in their duration, typically lasting hours or a single day, as opposed to the minimum four days for hypomania and two weeks for depression seen in bipolar disorder. The core argument is that BPD mood swings are always triggered, even if the individual is not consciously aware of the cause, challenging the perception that these emotional shifts come "from nowhere."

The podcast details several key types of triggers. A prominent trigger is the high sensitivity to abandonment or rejection, often manifesting in relationship dynamics where seemingly innocent comments can lead to a rapid spiral into self-loathing and feelings of worthlessness. Another significant internal vulnerability is the pervasive feeling of emptiness, which can cause individuals to unravel under stress, boredom, or frustration, even when alone. Dissociative symptoms, such as depersonalization (feeling disconnected from oneself) and derealization (perceiving the world as unreal), are also identified as triggers that can abruptly shift mood from peacefulness to panic. Furthermore, memories of past trauma, including childhood abuse or emotionally abusive relationships, can flash across the mind, inducing overwhelming despair without a clear conscious connection to the present emotion.

Dr. Marks emphasizes the importance of therapy, particularly Dialectical Behavior Therapy (DBT), as a crucial intervention. Therapy helps individuals with BPD to identify and understand the connections between these triggers and their intense emotional responses, whether the triggers are conscious or unconscious. By recognizing that emotions stem from an underlying cause, individuals can begin to accept, process, and allow these feelings to pass without becoming overwhelmed. DBT specifically teaches strategies for distress tolerance and emotion regulation, providing practical tools to manage and navigate these challenging emotional states more effectively.

The broader implication of this discussion is the empowerment that comes from demystifying BPD mood swings. Moving beyond the belief that emotions are random or uncontrollable, and instead understanding their specific origins, is a vital step towards emotional mastery. This knowledge enables individuals to engage proactively with therapeutic strategies, fostering greater self-awareness, resilience, and ultimately, an improved quality of life by transforming overwhelming emotional experiences into manageable and understandable processes.

"with borderline personality disorder, you get quick shifts in moods that can last hours, or even a day, whereas with bipolar disorder, you get shifts in mood states that last for a minimum of four days for hypomania and two weeks for depression."

"I agree with your psychologist, that with borderline personality disorder the shifts in mood from high to low, to irritable to elated, are triggered in some way."

"The catch is, the trigger may not always be conscious. That is, it may not always be identifiable to you what's triggering you."

"Remember, one of the symptoms of borderline personality disorder is having a very high sensitivity to feel abandoned or rejected in some way."

"Another symptom of borderline personality disorder is feel empty, and this an internal vulnerability that can make you unravel in the settings of stress, boredom, or any kind of frustration, and these are factors that can happen while you're alone, and does not involve a relationship dynamic."

"With depersonalization, you feel disconnected from yourself. You can look in the mirror and not recognize your own face, or you can feel like you're watching yourself go through the day."

"Many people with borderline personality disorder have been abused in the past, maybe in childhood, or young adulthood, or you may have had a series of emotionally abusive relationships."

"Therapy is something that can help you make these connections, so that you don't have to be as overwhelmed by the emotions that seem like they're coming out of nowhere."

"If you start by understanding that the intense emotions do come from somewhere, then you can learn to accept the emotions, process them, and let them pass without overwhelming you."

"In dialectical behavior therapy, you learn to do this with lessons on distress tolerance and emotion regulation, and there's a lot of strategies that are taught in dialectical behavior therapy."