Emotionally unstable personality syndrome, EUPS, or borderline personality syndrome, also known as it, means you deal with strong emotions in a way that can be harmful to yourself. There are treatments that can help you with EUPS. It is also much you can do yourself to feel better.

There are several terms for the diagnosis of EUPS or borderline personality syndrome. The reason for this is, among other things, that healthcare uses different diagnostic manuals.

Sometimes the term personality disorder is used in connection with EUPS. Personality Disorder is a direct translation of English’s “personality disorder”. many countries, it can be misleading because it is not a disturbance of one’s personality that causes the problems, but a composition of symptoms that are connected without any known cause behind, ie a syndrome.

This article uses Emotionally Unstable Personality Syndrome and the abbreviation of EUPS. 

Symptoms of EUPS

You who have EUPS often have strong feelings that change quickly. You can often try to deal with strong emotions through behavior that can be destructive to yourself. It is also common for you to have difficulties in close relationships. 

Getting the EUPS diagnosis does not mean that you will always have it. Many learn over time how to handle their feelings and relationships and can live a good life.

To be diagnosed, five or more of the following symptoms of EUPS should agree with you:

  • You have a strong fear of being abandoned.
  • You have confused thoughts and feelings for yourself. You often find that your self-image does not match the view of the environment about you.
  • You often experience an inner emptiness.
  • You have strong emotions that can quickly change from one extreme state of emotion to another. For example, you may feel strong irritation, anxiety or depression that can last for a few hours, for at most a few days.
  • Feelings for other people can change quickly, from, for example, intense admiration to extreme degradation.
  • You may feel a wave of intense anger that the surroundings perceive as excessive in relation to the cause.
  • You can sometimes become very suspicious or experience what happens as unreal.
  • You are impulsive and can, for example,  abuse drugs , sex, food or money.
  • You cut yourself or hurt yourself in other ways. You may also have recurring thoughts on ending your life.

The symptoms can vary from person to person

The symptoms of borderline personality syndrome you can have and how strongly they affect your life vary greatly from person to person. Here are some sections on what the symptoms can mean for the person who has EUPS and how they can be interrelated.

Emptiness and uncertainty about who you are

It is common for those who have EUPS to experience a great emptiness within themselves that others may find difficult to understand. You may feel alone and misunderstand. It can evoke strong feelings of shame.

You can also feel uncertain about who you are and what you really have for values. This allows you to be easily influenced by your surroundings. What you like and want can, therefore, vary greatly between different times, and depending on who you spend time with. There is a risk that you lose what you want and feel good about.

Fear of being abandoned

You can easily become dependent on the people around you if you are unsure of who you are. In relationships, you may want to constantly get confirmation from your partner, even if it means you are not feeling well. 

The fear of being abandoned controls you. Sometimes it controls you so much that you end relationships. The reason may be that you would rather abandon someone than being abandoned yourself. You may feel that you need to constantly be on your guard and be unsure if you can trust other people.

Fast switching between different emotions

Your feelings change quickly from everything being good or pretty good, to the fact that you think most things are very bad. You have a hard time seeing the nuances in between and interpreting the outside world based on the feeling that is strongest at the moment.

Difficult in close relationships

How you relate to other people can vary greatly. This can be seen particularly clearly in close relationships. One moment you may like a person very much, in the next moment you will feel very bad about it. Feeling trust in other people is often difficult for you.

It may be difficult for others in your area to keep up with the fast shifts and relate to them. For example, you can be perceived as unreliable, aggressive or emotional, without you really being.

Feelings of unreality

When you are involved in something difficult or unpleasant, you may have experiences that may be an expression of something called dissociation. It means that you experience yourself, the surroundings or what happens as unreal. You may also feel that what is happening does not really affect you.

Sometimes you may have memory gaps that are not due to, for example, drinking alcohol or taking other drugs. It can also manifest as identity disorders, which means that you feel alien to yourself. You may also find that you have several personalities in you that do not agree with each other.

Self-harm and impulsive behavior

It is common for people with EUPS to injure themselves in different ways, for example by cutting themselves or otherwise injuring themselves. Abuse of drugs, food, sex or money can also occur. Self-harm or abuse are often impulsive ways of trying to deal with anxiety or other emotions that are difficult to endure.

At the moment you may feel relief, but harming yourself is never a solution to what feels difficult. It is important to get help and to learn to manage their emotions in other ways. Therefore, it is often good to receive support through, for example, calls or some form of therapy.

suicidal thoughts

When someone is feeling very bad and has feelings that are difficult to handle, thoughts of suicide may seem like a possible way out. Often, thoughts change after a while. But sometimes the thoughts remain for a long time. 

You may have the feeling of having great hopelessness within you that you feel no one else can understand. You can feel useless or abandoned. 

It is good to tell someone you trust if you have thoughts of hurting yourself or if you have thoughts of suicide. It could be, for example, a relative or someone working in healthcare. You can also call a support organization or phone call. You can be anonymous when you talk to someone in a phone call.

When and where should I seek care?

Contact a health care center if you are mentally ill and have difficulty coping with your everyday life. You can contact many receptions by logging in.

Your health care provider makes an assessment of whether you need psychiatric care and then writes a referral to a psychiatric clinic.

Seek emergency care right away if there is a danger to your or someone else’s life

Immediately contact a psychiatric emergency room if you feel so bad that the situation feels unbearable and you feel that you can no longer cope.

What can I do for myself?

You may need to learn how to manage your sensitivity in a way that you feel good about. A good start is to try to accept the sensibility as a part of yourself. You may think that your sensitivity may be a problem, but at the same time, it can be an asset if you make some changes. Here are some examples of things you can do yourself to feel better.

Good routines and physical activity help you feel better

The vast majority of people feel good about having a regular life with regular routines. For those who have a sensitivity, it can be even more important. You may need to make sure to eat regularly and sleep enough hours. Sensitivity can increase if you are hungry, tired, thirsty and make it harder for you to resist impulses that can hurt you or anyone else.

It is good for your physical and mental health if you are regularly touching the body. Exercising two to three times a week is an effective way to reduce anxiety, depression, and other unpleasant feelings. However, avoid intense exercise to lose weight or maintain low body weight.

Avoid alcohol, other drugs, and sedatives

It is important to abstain from alcohol or other drugs. Even if you can feel relief for the moment, it makes it harder for you to deal with unpleasant feelings in the long run. Also, avoid sedative or analgesic drugs of the varieties that can lead to an addiction. You who want to talk to someone about alcohol or your drinking can call the Alcohol line.

Practice in an environment where you feel good

You may need to practice finding ways to stand out when you are stressed and have strong emotions. Sometimes you may need to practice taking a break from certain situations. Then you have time to calm down and think before you act.

In your close relationships, you can practice being clear with what you think and feel. It makes it easier for your surroundings to understand you. In a conflict, you can try to listen to how the other person perceives the situation, even if you disagree. Imagine that what you know, and what the other person feels, are just as true and that these different experiences can exist simultaneously. It can help you gain perspective on your emotions.

Choose people you feel good about the meeting, who accept you as you are and who treat you with respect and consideration. Avoid abusive environments that make it harder for you to feel better.

Conscious presence and creativity can help

Many people feel that meditation or another exercise in conscious presence or mindfulness can reduce symptoms. These are methods that can help you become aware of their behavior, thoughts, and feelings. Trying conscious awareness or mindfulness can be a great way to get started on a change.

Sensitivity can often be associated with creative ability. Being able to create by writing, painting or making music, for example, can be a good way to handle difficult emotions. Sometimes it can be good to have a therapist to support you.

Investigation

When you seek care for EUPS, you often meet a doctor and a psychologist, and sometimes other people who work in healthcare.

The diagnosis is made with a special type of interview

In order for your therapist to diagnose EUPS, you need a call called structured interview. This means that the practitioner asks questions based on a template. With the help of the interview, the therapist wants to find out if your symptoms are consistent with the diagnosis of EUPS.

You are feeling badly awaited with a structured interview. This is because the therapist needs to know how to react and respond when you are not in an emergency.

Sometimes you also have to fill in forms yourself. This can be done in your own words or by marking the answer on a scale or ticking for completed answer options.

Sometimes it can be good for someone outside to help you describe your problems if you think you can have EUPS.

Your therapist will interpret the answers and use the results to diagnose EUPS or another diagnosis. It is not uncommon for a person to have other diagnoses besides EUPS.

Other diagnoses that may resemble EUPS

Symptoms of EUPS are common and can be similar to problems associated with other conditions. Therefore, your doctor needs to check if you have another diagnosis, in addition to EUPS, or you have another diagnosis.

Examples of other diagnoses may be the following:

Getting a diagnosis

Getting a diagnosis can be experienced in different ways. Some may sometimes feel relieved to receive a diagnosis that tells you that you are not alone. You will also find out what treatments can help you. It can give hope that you will get better.

Treatment of EUPS

Dialectical behavioral therapy, DBT, and mentalization-based therapy, MBT, are two examples of effective therapies at EUPS. At some clinics, you may also be offered Emotional Regulation Group Therapy, ERGT, which is group therapy.

Sometimes a referral from your doctor is required to go to therapy. Depending on where you are seeking care, there may be a waiting period before you can begin a psychotherapeutic treatment.

Dialectical behavioral therapy

Dialectical behavioral therapy, DBT, is a form of cognitive-behavioral therapy where you learn to manage your thoughts and feelings in a way that helps you feel better. One reason in DBT is to accept the feelings and thoughts you have. At the same time, learn different ways to handle them so you can feel good.

You also get to practice changing behaviors that can be a hindrance in everyday life and in contact with others. The idea is that you will get a better quality of life by learning new ways of dealing with different situations.

Conscious presence or mindfulness is another part of the treatment of EUPS that can help you with emotional instability to become aware of how you can do to cope with strong emotions.

Mentalization-based therapy

Mentalization-based therapy, MBT, is a form of therapy that has been developed specifically for treatment at EUPS. The therapy should help you increase your ability to interpret both your own and other people’s actions. This way you can learn to better understand how you and others feel and react.

Mentalization-based therapy is about enhancing the experience of yourself and learning to create safe relationships. In therapy, you primarily talk about how you think and interpret what you do.

Drug

Some feel best without drugs. Others may need an antidepressant or mood-stabilizing drugs and in some cases antipsychotic medication to feel better. Sometimes you may need drugs during difficult times in your life, but you can do without when you feel better again.

It is important that you do an evaluation together with your therapist which treatment will help you feel better.

Related to someone with EUPS

You who are close relatives may need advice and support from others in similar situations because EUPS is often about difficult feelings in close relationships.

Sometimes you may feel powerless

Many times you may have to deal with severe emotional outbursts. It can be both difficult to understand and to relate to. People who have EUPS may require immediate attention, while you may be rejected when trying to help. You can also feel powerlessness over how to be good support.

As a relative of someone with EUPS, it is often important to set limits on what you can do with. It is always good to ask the person who has EUPS to seek care, preferably repeatedly if needed. Getting treatment of borderline personality syndrome and support is especially important if your loved one is acutely ill, injures himself or has thoughts of suicide. 

You can contact the health care provider if you have a relative with EUPS who does not wish to seek medical care. Then you will have the opportunity to discuss the situation with the healthcare staff and be advised how you can help your loved one.

Relatives may also receive support

You who are related and support, help or care for a person with EUPS can also receive support. It is regulated by law that the municipalities must offer related assistance and support. You can find family support information on your municipality’s website. Occupational psychiatric clinics can also sometimes offer some kind of support.

If you are a close associate and want to get in touch with others who have similar experiences, you can contact the Borderline Anhörigföreningen Borderline or the SHEDO association.

Influence and participate in your care

You can seek care at any healthcare center you want throughout the country. This also applies if you want to seek care at open specialist clinics. Sometimes a referral is required. Being able to influence and participate in their care is a right that is regulated by the Patient Act.

Ask if you do not understand

In order for you to be involved in your health care, it is important that you understand what the health care provider says. Ask questions if you don’t understand. Once you have received information about your treatment you can give your consent or express a yes in another way. You can also refuse treatment.

Fixed care contact and interpreter can be a good support

You are entitled to permanent care contact if you have contact with many different persons in connection with your care. It is a person who among other things helps to coordinate your care.

The interpreter can often be booked by the health care center or reception that treats you. Feel free to inform the healthcare provider at the first contact if you need interpretation. The interpreter has a duty of confidentiality  just like everyone else who works in the health care sector. This means that they are not allowed to disclose information about you.

Ehtisham Nadeem

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