People with Borderline Personality Disorder (BPD) may face various challenges and struggles that can influence their decisions regarding medication and therapy adherence. Here are some possible reasons why individuals with BPD might stop taking their prescribed medications and refuse therapy:
Fear of Abandonment: Individuals with BPD often have an intense fear of abandonment and rejection. Engaging in therapy or taking medications may bring up feelings of vulnerability and the fear that their therapist or healthcare provider will eventually leave them, leading them to avoid treatment altogether.
Emotional Instability: BPD is characterized by intense and fluctuating emotions, which can make it challenging for individuals to remain consistent in therapy or medication adherence, especially during times of emotional distress.
Splitting and Idealization-Devaluation: People with BPD may engage in "splitting," where they see things or people as all good or all bad. They may idealize therapy or medication initially, but if they feel disappointed or let down, they may quickly devalue these interventions and decide to stop them altogether.
Negative Past Experiences: Some individuals with BPD may have had negative experiences with therapy or medications in the past, leading to distrust and reluctance to engage in these treatments again.
Self-Sabotage and Avoidance: Due to deep-seated feelings of inadequacy or self-worth issues, individuals with BPD may self-sabotage their progress in therapy or stop medications as a way of avoiding confronting their challenges or the fear of change.
Lack of Insight: BPD can impair an individual's ability to understand or recognize the impact of their actions on their own well-being, making it difficult for them to see the benefits of therapy or medication.
Substance Abuse: Co-occurring substance use disorders are relatively common among individuals with BPD. Substance abuse can interfere with therapy and medication adherence, as individuals may prioritize the use of substances over treatment.
Feeling Misunderstood: If individuals with BPD feel that their therapist or healthcare provider does not understand them or their struggles, they may become resistant to treatment and decide to discontinue therapy or medications.
Impulsivity: BPD is associated with impulsivity, which can lead individuals to act on their emotions and make decisions without fully considering the consequences, including stopping medication or avoiding therapy sessions.
Stigma: There is still stigma surrounding mental health, and individuals with BPD may internalize this stigma, feeling ashamed or embarrassed about their diagnosis, which can lead to reluctance in seeking or continuing treatment.
It is important to note that each individual's experience with BPD is unique, and the reasons for treatment non-adherence may vary. Addressing these challenges typically requires a compassionate and individualized approach, involving skilled mental health professionals who can work collaboratively with the person to build trust and develop a treatment plan that aligns with their needs and goals. Patience, understanding, and ongoing support are essential when assisting someone with BPD on their journey toward recovery.