Common Co-Occurring Disorders: Social Anxiety Disorder and BPD

Social anxiety and BPDBorderline Personality Disorder (BPD) is a complicated psychiatric disorder that manifests a bit differently in each person diagnosed with it. Despite this, a deep-seated fear of abandonment or rejection by others is the one symptom of BPD that appears to be universal among people with BPD. The fear of rejection can be so debilitating that it greatly inhibits a person with BPD’s ability to interact with others, especially strangers.

A marked and persistent fear of social interaction is often diagnosed as Social Anxiety Disorder, and it is a common co-occurring disorder for those with Borderline Personality Disorder. It may even be an initial diagnosis if it presents as the biggest problem a patient has to address through the therapeutic process.

Social Anxiety Disorder Symptoms

Fear of public speaking has long been one of the most common phobias people face, regardless of whether they suffer from a mental illness or have been diagnosed with a psychiatric disorder. Even celebrities find themselves suffering from Social Anxiety Disorder.

Many of us loathe the notion of standing up in a room full of strangers and subjecting ourselves to their judgment or scrutiny. It is a normal human concern: we all want to be accepted by others and successfully integrate in group situations.

For people suffering from Social Anxiety Disorder, this common fear can reach such debilitating levels that they isolate themselves almost completely from having to interact with strangers, even to the point where phone calls can be difficult.

In those with Borderline Personality Disorder, Social Anxiety Disorder can reach such extreme levels that isolation becomes the norm, thus causing dependency on other people and exacerbating feelings of low self-esteem, depression, and helplessness. People with BPD often become dependent on others in an effort to avoid abandonment. Family members become caretakers who are obligated to care for the person with BPD, as their social anxiety inhibits them from working or completing regular errands. In this way, people with BPD attempt to keep others from leaving them.

Intense fear of social interaction can cause physical responses that are close to “fight or flight” in some people, meaning that the idea of mingling with others can cause a racing heart, excessive sweating, trembling, nausea, and muscle tension. These types of physical responses are common in anyone with Social Anxiety Disorder, but they represent imagined rejection rather than an actual threat.

Treatment for Social Anxiety and BPD

Borderline Personality Disorder treatment (especially Dialectical Behavior Therapy) addresses this kind of anxiety by teaching patients to be mindful of their feelings without allowing them to take over and cause severe emotional responses.

Mindfulness, or present moment awareness, can teach us to sit with our feelings and thoughts without magnifying negative emotions by putting more energy into them. In conjunction with learning to transform and disempower negative thoughts through mindfulness, medications can be prescribed that reduce anxiety and give you a greater ability to cope with social situations.

With proper treatment, both social anxiety and BPD can be overcome to a degree that allows you to improve your social skills, move on to develop healthy relationships with others, and reach life goals that otherwise would have been impossible.

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  1. 5 Ways to Reduce Back-to-School Anxiety | Borderline Personality Treatment - 06. Sep, 2012

    […] Sometimes symptoms can be so severe that they disrupt everyday life. The National Institute of Mental Health (NIMH) identified the following as just some of the symptoms of an anxiety disorder, which commonly co-occurs with Borderline Personality Disorder: […]

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