Insomnia and Borderline Personality Disorder: How DBT for Sleep Can Help

By Jeanette Lorandini

As many as 3 in 10 American adults struggle with chronic insomnia. There are countless reasons for this troubling trend. However, there is one cause that may not jump out as obvious.

That cause is Borderline Personality Disorder (BPD). BPD is a condition known for its varying behaviors and moods. People with a borderline personality disorder may make impulsive choices.

They often experience episodes—lasting from hours to days—blending anxiety with anger and depression. Seemingly everyday events can trigger these and other symptoms. Adding to all this, people with BPD struggle with insomnia that can make the condition worse.

The BPD-Insomnia Connection

How DBT for Sleep Can HelpA growing body of research has found insomnia playing a role in heightening BPD-related behaviors and choices. In some cases, these are already dangerous choices, e.g. substance abuse, self-harm, and suicidal thoughts.

Needless to say, intensifying such behaviors can be very risky. Here are a couple of other ways insomnia negatively impacts people with PBD:

Emotional Regulation

Life within a society requires us to regulate our emotions for the purposes of our interactions. BPD makes emotional regulation much harder. Insomnia makes emotional regulation much harder. Together, it exacerbates the symptoms and creates a cycle.

Strong emotions can make it even harder to sleep, and then it goes around again.

Paranoia

When people with BPD get sufficient rest, their tendency toward paranoia lessens. When insomnia enters the picture, paranoia increases. So do relationship problems, self-harm, and the likelihood of attempting suicide. Yet again, a self-feeding cycle is formed.

Obviously, managing sleep disorders in people with BPD is a particularly urgent task. One of the most successful approaches toward this end has been dialectical behavioral therapy (DBT).

How DBT for Sleep Can Help People With DBT

DBT, a type of cognitive-behavioral therapy (CBT), is used to treat many mental health conditions. It can be particularly useful for BPD. The “dialectical” part involves fusing two elements—acceptance and change. As a result, DBT can teach people to:

  • Be more mindful (live in the moment).
  • Improve relationships.
  • Develop healthy coping mechanisms for stressful situations.
  • Regulate their emotions.

It’s not hard to see how essential, general skills like this would enhance one’s sleep. In addition, your DBT therapist will help people with BPD create a mindful bedtime routine that can facilitate healthier sleep patterns. This may include:

  • Getting to bed at roughly the same time every evening.
  • Rising at roughly the same time every morning.
  • Preparing your bedroom as you like it (e.g. many people focus on noise levels, light levels, and temperature).
  • Paying close attention to what you eat and before bedtime and the timing of such meals.

Some specific sleep-related exercises are:

Mental Awareness

Racing and intrusive thoughts can hamper anyone’s sleep habits. If you notice thoughts keeping you awake, bring all your awareness to those thoughts. Identify and label them. But, most of all, observe them. You may find that a thought is just as fleeting as a sound or a sensation.

Physical Awareness

Think about one body part at a time. Focus your energy to relax that spot and then move on. Bit by bit, allow your entire frame to relax and move into a sleep-friendly state.

Breathing Exercises

In many cases, the most successful involves counting. You may simply count each breath. Another option is to count the length of each inhale and then each exhale.

Learn More and Get Started!

Like anything with a long name, dialectical behavioral therapy may seem complicated at first. Let’s connect with a consultation and help you learn what you need to learn about this valuable treatment approach.

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