A qualitative description of the daily living functioning of people diagnosed with borderline personality disorder from consumer, carer and clinician perspectives

Abstract Introduction Borderline personality disorder (BPD) is a severe and prevalent mental illness. Longitudinal research consistently demonstrates that people diagnosed with BPD experience persistent functional impairment despite current psychotherapeutic treatment. Functional impairment is typically defined in terms of performance in vocational and relational domains. However, functional recovery across multiple domains of functioning should also be considered, such as leisure, self‐care, health and household management. This study aimed to describe the daily living functioning of people diagnosed with BPD from multistakeholder perspectives. Methods This qualitative descriptive study used semi‐structured interviews with 22 participants, including consumers ( n = 4), carers ( n = 5) and clinicians ( n = 13). Data were analysed using reflexive thematic analysis. Consumer and community involvement Consumer, carer and clinician consultants reviewed a draft of the interview guide and provided feedback on the terminology, question ordering and provision of practical examples. Their feedback was incorporated and amendments were made prior to data collection. Findings Five themes were generated: (1) structured routines, (2) extremes of doing, (3) a lot of energy required to manage in daily life, (4) doing when disconnected from values and identity and (5) doing through others. People diagnosed with BPD experienced challenges establishing and maintaining structured routines, engaged in boom‐and‐bust activity patterns, expended considerable energy managing emotions and interpersonal interactions, struggled to identify values to derive meaning from daily activities and relied on others to initiate and complete daily activities. Conclusion Functional recovery outcomes are important for people diagnosed with BPD. Occupational therapists are well positioned to support functional recovery for this population, which could involve exploring daily living functioning beyond a psychotherapeutic framework, including the structure of routines, sleep patterns, activity pacing, energy conservation, values identification, and the extent of carer involvement in daily activities.