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Many people haven't even told their parents." To be diagnosed, you have to fulfil at least five of the nine criteria for BPD.These traits can include intense mood swings, an overwhelming fear of being alone, an impulse to self-harm or act recklessly, and psychotic symptoms such as hallucinations or delusions."A lot of families and friends struggle with the same things," Imi tells me.

Furthermore, some of the skills that are taught in STEPPS include self-care skills (such as sleep, exercise, or balanced eating), as well as problem solving, communication and relationship skills.In addition to learning skills for dealing with intense emotions, anxiety, depression, anger, and the self-destructive impulses that often come along with these overwhelming feelings for people with Borderline Personality Disorder, the STEPPS participants are encouraged to share appropriate topics from their skills training with close friends and family members, and also with their therapists.One goal is to de-stigmatize the disorder by helping people understand one of the main premises of STEPPS: Namely, that Borderline Personality Disorder stems from a certain biological sensitivity or disposition that meets with certain environmental factors.What makes STEPPS different from many other approaches is that people in the person’s environment, such as family members and friends are included in the training and are used as “reinforcers” of the skills, in other words, they are used as a resource for the person to support them in learning those skills."On many occasions I've said it's just depression, or not told friends or family at all, in case they thought I was weird.

I know people [with BPD] who don't disclose anything about their mental health due to the stigma.Lottie was 24 when she was diagnosed with BPD; talking about it a year on, she tells me: "At the time, I was adamant about ending my life.I couldn't deal with the rollercoaster in my head; I always felt like I never truly belonged, like my friends and relatives would have been better off without me." It's not an easy thing to hear, as a friend, but I know it must be an even harder feeling to live with.Borderline Personality Disorder – which is, perhaps more helpfully, also known as Emotionally Unstable or Emotional Regulation Personality Disorder – is a relatively rare mental health condition, affecting around one per cent of the population, but 75 per cent of those with the diagnosis are women."At the core of BPD really is a difficulty in regulating emotions, meaning that someone with BPD can find emotions overwhelming, out of control, or always changing," explains psychotherapist Imi Lo, who specialises in the treatment of Borderline Personality Disorder.Lottie is still the warm, loving friend she's always been, and she's come a long way thanks to the brilliant, supportive therapist who helps her manage the condition.