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What is Borderline Personality Disorder (BPD)?

Borderline personality disorder

What is Borderline Personality Disorder (BPD)?

Borderline personality disorder (BPD) is a mental illness characterized by an ongoing pattern of different moods, self-images, and behaviors. These symptoms can result in impulsive actions and create issues in relationships. People who have BPD may experience highly intense anger, depression, and anxiety that can last for a few hours up to various days. In addition, they may have difficulty regulating or handling these emotions or struggle with impulse control. 

What are the symptoms of Borderline Personality Disorder (BPD)?

People with BPD have mood swings and can feel moments of instability and insecurity. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), some signs and symptoms of BPD may include:

  • Intense efforts to avoid real or imagined abandonment by loved ones.
  • Unstable personal relationships that go between idealization and devaluation (love/hate relationships). This symptom is referred to as “splitting.”
  • Distorted and unstable self-image, which can impact a person’s mood, values, opinions, goals, and relationships.
  • Impulsive behaviors with potentially dangerous consequences, like overspending, unsafe sex, reckless driving, or misusing substances.
  • Self-harming behavior, such as suicidal threats or attempts.
  • Depression, irritability, or anxiety lasting a few hours to a few days.
  • Chronic feelings of emptiness and boredom.
  • Inappropriate, and uncontrollable anger, which can be followed by shame and guilt.
  • Dissociative episodes, like disconnecting from your thoughts, or “out of body” type of feelings, and stress-related paranoid thoughts. In severe cases of stress, there may be shorter psychotic episodes.

Recognizing Borderline Personality Disorder

If you are wondering if you might have BPD, see if you identify with the following statements:

  • I feel “empty” much of the time. 
  • My emotions often shift quickly, and I experience extreme sadness, anger, and anxiety.
  • I’m afraid often that my loved ones will abandon me or leave.
  • I would say that most of my romantic relationships are intense but unstable.
  • The way I feel about people in my life can dramatically shift, and I’m not always sure why. 
  • I do things often that I know are life-threatening, dangerous, or unhealthy, like reckless driving, having unsafe sex, abusing substances, or going on spending sprees.
  • I’ve tried hurting myself and engaging in self-harm behaviors like cutting or threatening suicide.
  • When I’m not secure in a relationship, I will lash out or make impulsive gestures to keep the other person close.

If you identify with many of these statements, then there is a possibility you may have BPD. However, you will need a mental health professional to make the official diagnosis since BPD is often similar to other conditions like ADHD, Bipolar II, and others. Even if you don’t have an official diagnosis, you can always use self-help tips online or on social media to help with your symptoms. 

Causes of Borderline Personality Disorder

While the causes of BPD are not fully understood, researchers believe it could be a combination of things, like:

  • Genetics: Although no specific gene or gene profile has been shown to cause BPD, researchers suggest that individuals who have a close family member with BPD could be at a greater risk for developing the disorder. 
  • Environment: People who have gone through traumatic life events, like physical or sexual abuse during childhood or neglect from parents, can be at risk for developing BPD.
  • Brain function: The emotional regulation system may look different in people with BPD. As a result, there could be a neurological basis for some symptoms they experience. More specifically, the parts of the brain that are responsible for emotions and decision-making may not communicate well with each other. 

What are some complications of Borderline Personality Disorder?

Borderline personality disorder can create problems in many areas of a person’s life. It can negatively impact relationships, jobs, school, and self-image. Because of this, people with BPD may experience the following:

  • Frequent job changes or losses
  • Not being able to complete an education
  • Legal issues, like jail time
  • Conflict-filled relationships
  • Self-injury, like cutting or burning
  • Hospitalizations
  • Being involved in abusive relationships
  • Unplanned pregnancies, sexually transmitted infections (STIs), car accidents, and physical fights
  • Attempted or completed suicide

In addition, people with BPD may have other mental health conditions, like:

  • Depression
  • Substance use disorders
  • Anxiety disorders
  • Eating disorders
  • Bipolar disorder
  • Post-traumatic stress disorder (PTSD)
  • Attention-deficit Hyperactivity Disorder (ADHD)
  • Different types of personality disorders

Can BPD Be Treated?

In the past, many mental health professionals found it challenging to treat borderline personality disorder (BPD). As a result, they determined that little could be done about this mental health condition. However, now we know that this couldn’t be further from the truth and that BPD is treatable. In actuality, the long-term prognosis for BPD is even better than those for depression and bipolar disorder. However, the treatment for BPD does need a specialized approach. All in all, most people with BPD symptoms can and do improve with the proper treatments and support.

What Is the Treatment for BPD?

In previous years, specialized treatment for BPD was difficult to find. However, this disorder is getting more recognition and diagnosed more often. As a result, more communities have created specialized treatment programs that enhance mental outcomes for people with BPD.

Psychosocial treatment for BPD aims to fit the client’s goals and the clinician’s skills. These types of therapy may include:

  • Dialectical behavior therapy (DBT)
  • Cognitive-behavioral therapy (CBT)
  • Schema therapy
  • System training for emotional predictability and problem solving
  • Transference-focused psychotherapy
  • Mentalization-based therapy

Even though no medication specifically treats BPD, some medication may be prescribed to minimize specific symptoms. For instance, depression and psychotic episodes. Medication can help improve severe symptoms in BPD; however, it does not cure BPD and is not always appropriate for people who have this diagnosis.

In Summary 

According to treatment outcome research, treatment does work for BPD. Many people with this mental health condition learn to cope with their symptoms better. However, since symptoms can be complex, people with BPD usually require long-term treatment over several years.

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Kaitlen Knowles, Clinical Social Work/Therapist, LCSW (she, her), Rochester, NY

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