Borderline Personality Disorder

Borderline personality disorder (BPD) is a personality disorder marked by a pervasive pattern of instability of interpersonal relationships, mood swings, and unstable self-image. Borderline personality disorder can influence the way you perceive yourself and others, leading to impulsive behavior, relationship issues, and problems functioning in everyday life. BPD patients may experience intense episodes characterized by striking negative emotions that last from a few hours to days.

With BPD, you may have an intense fear of abandonment, and it can feel difficult to handle being alone. However, mood swings, impulsiveness, and anger may interfere with interpersonal relationships and push others away.

If you’ve been diagnosed with BPD, there’s good news—many people with BPD get better over time with treatment, and treatment can help reduce symptoms and improve your quality of life.

How Common is Borderline Personality Disorder?

According to the National Institute of Mental Health, approximately 1.6% of adults in the United States have Borderline Personality Disorder. However, the actual percentage of people with BPD may be higher due to misdiagnosis of mental health conditions that appear similar to BPD, such as bipolar disorder and substance use disorder.

BPD is more common among women than men. In the United States, approximately 75% of people who meet the diagnostic criteria for BPD are women.

What Causes Borderline Personality Disorder?

The cause of borderline personality disorder remains unclear, but research suggests that multiple factors may contribute to a higher risk of developing BPD, such as:

• Genetic factors: People who have family members, such as parents or siblings, with BPD may face a higher risk of developing the disorder.

• Environmental factors and social factors: Many BPD patients report traumatic life events during childhood, such as abandonment, sexual abuse, or substantial adversity. Other BPD patients report exposure to unstable relationships and hostile interpersonal conflicts.

• Brain structure: Recent research suggests that people with BPD experience structural and functional changes in the brain, especially those that control impulsiveness and emotional regulation.

Symptoms of Borderline Personality Disorder

BPD affects how you perceive yourself, how you relate to others, and how you behave. Under the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the criteria for a BPD diagnosis include:

• Frantic efforts to avoid real or imagined abandonment.
• A pervasive pattern of unstable and intense interpersonal relationships characterized by extremes of idealization and devaluation.
• Identify disturbances, which involve a persistently unstable self-image or sense of self.
• Potentially self-damaging impulsivity (e.g., overspending, risky sex, substance abuse, reckless driving).
• Recurrent suicidal behavior, suicide attempts, or threats, or self-mutilating behavior.
• Affective instability due to intense mood swings (e.g., episodic dysphoria, irritability, or anxiety that lasts a few hours or days).
• Chronic feelings of emptiness.
• Inappropriate, intense anger, or difficulty controlling anger.

BPD usually begins by early adulthood, and the personality disorder seems to be worse in young adulthood.

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Treatment Options for BPD

Borderline Personality Disorder is challenging to address. But with new ways to treat BPD, many people with BPD experience fewer or less severe symptoms and improved quality of life. The treatment of borderline personality disorder typically involves:

• Therapy: According to the American Psychiatric Association, psychotherapy is the most effective treatment for individuals with BPD, and therapy is integral to a successful BPD treatment plan. Reaching out to a mental health professional can help individuals with BPD control their emotions, reduce symptoms, and improve their quality of life.

• Medications: Medications, such as mood stabilizers and anti-anxiety medications, may be used in combination with talk therapy to treat borderline personality disorder. Your clinician may prescribe medication to address some of BPD symptoms, such as mood swings and depression, as well as other co-occurring mental disorders, such as traumatic stress disorder and anxiety disorders.

• Hotlines: If you need immediate mental health support or if you’re having suicidal thoughts, call the National Suicide Prevention Lifeline (NSPL) at 1-800-273-8255 or the National Alliance on Mental Illness Helpline at 1-800-950-NAMI. If someone you know is struggling with a mental health crisis, call the NSPL or dial 911 in an emergency.

• Check-ups: The symptoms associated with BPD can sometimes be linked to underlying medical conditions or co-occurring mental health conditions. Staying up-to-date with visits to your primary care physician can help rule out related medical conditions.

• Social support: If your loved one struggles with BPD, offer emotional support, understanding, and patience. Learning more about mental disorders, including personality disorders and mood disorders, can help you better understand your friend or family member.

Finding a Therapist for BPD

As the primary therapeutic approach for BPD patients, psychotherapy can help teach people with BPD how to interact effectively with others and express themselves. A mental health professional can provide individual treatment or may recommend therapist-led group therapy sessions.

The most common types of psychotherapy used to treat BPD include:

• Dialectical behavior therapy (DBT): This type of treatment was developed for BPD patients. DBT uses concepts of mindfulness, acceptance, and awareness to teach skills that can help reduce impulsiveness, control negative emotions, and improve interpersonal relationships.

• Cognitive-behavioral therapy (CBT): CBT can help BPD patients identify and change core beliefs and behaviors underlying unstable perceptions of themselves and others, as well as problems interacting with others. CBT may help reduce mood swings, anxiety symptoms, and other severe symptoms, such as self-mutilation and substance abuse.

• Psychodynamic psychotherapy: Two types of therapy, mentalization-based therapy, and transference-focused therapy can help BPD patients discuss past experiences, explore emotions, and identify recurring patterns in interpersonal relationships.

Friends and family members of BPD patients may consider seeking counseling from an experienced mental health professional. BPD is a serious mental illness, and having a loved one with BPD is stressful and puts immense strain on relationships. Family therapy and individual counseling can help you better understand and support your loved one.

If you’re seeking treatment for BPD, it’s essential to work with a mental health professional with whom you feel comfortable. BPD can make it difficult for people with BPD to maintain a trusting relationship with their mental health provider.At WithTherapy, we connect each patient to a personalized shortlist of mental health professionals and use science and research to match personal preferences. We’ll connect you with a mental health provider you feel comfortable with, regardless of your preferences and requirements. One of the qualified mental health professionals on the WithTherapy platform will help you understand your thoughts and feelings and improve your symptoms.

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