Borderline Personality Disorder

Borderline personality disorder (BPD) is a type of mental illness. People with BPD have unstable moods, reckless actions, and a hard time managing their emotions. If you have BPD, you may have problems with daily tasks, obligations, and life events. You may have trouble keeping jobs and relationships. And you may use food, alcohol, or other substances to cope.

It’s important for you to get treatment, because you are at higher risk of suicide. You are also at higher risk for depression, anxiety, substance abuse, and self-harm. Experts are still learning about the condition, but certain kinds of treatment can help and are often quite successful.

Symptoms of borderline personality disorder

The symptoms of BDP often show up in adolescence or teen years. The symptoms can vary from person to person. But people with BPD will have at least five of these symptoms over a period of time:

  • A pattern of severe mood changes over hours or days

  • Extreme anger and problems with controlling anger

  • Intense, up-and-down relationships with family and friends that can go quickly from very close to anger and hatred

  • Extreme fear of and reactions to abandonment, and extreme behaviors to avoid abandonment

  • A rapidly changing sense of self that can result in sudden changes in goals, values, or behaviors

  • Feeling disconnected from themselves, their body, or reality, or having paranoid thoughts

  • Ongoing feelings of emptiness

  • Self-destructive behaviors, such as substance abuse, binge eating, unsafe sex with multiple partners, unsafe driving, or reckless spending

  • Suicide attempts or self-harming behavior, such as cutting, hair pulling, or burning

What causes borderline personality disorder?

Doctors don’t know the exact causes of BPD. Some studies have shown it may be passed down in families. Your social and cultural surroundings may also play a part. For example, you may be at higher risk for BPD if you are part of a community with unstable relationships.

Diagnosing borderline personality disorder

If you have BPD symptoms, you can be diagnosed by a mental health provider. This type of specialist can include a psychiatrist or a psychologist. Or you may be seen by a clinical social worker or psychiatric nurse practitioner. The mental health provider will ask about your medical history and your symptoms. You may be asked about your family’s history of mental health conditions. You may also have a physical exam. This can rule out other illness. Make sure to tell the mental health provider about any health conditions you have and any medications you take.

Treatment for borderline personality disorder

Many people with BPD respond well to treatment and get better. The most common treatment for BPD is psychotherapy. It can be done one-on-one or in a group setting. It may also be helpful if your family is part of the treatment. A trained psychotherapist may use one or more of these methods:

  • Cognitive behavioral therapy. This type of therapy gives you tools to help change your thoughts and actions.

  • Dialectical behavior therapy. This type of therapy helps you to be more aware of the current moment. It teaches you how to reduce extreme emotions and actions.

  • Schema-focused therapy. This type of therapy helps you change how you see yourself. It helps you turn negative views into more positive ones.

  • Systems Training for Emotional Predictability and Problem Solving, or STEPPS. This type of therapy trains you to use tools to manage your reactions to certain situations.  Family and friends are also trained.

Medications can also help some people with BPD. Neuroleptic and atypical antipsychotic medication can help with some symptoms. Antidepressant and anti-anxiety medication can be used to treat symptoms of depression or anxiety that may happen at the same time as BPD.

If you have severe symptoms, you may need hospital care for a period of time.

Living with borderline personality disorder

If you have BPD:

  • See your health care provider or therapist on schedule. Don’t skip appointments.

  • Make sure to get enough sleep. Tell your health care provider if you’re having trouble sleeping.

  • Keep a healthy diet, and eat at regular meal times.

  • Be physically active to help reduce stress and boost mood.

  • Keep track of people, places, or situations that trigger your symptoms.

  • Talk with your health care provider right away if your symptoms get worse, or if you feel suicidal.