Borderline personality disorder (BPD) is one of a group of illnesses known as personality disorders. People with this disorder also have a high risk of developing other mental disorders including substance use disorders, depression, and eating disorders.
BPD affects a person's thoughts, leading to extreme emotional reactions, a loss of sense of self, trouble forming or maintaining relationships, self-destructive actions, and self-harm or suicide attempts. With the help and support of a good care team, borderline personality disorder can be treated and controlled.
Borderline Personality Disorder Symptoms
Only a doctor or therapist can make a diagnosis and help you begin treatment. Some symptoms that may indicate that you or a loved one has borderline personality disorder include:
- Intense, irrational fear of abandonment or being alone
- Engaging in acts of self-harm
- Engaging in risky, dangerous behaviors
- Showing signs of impulsivity
- Trouble forming or maintaining relationships; a pattern of instability in relationships
- Sudden, violent mood swings
- Problems regulating your emotions or feeling like they are out of control
- Extreme self-criticism and poor self-image
- Physically, emotionally, or sexually abusing someone else
- Making plans or expressing intent to hurt others - seek help immediately by calling 911
- Engaging in suicidal behaviors or making suicide plans - seek help immediately by calling 911
Borderline Personality Disorder Causes and Risk Factors
Many factors may be correlated with the development of a personality disorder like borderline personality disorder. Some factors that may put one at risk for developing borderline personality disorder include:
- Childhood sexual, emotional, or physical abuse
- Childhood abandonment, or rejection by parental figures
- Structural or functional issues in the brain or a traumatic brain injury
- Exposure to trauma like war, becoming an orphan, or instability or violence in childhood
- Having another family member with borderline personality disorder or a personality disorder
Borderline Personality Disorder Treatment
A qualified care team can help you come up with a treatment plan to get your borderline personality disorder under control using medication, therapy, and support.
Medication: Mood stabilizers and anti-depressants along with other drugs, have been used to help control BPD.
Therapy: Dialectical behavior therapy (DBT) is commonly used to help treat borderline personality disorder. Learn more about DBT; find programs that offer DBT-informed treatment and comprehensive DBT at Sheppard Pratt.
Education: Knowing more about borderline personality disorder and other personality disorders can help you explain what’s going on to your friends and loved ones. It can also help you learn about your treatment options. Find more educational resources through Sheppard Pratt.
Support: Getting the support that you and your family need is a big step toward improving your life. Find a support group that can help.
Overview
Borderline personality disorder is a mental health disorder that impacts the way you think and feel about yourself and others, causing problems functioning in everyday life. It includes self-image issues, difficulty managing emotions and behavior, and a pattern of unstable relationships.
With borderline personality disorder, you have an intense fear of abandonment or instability, and you may have difficulty tolerating being alone. Yet inappropriate anger, impulsiveness and frequent mood swings may push others away, even though you want to have loving and lasting relationships.
Borderline personality disorder usually begins by early adulthood. The condition seems to be worse in young adulthood and may gradually get better with age.
If you have borderline personality disorder, don't get discouraged. Many people with this disorder get better over time with treatment and can learn to live satisfying lives.
Symptoms
Borderline personality disorder affects how you feel about yourself, how you relate to others and how you behave.
Signs and symptoms may include:
- An intense fear of abandonment, even going to extreme measures to avoid real or imagined separation or rejection
- A pattern of unstable intense relationships, such as idealizing someone one moment and then suddenly believing the person doesn't care enough or is cruel
- Rapid changes in self-identity and self-image that include shifting goals and values, and seeing yourself as bad or as if you don't exist at all
- Periods of stress-related paranoia and loss of contact with reality, lasting from a few minutes to a few hours
- Impulsive and risky behavior, such as gambling, reckless driving, unsafe sex, spending sprees, binge eating or drug abuse, or sabotaging success by suddenly quitting a good job or ending a positive relationship
- Suicidal threats or behavior or self-injury, often in response to fear of separation or rejection
- Wide mood swings lasting from a few hours to a few days, which can include intense happiness, irritability, shame or anxiety
- Ongoing feelings of emptiness
- Inappropriate, intense anger, such as frequently losing your temper, being sarcastic or bitter, or having physical fights
When to see a doctor
If you're aware that you have any of the signs or symptoms above, talk to your doctor or a mental health provider.
If you have suicidal thoughts
If you have fantasies or mental images about hurting yourself or have other suicidal thoughts, get help right away by taking one of these actions:
- Call 911 or your local emergency number immediately.
- Call a suicide hotline number. In the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) any time of day. Use that same number and press "1" to reach the Veterans Crisis Line.
- Call your mental health provider, doctor or other health care provider.
- Reach out to a loved one, close friend, trusted peer or co-worker.
- Contact someone from your faith community.
If you notice signs or symptoms in a family member or friend, talk to that person about seeing a doctor or mental health provider. But you can't force someone to seek help. If the relationship causes you significant stress, you may find it helpful to see a therapist yourself.
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Causes
As with other mental health disorders, the causes of borderline personality disorder aren't fully understood. In addition to environmental factors — such as a history of child abuse or neglect — borderline personality disorder may be linked to:
- Genetics. Some studies of twins and families suggest that personality disorders may be inherited or strongly associated with other mental health disorders among family members.
- Brain abnormalities. Some research has shown changes in certain areas of the brain involved in emotion regulation, impulsivity and aggression. In addition, certain brain chemicals that help regulate mood, such as serotonin, may not function properly.
Risk factors
Some factors related to personality development can increase the risk of developing borderline personality disorder. These include:
- Hereditary predisposition. You may be at a higher risk if a close relative — your mother, father, brother or sister — has the same or a similar disorder.
- Stressful childhood. Many people with the disorder report being sexually or physically abused or neglected during childhood. Some people have lost or were separated from a parent or close caregiver when they were young or had parents or caregivers with substance misuse or other mental health issues. Others have been exposed to hostile conflict and unstable family relationships.
Complications
Borderline personality disorder can damage many areas of your life. It can negatively affect intimate relationships, jobs, school, social activities and self-image, resulting in:
- Repeated job changes or losses
- Not completing an education
- Multiple legal issues, such as jail time
- Conflict-filled relationships, marital stress or divorce
- Self-injury, such as cutting or burning, and frequent hospitalizations
- Involvement in abusive relationships
- Unplanned pregnancies, sexually transmitted infections, motor vehicle accidents and physical fights due to impulsive and risky behavior
- Attempted or completed suicide
In addition, you may have other mental health disorders, such as:
- Depression
- Alcohol or other substance misuse
- Anxiety disorders
- Eating disorders
- Bipolar disorder
- Post-traumatic stress disorder (PTSD)
- Attention-deficit/hyperactivity disorder (ADHD)
- Other personality disorders