What is borderline personality disorder?
Borderline personality disorder (BPD) is a mental illness.
It develops during adolescence or early adulthood. It’s marked by a pattern of
emotional instability, impulsive behavior, distorted self-image, and unstable
relationships. According to the National Institute of Mental Health, about 1.6
percent of adults in the United States have BPD.
What causes BPD?
Researchers are still trying to learn the exact cause of
BPD. Multiple factors may contribute to the disorder, including genetics,
environmental factors, and serotonin abnormalities.
BPD may be a genetic condition. A study on twins and BPD
published in the Journal
of Personality Disorders suggests the disorder has a substantial genetic
Growing up in an unstable, abusive, or neglectful
environment may raise your risk of developing BPD.
Serotonin is a hormone that helps regulate mood. Abnormalities
in serotonin production may make you susceptible to BPD.
Who is at risk of BPD?
You may be at risk of developing BPD if:
- you have a family member with BPD
- you felt emotionally unstable or emotionally
vulnerable as a child
- people in your household were impulsive when you
were a child
- you were emotionally abused as a child
Symptoms and diagnosis of BPD
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental
Disorders (DSM), the following criteria are all signs and symptoms
- You frantically try to avoid real or imaginary
- You have a pattern of unstable relationships.
You alternate between idealizing and devaluing others in your relationships.
- You have an unstable self-image or
- You act impulsively in at least two areas of your
life in ways that can be self-damaging. For example, you may spend too much
money or abuse substances.
- You have a history of suicidal or
- You have frequent mood swings. They usually last
for a few hours but may last for a few days or more.
- You have severe and long-term feelings of
- You have difficulty controlling your anger or you
get severely angry without cause. You may feel angry all the time, display your
anger frequently, or get in frequent physical fights.
- You have periods of stress-related paranoia or
experience severe dissociation. Dissociation occurs when you feel like your
mind is detached from your emotions or body.
You must meet at least five of the official criteria from
the DSM to be diagnosed with BPD.
If your doctor thinks you might have BPD, they will probably
refer you to a mental health professional. They can make a diagnosis. They will
ask you questions and analyze your emotional and behavioral history.
How is BPD treated?
Your mental health professional may recommend one or more
treatments for BPD, including psychotherapy, medication, or hospitalization.
Psychotherapy is the main treatment for BPD. Your mental
health professional may recommend one of the following types: cognitive behavioral
therapy (CBT), dialectical behavior therapy (DBT), and schema-focused therapy.
CBT helps you to identify and change unhealthy beliefs,
behaviors, and inaccurate perceptions you may have about yourself or others. It
teaches you healthy ways to react when you feel angry, insecure, anxious, or
DBT teaches you how to recognize, be aware of, and accept
your beliefs and behaviors. You also learn healthy responses to these behaviors
Schema-focused therapy helps you to view yourself and the
world in a more positive way.
Medication doesn’t cure BPD, but it can relieve symptoms.
Your doctor may prescribe medication in addition to psychotherapy treatment. For
example, they may prescribe:
- antidepressants to treat depression
- antipsychotics to treat aggressive symptoms
- antianxiety medications to treat anxiety
If your symptoms are severe, your doctor may recommend that
you temporarily stay in a hospital for treatment. You may also be hospitalized
for suicidal behavior, suicidal thoughts, or thinking about harming yourself or
Omega-3 fatty acids may relieve symptoms of depression and
aggression in people who have BPD. More research is needed to confirm the
benefits of omega-3 fatty acids.
What are the possible complications of BPD?
BPD may raise your risk of other disorders, such as:
- anxiety disorders
- eating disorders
- bipolar disorder
- substance abuse
Your BPD symptoms can also increase your risk of:
- work problems
- relationship problems
- being in an abusive relationship, as the abused
or the abuser
- sexually transmitted infections
- getting in a motor vehicle accident
- getting in physical fights
- becoming the victim of violent crimes
What is the outlook for someone with BPD?
The outlook for people with BPD varies. You may face lifelong
challenges associated with your BPD. At times, you may struggle with suicidal thoughts
or self-harming behaviors. Following your doctor’s prescribed treatment plan is
essential. It can reduce the severity of your symptoms and help you lead a safe
and fulfilling life.