Borderline Personality Disorder
Borderline personality disorder is an illness marked by an ongoing pattern of varying moods, self-image, and behavior. These symptoms often result in impulsive actions and problems in relationships. People with borderline personality disorder may experience intense episodes of anger, depression, and anxiety that can last from a few hours to days.
Signs and Symptoms
People with BPD experience wide mood swings and can feel a great sense of instability and insecurity. According to the Diagnostic and Statistical Manual diagnostic framework, some key signs and symptoms may include:
Feelings of dissociation, such as feeling cut off from oneself, seeing oneself from outside one’s body, or feelings of unreality
Recurring thoughts of suicidal behaviors or threats
A pattern of intense and unstable relationships with family, friends, and loved ones, often swinging from extreme closeness and love (idealization) to extreme dislike or anger (devaluation
Efforts to avoid real or imagined abandonment, such as rapidly initiating intimate (physical or emotional) relationships or cutting off communication with someone in anticipation of being abandoned
Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating. Please note: If these behaviors occur primarily during a period of elevated mood or energy, they may be signs of a mood disorder—not borderline personality disorder
It is estimated that 1.4% of the adult US population experiences Borderline Personality Disorder. Nearly 75% of people diagnoses with BPD are women. Recent research suggests that men may be equally affected by BPD, but are commonly misdiagnosed with PTSD or depression
Diagnosis
BPD is diagnosed based on a psychological evaluation that assesses the history and severity of the symptoms
Causes
The cause of borderline personality disorder is unknown. Genetic, family, and social factors are thought to play roles.
Risk factors for BPD include:
Abandonment in childhood or adolescence
Disrupted family life
Poor communication in the family
Sexual, physical, or emotional abuse
Related Conditions
BPD can be difficult to diagnose and treat, and successful treatment includes addressing any other conditions a person might have. Many with BPD also experience additional conditions like:
Anxiety Disorders
Post-traumatic Stress Disorder
Bipolar Disorder
Depression
Eating Disorders (notably bulimia nervosa)
Substance Use Disorders
Treatments and Therapies
Individual talk therapy such as cognitive behavioral therapy and dialectical behavioral therapy may successfully treat BPD. In addition, group therapy can sometimes be helpful.
Medications have less of a role in the treatment of BPD. But in some cases, they can improve mood swings and treat depression or other disorders that may occur with this condition.
Psychosocial Rehabilitation (PSR) can be beneficial in treating BPD as the model allows for those who suffer from BPD to receive help in the settings in which their symptoms are the most present.
While most people can live in the community during their treatment (outpatient), higher levels of care may be useful at moments when more intensive clinical support is needed. For example, a hospital inpatient unit can provide a safe environment for a person with BPD who is actively suicidal.
Helpful reads related to BPD:
“I Hate You--Don't Leave Me: Understanding the Borderline Personality” by Jerold Kreisman
“Loving Someone With Borderline Personality Disorder” by Shari Y. Manning
“Get Me Out of Here” by Rachel Reiland
“Stop Walking on Eggshells” by Paul Mason and Randi Kreger
“Coping with BPD” by Blaise Aguirre and Gillian Galen
