Borderline Personality Disorder (BPD)

What is Borderline Personality Disorder (BPD)

Borderline personality disorder is a mental health disorder. People with this condition:

  • Have unstable moods and relationships.
  • Have trouble controlling emotions.
  • Often engage in impulsive or reckless behavior.
  • Often fear being abandoned by friends or family.

People with BPD often have other mental health issues, such as depression, an anxiety disorder, a substance abuse disorder, or an eating disorder. They may develop suicidal thoughts or behaviors.

What are the causes?

The exact cause of this condition is not known. Possible causes may include:

  • Genetic factors. These are traits that are passed down from one generation to the next. Many people with BPD have a family history of the disorder.
  • Physical factors. The part of the brain that controls emotion may be different in people who have this condition.
  • Social factors. Traumatic experiences involving other people may play a role in the development of BPD. These may include child abuse or neglect.

What increases the risk?

This condition may be more likely to develop in people who:

  • Have a parent or close relative with the condition.
  • Experienced physical or sexual abuse as a child.
  • Experienced neglect or were separated from their parents as a child.
  • Have unstable family relationships or an unstable home.

What are the signs or symptoms?

Symptoms of this condition usually start during the teen years or in early adulthood. Symptoms include:

  • Extreme overreactions to the possibility of being abandoned by family or friends. This may include explosive responses to seemingly minor events, such as a change of plans.
  • Volatile relationships with friends and relatives. This may include extreme swings from feelings of love to intense anger.
  • Distorted or unstable self-image. This may affect mood, relationships, and future goals or plans.
  • Reckless or impulsive behaviors, such as shopping sprees, risky sexual behavior, substance abuse, or overeating.
  • Self-harm, such as cutting.
  • Expressing thoughts of suicide.
  • Extreme mood swings that can last for hours or days.
  • Constant boredom.
  • Problems controlling anger. This can result in shame or guilt.
  • Paranoid thoughts.
  • Losing touch with reality, often in order to help deal with unbearable situations (dissociation).

How is this diagnosed?

This condition is diagnosed based on the person’s symptoms. Information about the person’s symptoms is gathered from family, friends, and medical and legal professionals. A health care provider who specializes in physical and psychological causes of mental conditions (psychiatrist) will do a psychiatric evaluation. The person will be diagnosed with BPD if she or he has at least five common symptoms of the condition.

How is this treated?

This condition is usually treated by mental health professionals, such as psychologists, psychiatrists, and clinical social workers. More than one type of treatment may be needed. Treatment may include therapy such as:

  • Psychotherapy. This may also be called talk therapy or counseling.
  • Cognitive behavioral therapy (CBT). This helps the person to recognize and change unhealthy feelings, thoughts, and behaviors. It helps him or her find new, more positive thoughts and actions to replace the old ones.
  • Dialectical behavioral therapy (DBT). Through this type of treatment, a person learns to understand his or her feelings and to regulate them. This may be one-on-one treatment or part of group therapy.
  • Schema-focused therapy (SFT). This form of therapy helps a person with a distorted self-image to see him or herself differently. This may be one-on-one treatment or part of group therapy.
  • Family therapy. This treatment includes family members.

Medicine may be used to help control emotions and behavior and to treat anxiety and depression. The person may need to stay in the hospital for protection if he or she is behaving in a dangerous way or expressing thoughts of suicide.

Follow these instructions at home:

The person with BPD should do these things:

  • Take over-the-counter and prescription medicines only as told by his or her health care provider.
  • Maintain a daily routine. The routine should include set times to eat and sleep.
  • Do regular physical activity to reduce stress. He or she should ask a health care provider to recommend activities.
  • Communicate with close friends and relatives about what triggers his or her symptoms.
  • Find comforting people and environments.
  • Keep all follow-up visits as told by her or his health care provider. This is important.

Where to find more information

Contact a health care provider if:

  • The person’s symptoms do not improve or they get worse.
  • The person has new symptoms.
  • The person uses drugs.
  • The person’s alcohol use increases.
  • The person has trouble sleeping.
  • The person eats too much or not enough.

Get help right away if:

  • The person harms himself or herself, or expresses serious thoughts about self-harming.
  • The person expresses serious thoughts about hurting others.
  • The person sees or hears things that are not there (has hallucinations).
  • The person disconnects from reality.
  • The person is unconscious.

If it ever seems like the person may hurt himself/herself or others, or may have thoughts about taking his or her own life, get help right away. You can go to your nearest emergency department.

Summary

  • Borderline personality disorder (BPD) is a mental health disorder. People with this condition may have unstable moods and relationships, have trouble controlling emotions, and may engage in impulsive or reckless behavior.
  • A health care provider who specializes in physical and psychological causes of mental conditions (psychiatrist) will do a psychiatric evaluation. The person will be diagnosed with BPD if she or he has at least five common symptoms of the condition.
  • This condition is usually treated by mental health professionals, such as psychologists, psychiatrists, and clinical social workers. More than one type of treatment may be needed.
  • Contact a health care provider if the person’s symptoms do not improve or they get worse.
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