Borderline personality disorder (BPD) is a often characterized by difficulties in regulating emotion. This difficulty sometimes leads to unstable mood swings, impulsivity and instability, poor self-image and difficult personal relationships. A person living with BPD sometimes will exhibit destructive behavior, such as self-harm (cutting) or suicide attempts. It’s estimated that 1.6% of the adult U.S. population has BPD. Nearly 75% of people diagnosed with BPD are women, but recent research suggests that men may be almost as frequently affected by BPD.
People with BPD experience wide mood swings and sometimes display a great sense of instability and insecurity. Signs and symptoms may include: Frantic efforts to avoid being abandoned by friends and family. Unstable personal relationships that alternate between idealization—“I’m so in love!”—and devaluation—“I hate her.” This is also known as “splitting.” Distorted and unstable self-image, which affects moods, values, opinions, goals and relationships. Impulsive behaviors that can have dangerous outcomes, such as excessive spending, unsafe sex, substance abuse or reckless driving. Suicidal and self-harming behavior. Periods of intense depressed mood, irritability or anxiety lasting a few hours to a few days. Chronic feelings of boredom or emptiness. Inappropriate, intense or uncontrollable anger—often followed by shame and guilt. Dissociative feelings—disconnecting from your thoughts or sense of identity, or “out of body” type of feelings—and stress-related paranoid thoughts. Suicide threats and attempts are very common for people with BPD. Self-harming acts, such as cutting and burning, are also common.
The causes of borderline personality disorder are not fully understood, but experts agree that it is the result of a combination of factors: Genetics. While no specific gene has been shown to directly cause BPD, studies in twins suggest this illness has strong hereditary links. BPD is about five times more common among people who have a first-degree relative with the disorder. Environmental factors. People who experience traumatic life events, such as physical or sexual abuse during childhood or neglect and separation from parents, are at increased risk of developing BPD. Brain function. The way the brain works is often different in people with BPD, suggesting that there is a neurological basis for some of the symptoms. Specifically, the portions of the brain that control emotions and decision-making/judgment may not communicate well with one another.
There is no single medical test to diagnose BPD, and a diagnosis is not based on one sign or symptom. BPD is diagnosed by a mental health professional following a comprehensive evaluation. To be diagnosed with BPD, a person must have at least 5 of the 9 BPD symptoms listed above.
Treatment for BPD generally includes psychotherapy and medications. Psychotherapy, such as dialectical behavioral therapy (DBT), cognitive behavioral therapy (CBT) and psychodynamic psychotherapy, usually works well for people with BPD. Medications are often used in treatment, but there is no one medication specifically made to treat the core symptoms of emptiness, abandonment and identity disturbance. Rather, several medications can be used off-label to treat the remaining symptoms. For example, mood stabilizers and antidepressants help with mood swings and dysphoria. Antipsychotic medication may help control symptoms of rage and disorganized thinking. Short-term hospitalization may be necessary during times of extreme stress, and/or impulsive or suicidal behavior to ensure safety.
BPD can be difficult to diagnose and treat—and successful treatment includes addressing any other disorders somebody might have. A person with BPD may have additional conditions like: anxiety disorders, such as PTSD. bipolar disorder, depression or eating disorders. They may also have other personality disorders or substance use disorders.
Although you may realize that your behaviors are destructive it may be difficult to control them. Treatment can teach you ways to cope. Here are some other ways to help manage your illness: Connect with others. Find emotional support from others living with BPD. It’s helpful to share your thoughts, fears and questions with other people who have the same illness. Use online message boards or groups found through social sites like meetup.com or Facebook. Avoid excessive use of drugs and alcohol. These substances can disturb emotional balance and interact with medications. Take care of your body. Eat well and exercise. To relieve stress, try activities like meditation or yoga.
Helping A Family Member Or Friend
The support of family and friends is critical in the treatment of BPD, as many people with this illness may isolate themselves from these relationships in times of greatest need. Look for warning signs. BPD often shows in erratic behavior, shopping sprees, sexual or substance binges and blow-up fights in relationships. If a person is open to it, discuss your friend or family member’s past episodes with them so he or she can clearly recognize the signs early. Encourage continued treatment. Family and friends can be helpful in encouraging someone to engage in proper treatment.
While this is a difficult condition to have or to have a loved one suffer from with the correct help, you or your loved one can live a stable life with BPD.