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 a pattern of unstable intense relationships, distorted self-image, extreme emotions and impulsiveness.
In general, someone with a personality disorder will differ significantly from an average person in terms of how he or she thinks, perceives, feels or relates to others. 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. The causes of BPD are unclear. However, as with most conditions, BPD appears to result from a combination of genetic and environmental factors.
Traumatic events that occur during childhood are associated with developing BPD. Many people with BPD will have experienced parental neglect or physical, sexual or emotional abuse during their childhood.
Some research have also 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.
How Can I Tell if I Have Borderline Personality Disorder?
The 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.
Many people experience one or more of the above symptoms regularly, but a person with borderline personality disorder will experience many of the symptoms listed above consistently throughout adulthood.
The term “borderline” refers to the fact that people with this condition tend to “border” on being diagnosed with additional mental health conditions in their lifetime, including psychosis. In addition to these symptoms, a doctor will have to make a diagnosis to confirm that what you are experiencing is truly borderline personality disorder and not some other condition.
A diagnosis is usually made in adults, not in children or teenagers. That’s because what appear to be signs and symptoms of borderline personality disorder may go away as children get older and become more mature.
Personality disorders disordera are diagnosed based on a:
- Detailed interview with your doctor or mental health provider.
- Psychological evaluation that may include completing questionnaires.
- Medical history and exam.
- Discussion of your signs and symptoms.
How Can It Be Managed?
It is mainly treated using psychotherapy, but medication may be added. Your doctor also may recommend hospitalization if your safety is at risk. Psychotherapy, also called talk therapy, is a fundamental treatment approach for borderline personality disorder. Your therapist may adopt the type of therapy to best meet your needs.
Types of psychotherapy that have been found to be effective include:
- Dialectical behavior therapy (DBT).
- Schema-focused therapy.
- Mentalization-based therapy (MBT).
- Systems training for emotional predictability and problem-solving (STEPPS).
- Transference-focused psychotherapy (TFP).
- Good psychiatric management.
Although no drugs have been approved by the Food and Drug Administration specifically for the treatment of borderline personality disorder, certain medications may help with symptoms or co-occurring problems such as depression, impulsiveness, aggression or anxiety. Medications may include antidepressants, antipsychotics or mood-stabilizing drugs.
- Mayo Clinic – Borderline Personality Disorder
- nhs.uk – Borderline Personality Disorder
- Psycom.net – Depression
- nimh.nih.gov – Borderline Personality Disorder
- yourhealthmind.org – Mental illnesses