Borderline personality disorder (BPD) is a serious mental health condition that is characterizing by difficulties regulating emotions and thoughts, unstable relationships, and impulsive behavior. An estimated 1.6% of adults in the United States have BPD. While the causes are not fully understandable, a combination of genetic and environmental factors likely plays a role.
Symptoms of Borderline Personality Disorder
People with BPD tend to experience intense and unstable emotions and moods that can shift fairly quickly. Some common symptoms include:
- Emotional dysregulation – Those with BPD frequently and rapidly experience exaggerated mood swings. They often feel persistent sadness, anger, and anxiety that feels out of proportion to the situation.
- Unstable relationships – People with BPD typically have intense, short-lived relationships with extremes between idealization and devaluation. They often fear abandonment and rejection. Additionally, they have difficulty being alone and tend to have love-hate relationships.
- Impulsivity – Individuals with BPD act impulsively by engaging in risky, dangerous behaviors without considering the consequences. For example, this impulsivity can lead to reckless driving, substance abuse, binge eating, casual sex, or spending sprees.
- Self-harm – People with BPD may make suicidal threats or actually engage in self-harm behaviors like cutting or burning. Oftentimes, this is a way to cope with painful emotions.
- Identity disturbances – Those with BPD experience a shifting sense of self, feelings of emptiness, and dissociative states. They also have chronic feelings of boredom or loneliness.
Furthermore, people with BPD have difficulties controlling their anger, are hypersensitive to criticism, and feel chronic emptiness or boredom. Their sense of self is typically unstable, and they often feel unsure of their identity and values.
Causes and Risk Factors
The exact causes of BPD are not known. However, research suggests a combination of genetic, environmental, neurological and social factors contribute to its development. Risk factors include:
- Family history of BPD or other mental illness
- Traumatic life events like childhood abuse or neglect
- Brain abnormalities or differences in structure and function
- Unstable family life, loss of caregivers, lack of secure attachments
BPD is believed to be linked to the way the brain regulates emotions and processes information. It often first appears in adolescence or early adulthood, and is diagnosed more often in females. Childhood trauma and unstable family environments also increase the risk.
Getting a BPD Diagnosis
If symptoms of BPD are present, it is important to see a mental health professional for evaluation and diagnosis. The provider will ask about your symptoms, thoughts, feelings, medical history, and family background.
No single test can definitively diagnose BPD. Rather, your provider will assess all the symptoms and rule out other possible causes to make an accurate diagnosis. BPD can be misdiagnosed as another mental illness like depression or bipolar disorder. A proper diagnosis leads to more effective treatment.
Treatment for Borderline Personality Disorder
While BPD is a challenging condition, the right treatment helps many people learn to manage symptoms and lead happy, fulfilling lives. Treatment is tailored to each person but often involves:
- Psychotherapy – This is the primary treatment for BPD. Dialectical behavior therapy (DBT) is a specialized type of talk therapy designed for BPD. It teaches coping skills for stress, relationships, and regulating emotions. Additionally, talk therapy helps process trauma and improve self-image.
- Medications – No medications are FDA approved to treat BPD specifically. However, antidepressants, mood stabilizers, and antipsychotic medications can be used to treat specific symptoms. Medications are often used alongside therapy.
- Hospitalization – During a mental health crisis like severe depression or suicidal thoughts, a brief hospital stay may be necessary to keep someone safe until mood improves.
- Support groups – Joining a support group provides connection with others facing similar challenges. Support groups can aid the recovery process.
- Alternative therapies – Options like art therapy, yoga, or mindfulness practices may support traditional treatments. But more research is needed on their effectiveness.
The most effective treatment for BPD is long-term therapy focusing on improving coping mechanisms and interpersonal relationships. With appropriate treatment, many people with BPD experience a reduction in symptoms and improvement in overall functioning. Support from professionals, family and friends is key.
Outlook for People with Borderline Personality Disorder
BPD was once thought to be untreatable, but that outdated perception is changing. With more advanced, compassionate treatment, many people achieve remission of symptoms or full recovery:
- With therapy, over half see improvement within a year. Between 10-15% fully recover.
- DBT can help reduce suicide attempts, self-harm, anger issues, depression, and hospitalizations.
- Medications provide relief from symptoms for many people.
- Although lapses may occur, the long-term outlook can be good with comprehensive treatment.
- Recovery is possible. With consistent treatment, people with BPD can lead fulfilling, productive lives.
If you or a loved one exhibit signs of BPD, reach out to a mental health professional. Though challenging to live with, borderline personality disorder is treatable. Early intervention, social support and proper treatment provide hope for improved quality of life.