Borderline Personality Disorder

meganlewisaprn
Feb 17
4 min read

What Is 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 with other people. A person with borderline personality disorder may experience episodes of anger, depression, and anxiety that may last from a few hours to days.

Recognizable symptoms typically appear during adolescence (teenage years) or early adulthood, although early symptoms can occur during childhood.

Signs and Symptoms

People with borderline personality disorder may experience mood swings and display uncertainty about how they see themselves and their role in the world. As a result, their interests and values may change quickly. Individuals may view things in extremes, such as all good or all bad, and their opinions of others can shift rapidly. Someone seen as a close friend one day may be viewed as an enemy or traitor the next.

These shifting feelings can lead to intense and unstable relationships.

Other signs and symptoms may include:

Efforts to avoid real or imagined abandonment
A pattern of intense and unstable relationships, alternating between idealization and devaluation
Distorted or unstable self-image
Impulsive and potentially dangerous behaviors, such as spending sprees, unsafe sex, substance misuse, reckless driving, or binge eating
Self-harming behaviors, such as cutting
Recurring thoughts of suicidal behaviors or threats
Intense and rapidly changing moods lasting hours to days
Chronic feelings of emptiness
Inappropriate or intense anger and difficulty controlling anger
Difficulty trusting others, sometimes accompanied by irrational fears about others’ intentions
Feelings of dissociation, such as feeling detached from oneself or experiencing unreality

Not everyone with borderline personality disorder experiences every symptom. Severity, frequency, and duration vary from person to person. Symptoms may be triggered by ordinary events, such as minor separations or changes in plans.

If impulsive behaviors occur primarily during periods of elevated mood or energy, they may indicate a mood disorder rather than borderline personality disorder.

What Causes Borderline Personality Disorder?

The exact cause is unknown. Research suggests that genetic, environmental, and social factors may contribute.

Family History

People with a close family member (such as a parent or sibling) with the disorder may be at higher risk of developing borderline personality disorder or related traits such as impulsiveness or aggression.

Brain Factors

Studies suggest structural and functional differences in brain areas that regulate impulse control and emotional regulation. It is not yet clear whether these differences are causes or effects of the disorder.

Environmental, Cultural, and Social Factors

Many individuals report traumatic life events, including abuse, abandonment, or adversity during childhood. Others may have experienced unstable or invalidating relationships.

Risk factors increase vulnerability but do not guarantee that someone will develop the disorder.

Diagnosis

A licensed mental health professional—such as a psychiatrist, psychologist, or clinical social worker—can diagnose borderline personality disorder through a thorough clinical interview and discussion of symptoms.

A comprehensive medical evaluation may also help rule out other possible causes. Mental health professionals may ask about personal and family medical histories, including any history of mental illness.

Co-Occurring Conditions

Borderline personality disorder often occurs alongside other mental health conditions, which can complicate diagnosis and treatment. These may include:

Major depressive disorder
Bipolar disorder
Anxiety disorders
Attention-deficit/hyperactivity disorder (ADHD)
Substance use disorders
Eating disorders

In some cases, severe mood episodes may include psychotic symptoms such as hallucinations or delusions.

Treatment

Borderline personality disorder has historically been viewed as difficult to treat. However, with evidence-based treatment, many individuals experience fewer and less severe symptoms, improved functioning, and better quality of life.

It is important to seek and remain engaged in treatment.

Research indicates that individuals who do not receive appropriate treatment are more likely to develop additional chronic medical or mental health conditions and may be less likely to make healthy lifestyle choices.

Suicide and Self-Harm

Borderline personality disorder is associated with higher rates of self-harm and suicide attempts compared to the general population.

If you or someone you know is in immediate distress or thinking about self-harm:

Call or text 988 (Suicide & Crisis Lifeline)

Visit: https://988lifeline.org or call 911 in a medical emergency.

For more information on suicide prevention: https://www.nimh.nih.gov/health/topics/suicide-prevention

Psychotherapy

Psychotherapy is considered the first-line treatment for borderline personality disorder. It may be delivered individually or in group settings.

Two commonly used evidence-based therapies include:

Dialectical Behavior Therapy (DBT)DBT incorporates mindfulness and acceptance strategies and teaches skills for emotional regulation, distress tolerance, interpersonal effectiveness, and reduction of self-destructive behaviors.

Cognitive Behavioral Therapy (CBT)CBT helps individuals identify and change distorted beliefs and behaviors that contribute to emotional and relational difficulties.

Learn more about psychotherapy approaches: https://www.nimh.nih.gov/health/topics/psychotherapies

Medications

Medications are not typically considered the primary treatment for borderline personality disorder, as benefits may vary. However, medications may be prescribed to address specific symptoms such as mood instability, depression, anxiety, or co-occurring conditions.

Individuals should discuss risks, benefits, and potential side effects with a qualified health care provider.

For medication safety information: https://www.fda.gov/drugs