What is Borderline Personality Disorder?

Borderline Personality Disorder (BPD) is a chronic mental health disorder that’s characterized by extreme emotional reactions, self-image issues, fear of abandonment, instability in relationships, and intense mood swings. BPD can be disruptive to a person’s everyday life and impact their ability to function normally. The condition affects how a person behaves, how they relate to others, and how they feel about themselves, and it involves persistent, day-to-day emotional symptoms that are usually triggered by environmental factors like a relationship conflict or stress at home or at work.

When someone has BPD, their emotional reactions tend to be intense and highly disproportionate to the event at hand, noticeably inappropriate to the circumstances around them. For example, if the significant other a person without BPD does not return their phone call right away, it might annoy them or frustrate them for a moment, but then they would be able to move on normally with their day. For someone with BPD, a minor event like this could trigger a full on fit of rage or an anxiety attack, leading to explosive episodes or desperate cries for attention.

The symptoms of borderline personality disorder usually begin in early adulthood, which is often the hardest time for individuals with BPD and the period during which they suffer the most impairment. For some, the condition gradually improves with age. If you or someone you love is struggling with BPD, all hope is not lost. People with BPD tend to benefit significantly from professional mental health services, and the majority stabilize and are able to lead healthy, productive lives after finding the proper mental health care.

 

What are the symptoms of Borderline Personality Disorder?

BPD is characterized by daily emotional symptoms that are short-lived, but can impact everyday life and relationships. Signs and symptoms of BPD may include some or all of the following:

• Fear of abandonment
• A pattern of unstable relationships
• Shifting self-identity and self-image
• Periods of stress-related paranoia
• Frequent temper tantrums
• Feelings of emptiness
• Difficulty tolerating being alone
• Intense mood swings lasting from a few hours to a few days
• Partaking in impulsive and risky behavior, such as:
  • Binge eating
  • Gambling
  • Reckless driving
  • Sabotaging success by suddenly ending a healthy relationship or quitting a good job
  • Spending sprees
  • Substance abuse
• Self-injury or suicidal threats or behavior

 

What are the causes of BPD?

The exact cause of borderline personality disorder is unknown, but researchers believe that both environmental and genetic factors are at play in predisposing people to the condition. Studies and research have suggested that BPD results from a combination of individual temperament, experiencing neglect, abandonment, or abuse as a young child, and a series of traumatic or upsetting events that may trigger the onset of the disorder in young adulthood.

 

Genetic Factors

• BPD is much more commonly diagnosed in women than it is in men.
• BPD tends to be more common among people who have close relatives with the disorder.
• People with BPD tend to be more vulnerable to environmental stress.
• Studies suggest that certain traits involved in BPD, such as impulsive aggression and intense emotional reactions, stem to a large degree from genetic, brain-based differences.
• Some research has shown that in people with BPD, certain brain chemicals that help regulate mood, such as the neurotransmitter serotonin, may not function properly.

Environmental Factors

• Studies have shown that many individuals with BPD report a history of childhood abuse, neglect or parental separation.
• Researchers have said that people with BPD are more likely to report having been sexually abused in their lifetime.
• Developmental factors from childhood, such as problems with emotional attunement between a developing child and their caregivers, seem to play a role in the development of BPD.
• Some people with BPD report growing up with caregivers who had substance use disorders or other significant health issues, and others report being exposed to hostile conflict in the home or unstable family dynamics.

 

How can living with BPD affect you?

Living with BPD can have negative impacts on everyday life, relationships, and both physical and mental health.

Everyday life

The chronic, day-to-day emotional symptoms that are associated with BPD can cave damaging consequences for everyday life. People with borderline personality disorder are more likely to repeatedly change jobs or lose their jobs, tend to take longer to complete an education or end up not completing an education at all, and are more likely to experience serious legal issues like jail time.

Relationships

Relationships that are fraught with conflict are a hallmark of borderline personality disorder. Even though people with BPD may want to have loving, long-lasting relationships, symptoms of their condition like inappropriate anger, mood swings, and impulsive decision making may push others away. Relationships for those with BPD are chaotic and often shift from idealizing someone one moment to suddenly hating them and dismissing them completely, usually after a perceived rejection or slight from that person.

Individuals with BPD also have difficulty reading and trusting people, and usually struggle to accurately perceive the emotions of others. Due to these complications, people with BPD are more likely to experience relationship issues like marital stress or divorce.

Health

Borderline personality disorder can result in serious physical and mental health outcomes. People with BPD are more likely to engage in self-harm behaviors such as cutting or burning their skin. This is a way for people with BPD to discharge painful, intense emotions like rejection or anger and it is an alarmingly common and dangerous symptom of BPD. In addition to self-harm, other risky and impulsive behaviors can include substance abuse, sexual promiscuity, and physical altercations.

BPD is known to occur alongside other mental health disorders. These can include alcohol or substance abuse, anxiety disorders, depression, eating disorders, and trauma.

Treatment for Borderline Personality Disorder

Psychotherapy, also known as talk therapy, is considered to be the first line treatment for borderline personality disorder. Group therapy, family therapy, and individual therapy have all shown to be effective forms of treatment for BPD.

Although it cannot cure the condition, psychotherapy is beneficial for people with BPD because it can help them learn skills to manage and cope with their symptoms, and it can offer treatment for any other mental health disorders that tend to occur alongside BPD. Goals of psychotherapy are to help patients with:

• Tolerating uncomfortable emotions
• Observing feelings rather than acting on them
• Improving relationships
• Becoming more aware of the feelings of others
• Developing a more coherent sense of self
• Learning more about BPD

Several forms of psychotherapy have proven effective in alleviating BPD symptoms. These include:

• Dialectical Behavioral Therapy (DBT)
• Mentalization Based Therapy (MBT)
• Cognitive Behavioral Therapy (CBT)
• Psychodynamic Therapy