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Topic » Borderline Personality Disorder

Borderline Personality Disorder

Borderline Personality Disorder site

Borderline personality disorder (BPD) is a psychiatric disorder in which the person suffers from unstable relationships, a distorted sense of self and reality, and emotional dysfunction.

What Is Borderline Personality Disorder?

Borderline personality disorder (BPD) is a mental health condition that strongly affects our ability to control our emotions and can distort how we see ourselves and others. BPD can cause impulsive behavior patterns, emotion regulation issues, poor self-image, mood swings, and impair daily functioning. It is a form of personality disorder that can lead to unstable social and personal relationships.

One 2016 study 1 defines borderline personality disorder (BPD) as “a psychiatric syndrome that is characterized by emotion dysregulation, impulsivity, risk-taking behavior, irritability, feelings of emptiness, self-injury, and fear of abandonment, as well as unstable interpersonal relationships”. Surveys 2 estimate that BPD affects 1.6% of the world population and has a lifetime prevalence of about 6%.

A person suffering from BPD has problems regulating his/her emotions and actions. He/she suffers from disoriented thoughts and beliefs and a sense of distorted reality. Because of this mental confusion, the person suffers from a lack of identity and a feeling of emptiness, thereby resorting to desperate attention-seeking behavior and dependence on others.

The patient becomes impulsive and reckless and fails to display any morals; consequently, he/she goes into a spiral of self-destructive behavior. Such behavior includes extremes of idealization, devaluation, and depersonalization of close relationships and volatile conduct that borders on self-harm and harming others around him/her.

Frequently, the BPD patient experiences mood swings and violent urges that come from hypersensitivity to rejection, self-complexity, thought repression, and a lack of resilience against stressors. He/she unconsciously or unintentionally acts out against loved ones—a phenomenon called splitting—without any sense of guilt or remorse. Paradoxically, they suffer from commitment and trust issues and fears of abandonment—because of which, they make frantic efforts to avoid real or imagined abandonment.

Research 3 also shows that people with BPD do not react positively or copingly to stressors, and this makes them spiral out of control. To “manage” such distressing incidents, they develop maladaptive and negative belief systems and unhealthy coping mechanisms like substance abuse, self-harm, abusive behavior, etc.

Read More About Self-Harm Here

What Are The Symptoms Of Borderline Personality Disorder?

Symptoms Of BPD
Borderline Personality Disorder

Borderline personality disorder symptoms include:

  1. Emotional dysfunction
  2. Extreme fears of abandonment
  3. Frantic efforts to avoid real or imagined abandonment
  4. Unstable social relationships
  5. Distorted sense of reality
  6. Lack of identity and morals
  7. Feelings of victimization
  8. Impulsive and reckless behavior
  9. Self-complexity
  10. Thought repression
  11. Lack of resilience against stressors
  12. Splitting, or sudden mood and behavioral changes
  13. Chronic feelings of emptiness
  14. Paranoia and dysphoria
  15. Depersonalization and dissociation
  16. Suicidal or self-harm tendencies
  17. Mental disorders like depression, psychosis, eating disorders, substance abuse disorders, anxiety disorders, stress disorders, ADHD, etc.

Read More About Paranoia Here

What Are The Types Of Borderline Personality Disorder?

There are 4 types of borderline personality disorder:

1. Discouraged Borderline Personality Disorder

Discouraged borderline is a type of BPD characterized by over-dependence 4 on others. It is marked by:

  • Extreme indecisiveness
  • Clinginess
  • “Passive follower” mentality

2. Impulsive Borderline Personality Disorder

People with impulsive BPD experience reckless thrill-seeking urges and have no regard for the consequences of their actions. This type of BPD is marked by:

  • Recklessness
  • Elusive and mercurial behavior
  • Superficial charm
  • Unwillingness to form meaningful relationships
  • Thrill-seeking behavior
  • Risk-taking behavior

3. Petulant Borderline Personality Disorder

Petulant borderline personality disorder is predominantly marked by emotional dysfunction and aggressive conduct. It is characterized by:

  • Mood swings
  • Irritability
  • Defiance
  • Passive-aggressive behavior
  • Low self-esteem
  • Unstable relationships

Read More About Self-Esteem Here

4. Self-destructive Borderline Personality Disorder

Self-destructive BPD is a type of BPD wherein a person takes to negative, delusional, and self-defeating thoughts and actions. Its markers include:

  • Lack of self-identity and control
  • Fear of abandonment
  • Commitment issues
  • Bitter moods and anger

What Are The Causes Of Borderline Personality Disorder?

Causes of BPD
Borderline Personality Disorder

BPD is caused by a myriad of factors. These include:

1. Genetics

According to a 2017 study 5, BPD “has moderate to high heritability based on twin and family studies”. It is found that 50% of BPD variation 3 is caused by genetics.

Read More About Genetics Here

2. Brain Abnormalities

BPD is caused by certain functional and structural changes in the brain, including:

  • Reductions in brain regions involved in the regulation of stress responses and emotion
  • Concentrations of neurometabolites in certain brain regions
  • Smaller hippocampus
  • Smaller amygdala
  • Reduced activity in the prefrontal cortex
  • Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis
  • Disturbed cortisol levels
  • Dysfunctioning stress hormones

3. Personality Traits

Certain personality traits make people more vulnerable to BPD than others. Dubbed the “borderline personality disorder traits”, these include:

  • Narcissism
  • Extraversion
  • Neuroticism
  • Masochism
  • Negativism
  • Avoidant personality
  • Depressive personality
  • Antisocial personality

Read More About Narcissism Here

4. Environmental Factors

Certain BPD risk factors are environment-related. Studies 6 show that BPD is caused by a multitude of psychosocial factors, including:

  • A history of child sexual abuse
  • Dysfunctional family environment
  • A history of parental abuse
  • A history of domestic violence
  • Experiences of bullying
  • Traumatic life events

What Are The Recurring Disorders With Borderline Personality Disorder?

The signs of borderline personality disorder are complex and confusing, interspersed with several comorbid disorders like:

  • Depression
  • Bipolar disorder
  • Anxiety disorders
  • Stress disorders
  • Personality disorders
  • Schizophrenia
  • Substance use
  • Eating disorders
  • Attention deficit hyperactivity disorder
  • Somatic symptom disorders
  • Dissociative disorders

Read More About Bipolar Disorder Here

How To Diagnose Borderline Personality Disorder

The criteria for diagnosis of borderline personality disorder have been laid out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) 7. It states that people suffering from BPD display “a pervasive pattern of instability of interpersonal relationships, of self-image, and affects as well as marked impulsivity beginning by early adulthood and present in a variety of contexts”. These include:

  • Frantic efforts to avoid real or imagined abandonment
  • A pattern of insecure and intense interpersonal relationships marked by oscillations between idealization and depreciation.
  • Identity disturbance
  • Self-damaging impulsivity related to spending, substance abuse, reckless driving, sex, binge eating, etc.
  • Affective instability is caused by a marked reactivity of mood
  • Chronic feelings of emptiness
  • Inappropriate, intense anger
  • Recurrent physical fights
  • Transient paranoid ideation or severe dissociative symptoms

Borderline Personality Disorder Test

The signs and symptoms of borderline personality disorder are sometimes similar to those belonging to depression, bipolar disorder, etc. Therefore, a series of medical and psychiatric tests are conducted for a timely and proper borderline personality disorder diagnosis.

Mental health professionals (MHPs) use a series of psychiatric tools 3 for the evaluation of BPD, including:

  • The McClean screening instrument for borderline personality disorder 8
  • Personality diagnostic questionnaire 9
  • Structured clinical interview for DSM-5 personality disorders 10
  • The Minnesota borderline personality disorder scale 11
  • The personality assessment inventory-borderline features scale 12

Read More About DSM 5 Here

What Is The Treatment For Borderline Personality Disorder?

BPD is a controversial disorder, but a large number of therapies, medications, and self-help strategies are available to help people successfully address and manage the disorder.

Some of the most effective treatment approaches are mentioned below:

1. Psychotherapies

Psychotherapy is the cornerstone of borderline personality disorder treatment. It addresses behavioral and conduct disorders, self-harm and suicidal tendencies, and emotional dysfunction in BPD patients. In fact, according to a 2022 study 13, psychotherapies improve treatment outcomes 14 when it comes to BPD symptom severity related to psychosocial functioning and depression.

Many long-term evidence-based psychotherapies 15 are used for the treatment of borderline personality disorder, comprising:

  • Dialectical behavior therapy (DBT) 16
  • Dynamic deconstructive psychotherapy (DDP) 17
  • Mentalization-based treatment (MBT) 18
  • Transference-focused psychotherapy 19
  • Schema-focused therapy 20
  • Systems training for emotional predictability and problem-solving (STEPPS) 21
  • General psychiatric management therapies 22

Read More About Major Depressive Disorder (Depression) Here

2. Medication

According to a 2012 study 23, “the role of pharmacotherapy in the treatment of borderline personality disorder is limited”. However, MHPs resort to short-term pharmacotherapy to treat severe cases of BPD. They use medication including:

  • Antidepressants
  • Antipsychotic agents
  • Mood stabilizers

Read More About Antidepressants Here

How To Cope With Borderline Personality Disorder

People suffering from BPD can also consider availing several self-help strategies to successfully manage their borderline personality disorder symptoms. These include:

  • Educating oneself about BPD
  • Availing therapy and medication
  • Developing coping skills to manage anger, mood swings, violent tendencies, etc.
  • Following a healthy lifestyle—with nutritious food and a good sleep hygiene regime
  • Using stress-reduction techniques (like deep breathing or meditation)
  • Exercising regularly
  • Distracting oneself from self-destructive tendencies
  • Grounding oneself
  • Communicating honestly
  • Reaching out to loved ones for support

Takeaway

A borderline personality disorder is a rare and controversial disorder that affects 1.6% of the global population. If untreated, the BPD symptoms can grow more severe and negatively impact a person’s mental and physical health, social relationships, employment and financial prospects, and quality of life. Thankfully, many BPD treatment methods are available that can help a person effectively manage his/her symptoms and live a normal and happy life.

Borderline Personality Disorder At A Glance

  1. Borderline personality disorder (BPD) is a psychiatric disorder in which the person suffers from unstable relationships, a distorted sense of self and reality, and emotional dysfunction.
  2. BPD affects 1.6% of the world population and has a lifetime prevalence of about 6%.
  3. Borderline personality disorder symptoms include abandonment fears, impulsivity, violent conduct, self-complexity, paranoia, substance abuse, etc.
  4. BPD is caused by genetic factors, brain abnormalities, and environmental factors.
  5. BPD can be easily diagnosed with long-term therapy and medication.

Frequently Asked Questions

1. Can I reduce the risk of inheriting BPD?

Reducing the genetic risk of BPD is not possible, but you can regulate the environmental factors that make a person vulnerable to BPD. This involves providing yourself or your children with a safe, healthy, and emotionally reciprocative environment to grow up in.

2. Can BPD be cured with psychotherapy?

BPD is mainly treated with psychotherapy, but, in some cases, medication is also used for its treatment.

3. Is an intimate relationship possible with someone with BPD?

BPD is a mental disorder that is characterized by emotional dysfunction and unstable relationships. It takes effort to be in an intimate relationship with someone suffering from BPD, but it is not impossible.

Take This Free Borderline Personality Disorder (BPD) Test

Borderline Personality Disorder Assessment
Borderline Personality Disorder Assessment
👇 References:
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