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Borderline personality disorder (BPD) is a mental illness characterized by difficulties regulating emotions. This means that people with BPD feel emotions intensely and for extended periods of time, and it is harder for them to return to a stable baseline after an emotionally triggering event.
This difficulty can lead to emotional instability, impulsive behavior, distorted self-image, unstable relationships, and intense emotional responses to stressors. Struggling with self-regulation can also result in dangerous behaviors such as self-harm.
BPD develops during adolescence or early adulthood. It's estimated that 1.4% of the U.S. adult population experiences PBD. Nearly 75% of people diagnosed with BPD are woman. Recent research suggests that men may be equally affected by BPD, but are commonly misdiagnosed with PTSD or depression.
People with BPD experience wide mood swings and can feel a great sense of instability and insecurity. According to the Diagnostic and Statistical Manual diagnostic framework, some key signs and symptoms may include:
Researchers are still trying to learn the exact cause of BPD. Multiple factors may contribute to the disorder, including genetics, environmental factors, and serotonin abnormalities.
While no specific gene or gene profile has been shown to directly cause BPD, research suggests that people who have a close family member BPD might be at a higher risk of developing the disorder.
People who experience traumatic life events (abuse, child neglect, etc.) are at increased risk of developing BPD.
The emotional regulation system may be different in people with BPD, suggesting that there is a neurological basis for some of the symptoms. Serotonin is a hormone that helps regulate mood and abnormalities in serotonin production may make a person more susceptible to BPD.
There is no definitive medical test to diagnose BPD, and a diagnosis is not based on one specific sign or symptom. BPD is best diagnosed by a mental health professional following a comprehensive clinical interview that may include talking with previous clinicians, reviewing previous medical evaluations, and interviews with friends and family.
An effective treatment plan should include the individuals preferences while also addressing any other co-existing conditions they may have. A mental health professional may recommend one or more treatments for BPD, including psychotherapy, medication, or hospitalization. The overarching goal of treatment is for a person with BPD to increasingly self-direct their own treatment plan as they learn what works and what doesn't.
Such as dialectical behavioral therapy (DBT), cognitive behavioral therapy (CBT), and psychodynamic psychotherapy. These are the first choices for BPD.
DBT teaches a person how to recognize, be aware of, and accept their beliefs and behaviors. They also learn healthy responses to these behaviors.
CBT helps to identify and change unhealthy beliefs, behaviors, and inaccurate perceptions a person may have about themselves or others. It teaches healthy ways to react when feeling angry, insecure, anxious, or suicidal.
Psychodynamic psychotherapy focusses on the psychological roots of emotional suffering. It works on self-examining and self-reflection, and uses the relationship between the therapist and patient as a window into problematic relationship patterns in the patient's life.
Medication doesn't cure BPD, but it can relieve symptoms. A doctor may prescribe medication in addition to psychotherapy treatment. For example, they may prescribe:
Antidepressants to treat depression.
Antipsychotics to treat aggressive symptoms.
Antianxiety medication to treat anxiety.
If a person's symptoms are severe, their doctor may recommend that they temporarily stay in a hospital for treatment. They may also be hospitalized for suicidal behavior, suicidal thoughts, or thinking about harming themselves or others.
The outlook for people with BPD varies. They may face lifelong challenges associated with their BPD. At times, they may struggle with suicidal thoughts or self-harming behavior. Following their doctor's prescribed treatment plan is essential. It can reduce the severity of their symptoms and help them lead a safe and fulfilling life.