Borderline Personality Disorder, or BPD, is a mental illness that causes emotional instability, mood swings, and self-destructive behaviors. People with BPD have difficulties maintaining healthy relationships, and they have high rates of substance abuse and mental illness, including anxiety and eating disorders, depression, self-harm, and suicidal tendencies.
If you have a loved one who suffers from Borderline Personality Disorder, understanding this condition and how it relates to other disorders like depression or substance abuse can help guide your search for effective treatment options as well as help you cope with the symptoms your loved one may exhibit.
Symptoms of Borderline Personality Disorder
According to the National Institute of Mental Health, most people who suffer from Borderline Personality Disorder have difficulty managing their thoughts and emotions, engage in reckless and impulsive behaviors, and have unstable relationships with others. In some cases, someone who has BPD may have brief psychotic episodes.
The Diagnostic and Statistical Manual for Mental Disorders is used to diagnose Borderline Personality Disorder, and a diagnosis requires that the patient has consistent patterns of behavior that include at least five of these symptoms:
- Extreme reactions to real or perceived abandonment, including rage, depression, or panic
- A history of volatile relationships that oscillate between extreme love and extreme hatred or anger
- A distorted self-image that results in frequent and sudden changes in opinions, values, feelings, and personal goals
- Dangerous or self-destructive behaviors, including abusing drugs or alcohol, engaging in unsafe sex, driving recklessly, or going on spending sprees
- Suicidal tendencies, threats of suicide, and self-harm, such as cutting or burning oneself
- Intense mood swings that may last anywhere from a few hours to a few days
- Long-term feelings of boredom, hopelessness, or emptiness
- Difficulty controlling anger or experiencing intense but inappropriate anger
- Exhibiting paranoia that’s related to stress
Dissociative symptoms resulting in the sensation of being cut off from the body or feeling in danger of losing touch with reality.
Symptoms of Borderline Personality Disorder typically begin during adolescence or early adulthood, although some symptoms may begin to occur during childhood. Symptoms can be triggered by events that are seemingly innocuous, such as reading or hearing words that have negative meanings or being separated from loved ones for even a small amount of time, such as during a short trip.
Consequences of Borderline Personality Disorder
People who have Borderline Personality Disorder are likely to be impulsive and make poor lifestyle choices, which dramatically increases their risk of being the victim of rape and other violent crimes. Additionally, self-harm and suicide are far more common among those with BPD than among the general population, with as many as 80 percent of people suffering from BPD exhibiting suicidal behaviors. According to the National Institutes of Mental Health (1), between four and nine percent of people who have BPD commit suicide.
In nearly 80 percent of Borderline Personality Disorder cases, at least one co-occurring disorder can be identified. In men, BPD commonly co-occurs with substance abuse or antisocial personality disorder, and in women, it often co-occurs with eating or anxiety disorders or major depression.
Diagnosing and Treating Borderline Personality Disorder
Borderline Personality Disorder is difficult to diagnose, partly due to symptoms of other disorders that overlap with those of BPD. A diagnosis is generally made after extensive interviews and a thorough investigation of the patient’s personal and family medical history.
Once a diagnosis is made, treatment typically includes both psychotherapy, or “talk” therapy, and in some cases, medications. Dialectical behavior therapy has been found effective for reducing suicide attempts associated with Borderline Personality Disorder, and cognitive behavioral therapy can help those suffering from BPD identify harmful core beliefs and replace them with healthier and more accurate ways of thinking.
Certain types of group therapy, when used along with other treatments, can help reduce symptoms and destructive behaviors associated with BPD, and family therapy is also beneficial in many cases.
For those with a substance addiction that co-occurs with Borderline Personality Disorder, a dual diagnosis addiction treatment program that addresses both the addiction and the BPD separately but in an integrated manner can help promote successful long-term recovery.
In some cases, medications may help patients manage specific symptoms, such as depression, anxiety, or aggression. For the most part, however, psychotherapy is the primary – and most effective – mode of treatment for Borderline Personality Disorder.