What is borderline personality disorder (BPD)?

Borderline personality disorder, abbreviated as BPD, can be defined as a mental illness. It is sometimes referred to as emotionally unstable personality disorder. People suffering from BPD have unstable moods and may act recklessly. They also find it difficult to maintain emotional stability consistently. If you suffer from BPD, you will likely experience difficulties with daily tasks, obligations, and life events. You may struggle to keep jobs and relationships. And you may use food, alcohol, or other substances as a coping mechanism.

You are more likely to attempt suicide. You have a higher risk of suffering from depression, anxiety, substance abuse, and self-injury. Research about the disorder is still in progress. There is a treatment that can help and often works well.

Who does borderline personality disorder affect?

Most personality disorders start during the teenage years when your personality keeps developing and maturing. So, very few people who are diagnosed with borderline personality disorder are under the age of 18.

Anyone can get BPD, but a family history of BPD puts you at higher risk. Anyone who has other mental health conditions, including anxiety, depression, or an eating disorder, is also more likely to develop BPD.

Currently, almost 75% of individuals diagnosed with BPD are AFAB (assigned female at birth). Studies suggest that AMAB (assigned male at birth) persons are also equally subjected to BPD but are likely misdiagnosed as PTSD or depression.

What are the signs & symptoms of borderline personality disorder?

Symptoms of BPD often occur during the teen years. A little different for everyone, but will have at least five symptoms of the following over some time:

• There is a pattern of significant mood swings that lasts over hours or days.
• Extreme feelings of anger and inability to control the anger
• Intense, on-and-off relationships with family and friends that can go in an instant from very close to feeling angry and hateful
• Rapid fluctuations in identity leading to a sudden change in goals, values, or behavior
• Self-destructive behavior such as substance abuse, binge eating, unsafe sex with different partners, unsafe driving, or reckless spending
• Excessively intense fear of or reactions to abandonment and excessively strong behaviors to prevent abandonment
• Feeling disconnected from their selves, body, or reality, or experiencing paranoid thoughts
• Continual experiences of inner emptiness
• Suicide attempts or other attempts at self-harm including but not limited to, cutting, hair pulling or burning

Borderline personality disorder symptoms may resemble features of other illnesses or issues. Always consult your physician for a diagnosis.

How is borderline personality disorder diagnosed?

If you show BPD symptoms, consult with a mental health provider for diagnosis. This specialist can either be a psychiatrist or a psychologist. Or it may also be a psychiatric nurse practitioner or a licensed clinical social worker.

The treatment will depend on the symptoms, the age and general condition of the patient, and the gravity of the disease. You might be asked about your family's history of mental health conditions. You might have a physical exam, which can rule out other illnesses. Ensure that you make the mental health provider aware of any health problems you have or any medicines you take.

What are the possible complications of borderline personality disorder?

BPD can significantly impair an individual's ability to cope and perform at work or in school. Other common issues experienced by individuals with BPD include other mood disorders such as:

• Anxiety
• Depression
• Bipolar disorder
• Substance abuse
• Eating disorders

Other psychiatric disorders

The individual may have multiple admissions to the hospital because of frequent suicide attempts, self-mutilation, and aggressive behaviours. It can also result in several imprisonments.

How is borderline personality disorder treated?

It is highly dependent on the symptoms you experience, your age, and your general health. Furthermore, the treatment will depend on the severity of the condition.

Many people with BPD improve significantly with treatment. Psychotherapy is the most common treatment for BPD. It can take place individually or in a group. Your family might also be part of the treatment. A qualified psychotherapist may use one or more of these techniques:

• Cognitive behavioral therapy (CBT) equips you with tools to help you change your thoughts and behaviors.
• Dialectical behavior therapy: It helps you become more conscious of the present moment. It teaches you to minimize extreme emotions and behaviors.
• Schema-focused therapy helps you change the way you perceive yourself, transforming your negative perception into a more positive one.
• Systems Training for Emotional Predictability and Problem Solving (STEPPS): This teaches you how to use tools to control your response to specific situations. Family and friends are also taught.
• Medications may also help some individuals with BPD: Medications are not typically the first treatment because their benefits in treating BPD are not established. When medications are prescribed, they are used to treat particular symptoms, such as depression or mood swings.
• Neuroleptic and atypical antipsychotic medicine can reduce some symptoms. Anti-anxiety and antidepressant medicine can be used for symptoms of depression or anxiety that may occur together with BPD.

If you experience severe symptoms, you might require hospital care for a period. 

Can borderline personality disorder be prevented?

No, unfortunately, there is no way to prevent borderline personality disorder.

BPD is often hereditary, meaning you may be at a higher risk of developing the disorder if you have a family history of BPD. Ask your doctor how to recognize symptoms of the disorder so that you can get treatment as soon as possible.

What is the prognosis for borderline personality disorder?

The majority of patients' symptoms tend to resolve over time. Some have complete remission in their 40s. People with borderline personality disorder with appropriate treatment can learn how to handle their symptoms so as to have a better life quality.

People with borderline personality disorder who receive no treatment or when it fails, are at greater risk for having the following problems:

• Substance use disorder and alcohol use disorder
• Depression
• Self-mutilation
• Suicide.

Suicide risk is 40 times higher in the people suffering from BPD compared to the general population. About 8% to 10% of those suffering from BPD commit suicide.

Unstable and chaotic personal relationships, along with job loss, often accompany the life of many who have not yet been treated for BPD. These are at a greater risk of divorcing, being estranged by family members and troubled friendships. Legal and financial troubles are also not out of the question.

When to seek medical care?

If you experience any of the above signs, speak to your physician or other regular care professional or consult a mental health professional.

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