A Comprehensive Guide to Borderline Personality Disorder

Published on: 06 Mar 2020
Clinically Reviewed by Reshawna Chapple, PhD, LCSW
borderline personality disorder

Borderline personality disorder (BPD) is a mental condition in which a person experiences ongoing patterns of turbulent and unstable emotions. The illness impacts a person’s mood, self-image and behavior over a long period of time and generally results in impulsive actions and problems in relationships with other people. With recognizable symptoms typically showing up during teenage years and into early adulthood, a person with this disorder may experience anger, depression, and anxiety lasting anywhere from a few hours to a few days. Fortunately, many people with this disorder can show marked improvement and manage symptoms with proven treatments.

Signs and Symptoms of Borderline Personality Disorder

Affecting how you feel about yourself and relate to others, BPD manifests as emotional and relational instability, which can lead to problems with romantic relationships, friendships, and also issues within the workplace, according to Talkspace therapist Christine Tolman, M.Ed. LCPC.

The most common signs and symptoms include:

  • Ongoing feelings of emptiness
  • An intense fear of abandonment that can lead to real or imagined separation or rejection from others
  • Patterns of unstable and intense relationships, such as adoring someone in one moment and suddenly finding that same person cruel in the next
  • Self-harm threats and thoughts of suicide, sometimes in response to fear of separation or percieved rejection
  • Abrupt changes in self-identity and self-image, including shifts in goals, values,
    and seeing yourself as a bad person or even non-existent
  • Short- and long-term mood swings, including intense happiness, irritability, shame, sadness, and/or anxiety
  • Experiencing impulsive and risky behavior, such as drug use, gambling, reckless driving, sabotaging success, or ending positive relationships without a significant reason
  • Intense anger, frequently losing your temper, or having physical fights

If you are consistently experiencing one or more of these common symptoms, and they are creating limitations or difficulties in your life, there are treatment options to consider.

Causes of Borderline Personality Disorder

This illness occurs equally in men and women, and while the causes of this mental health condition are unknown, there are some genetic, familial, and social risk factors that can play a role.

These include:

  • Childhood sexual, physical, or emotional abuse
  • Real or imagined fear of abandonment in childhood or adolescence
  • Trauma or unstable family life at a young age
  • Family history of BPD, including having a parent or sibling with BPD
  • Brain chemistry involved in impulse control and emotional regulation

It is important to note that risk factors are not the same as a cause — just because a person experiences some of the risk factors does not mean they will develop BPD. Just as many people develop BPD without any risk factors.

Treating Borderline Personality Disorder

While this illness has been historically viewed as difficult to treat, there are more recent, evidence-based treatments that are proven to help people with BPD experience fewer and less severe symptoms. Over time, these treatments help improve a person’s functioning, and quality of life. The key is to seek specialized treatment from an appropriately trained and credentialed mental health professional.

Getting diagnosed

The first step in treating BPD is getting diagnosed. You can either speak to your primary care doctor to request a referral for a therapist, or you can find a licensed therapist through a reputable source such as psychologytoday.com, or start today by giving online therapy a try.

The diagnosis process consists of a therapist asking you thorough questions about what symptoms you are experiencing and your emotional state and helping to determine if you have BPD, according to Tolman. Only a licensed professional can make an actionable diagnosis.


After diagnosis, specialized therapy can help you manage BPD symptoms over the long term. Therapy is a highly effective treatment method for this illness, as it helps change harmful and destructive thought patterns that drive emotional instability. Over time, new patterns of thinking can have a positive impact on your behavior and outlook. In some cases, a psychiatrist may determine that medication is also needed to assist in your treatment plan in addition to talk therapy.

The good news? Medication, therapy, and an overall healthy lifestyle can lead to increased satisfaction and stability following a diagnosis of borderline personality disorder, Tolman said.

When to Get Immediate Help

If you or someone you know with borderline personality disorder are having suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), 24 hours a day, 7 days a week. Calls are free and your information is kept confidential.

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