Signs of Borderline Personality Disorder
One of the first things people with types of BPD often notice is they have an incredibly hard time maintaining relationships. This pattern can ring true for platonic relationships as well as professional and romantic ones. They also might have great difficulty holding a job. Other signs of BPD can include dramatic mood swings, intense anger, or being overly possessive, jealous, and isolated.
“Individuals diagnosed with BPD typically have difficulties within the context of their relationships because the fear of abandonment is so intense. There are often feelings of low self-worth, unclear depictions of identity, and self-harm because of the hyperfocus on how other people are responding to them. Absorbing the emotional turmoil of the world leaves them feeling reactive and impulsive.”
— Meaghan Rice, Doctor of Psychology (PsyD.), Licensed Professional Counselor (LPC)
Despite BPD not having a true cure, treatment can be very beneficial and greatly reduce the severity and frequency of BPD symptoms. Effective treatment can come in the form of therapy, possibly medication, and holistic options. Consistent treatment will allow most people with BPD to have a greater quality of life.
As is true with most mental health conditions, early treatment is likely to increase overall effectiveness. It’s important to note that staying with a treatment plan is critical for reducing BPD symptoms. Often, someone with BPD will start feeling better and might consider stopping treatment, only to have their symptoms return, sometimes even more intensely than before.
Symptoms of Borderline Personality Disorder
Symptoms of BPD can include:
- Difficulty with romantic, work, and other relationships
- Negative thoughts
- Thoughts of self-harm
- Paranoia
- Impulsive behavior
- Fear of abandonment
- Extreme and intense anger
- Jealousy
- Suicidal thoughts
Not all people with a BPD diagnosis will have every BPD trait or symptoms. It’s more likely that someone will have just a handful of symptoms from the above list. Symptoms can also change over time. Additionally, it’s not uncommon for comorbid mental health conditions to exist (meaning other conditions can occur at the same time). Some of the most common comorbid conditions that occur with BPD include chronic depression, anxiety, post-traumatic stress disorder (PTSD), and eating disorders.
What Causes Borderline Personality Disorder?
The causes of borderline personality disorder are not fully understood. That said, it’s widely accepted that a number of factors, including genetics or traumatic life events, play a huge part in whether or not someone might end up with a BPD diagnosis.
While we have learned a lot about BPD, there’s still much more for us to discover about what causes borderline personality disorder.
Read on to learn what we know and understand so far, so you can have a better understanding of this common condition that affects an estimated 1.4% of the adult population in the United States.
What Research Says About BPD Causes
Studies on genetics
When researching what causes borderline personality disorder, scientists have found a strong link between BPD and genetics. A study with monozygotic twins (commonly known as identical twins) supports a genetic link to BPD. In this study of 92 pairs of identical twins, 35% were diagnosed with BPD.
There are numerous other explorations of genetic borderline personality disorder causes, although no specific genes have yet been identified as causing BPD.
Studies on the brain
In addition to genetics, many borderline personality disorder symptoms have been linked to abnormalities in the frontolimbic networks of the brain. These networks are the parts of the brain that are vital in promoting goal-directed behavior. In part, they support resistance to emotional distraction. Neuroimaging research lends to a theory that a dysfunctional frontolimbic network is possibly part of what causes BPD.
Another study found that those with BPD have a smaller hippocampus. Smaller volumes are associated with higher trauma-related clinical symptoms. So, it’s definitely possible that a smaller hippocampus is one of the causes of borderline personality disorder.
Studies on childhood trauma
Childhood trauma and abuse are known risk factors for developing borderline personality disorder in teens and young adults because cranial trauma received during childhood may result in lasting brain function abnormalities that could result in borderline personality disorder symptoms. Unfortunately, it does seem that neglect and/or child abuse is likely one of the potential BPD causes.
Some research has been done using a non-invasive testing approach called ERPs (Event-Related Potentials), offering hope that they might help us make diagnoses. ERPs work by measuring electrical brain activity related to cognitive and sensory events.
Through this research, scientists found that P3 (considered an index of attention) is slightly delayed in some people with BPD. They also found that there was a P3 profile similar to younger patients, showing a failure of maturation that may be a factor in the lack of development of a sense of self common in some people who have BPD.
“While there’s no one cause for BPD, it’s important to understand that BPD has many factors and can be managed with the support of a licensed mental health professional. Being able to understand how personal factors (genetic, brain chemistry/structure, upbringing) contribute to BPD symptoms can help you navigate the best course for treatment and well-being.”
— Jill Daino, Licensed Clinical Social Worker (LCSW-R), BC-TMH
Common Causes of Borderline Personality Disorder
Though we don’t yet have a firm understanding of the exact causes of BPD, much research and work have been put into furthering our grasp of this condition. Below is a more in-depth discussion of these 3 factors that are accepted as likely contributions or risks to someone developing borderline personality disorder.
“BPD has complex factors that contribute to its development and it’s unique to each person who has a BPD diagnosis. Genetics, brain chemistry/structure, and upbringing may all play a role, and knowing this can help the person better understand and manage their experience.”
— Jill Daino, Licensed Clinical Social Worker (LCSW-R), BC-TMH
Genetics
There’s a lot to still learn about BPD and genetics, but the research completed thus far shows a definite link. Studies have found an association between BPD and a mutation in a gene that regulates how the brain uses serotonin (a natural neurotransmitter in the brain).
Findings indicate that people with this particular genetic variant might be even more likely to develop BPD if they also had a difficult childhood (for example, separation, neglect, or abuse from supportive caregivers).
Personal environmental factors
Certain personal environmental factors may also increase the likelihood of developing BPD. Things such as childhood trauma and sexual abuse, neglect, and bullying are common in people diagnosed with BPD. It’s thought that the interplay of biological variables, coupled with a non-nurturing early environment, might play a role in predisposing someone to develop BPD.
Brain differences
Research shows that some people who have borderline personality disorder have higher levels of activation in the limbic system than those who don’t. The limbic system controls fear, anger, aggression, and impulsivity — this disparity might be linked to BPD’s emotional instability symptoms like fear of abandonment and intense anger.
Symptoms of the Types of Borderline Personality Disorder
BPD can be classified into four distinct types: discouraged, impulsive, petulant, and self-destructive BPD. Each type shares specific characteristics but also has its own symptoms, challenges, and optimal treatment techniques. It is possible to experience more than one type simultaneously or at different stages in life. Some individuals with BPD may also not exactly fit into any of these categories.
“Learning the signs and symptoms of borderline personality disorder can feel both overwhelming and empowering – knowing what you need to best support, like the right therapist and psychiatrist, can be incredibly beneficial to your health and your life. You deserve support!”
— Kate Rosenblatt, Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), MA
Discouraged borderline personality disorder
Theodore Millon described discouraged borderline personality disorder (also known as quiet BPD ) as being marked by frequent feelings of shame, guilt, emotional attachments, social anxiety, feelings of inadequacy, and obsessions.
Symptoms of discouraged borderline personality disorder
- Marked interpersonal difficulties
- Fear of abandonment
- Unstable self-image
- Self-blame
- Intense anger (known as BPD rage)
- Feelings of emptiness
- Being emotionally attached
- Helplessness
- Paranoid ideation
- Obsessive-compulsive tendencies
- Social retreat
- Perfectionism
- Anxiety
Impulsive borderline personality disorder
Impulsive behavior is a common trait in BPD in general, but it’s prevalent enough in some people to be considered one of the four types of BPD addressed by Millon. Those with impulsive borderline personality disorder have an intense need for immediate gratification and often discount delayed rewards. They tend to experience intense emotions of rejection and anger.
Symptoms of impulsive borderline personality disorder
- Preference for immediate gratification (eg. substance abuse)
- Discounting long-term results
- Feelings of rejection
- Feelings of intense anger
Petulant borderline personality disorder
People with petulant BPD can display outbursts of anger that aren’t appropriate for a given situation. They might have an unstable self-image accompanied by feelings of being unloved. They feel a strong urge to manipulate or control others and tend to become possessive, resulting in difficulty maintaining interpersonal relationships. Overall, they’re likely to lack emotional stability.
Symptoms of petulant borderline personality disorder
- Inability to enjoy harmonious relationships
- Difficult to satisfy
- Feelings of extreme anger and frustration
- Frequent irrational, emotional outbursts and mood swings
- Impatience with others in normal social situations
- Seldom can admit they are wrong
- Often behave in a passive-aggressive manner
Self-destructive borderline personality disorder
These BPD types can be their own worst enemies. People with self-destructive borderline personality disorder frequently self-sabotage interpersonal relationships with family members and friends. They might engage in dangerous or risky behaviors, and generally have little regard for the consequences of their actions.
Symptoms of self-destructive borderline personality disorder
- Substance abuse
- Self-hatred
- Self-harming behavior
- Frequent depression
- Feelings of bitterness
- Suicidal thoughts
What Is BPD Splitting?
Splitting behavior is a defense mechanism that allows people with types of BPD to reframe something in black-and-white terms. It’s called splitting because it involves putting people, places, and things into one of two categories. Splitting can cause people to view something as entirely good or completely bad.
While most people with BPD understand that the world is complex, splitting behavior can cause them to shift rapidly between two extremes. For example, someone with BPD may think that another person is amazing one day, only to see them as the worst person in the world the next. This sudden shift generally occurs after a negative interaction — even if the exchange is brief. In one moment, they feel confident in the relationship, then they’ll suddenly view the person as worthless as soon as they make a mistake.
A splitting episode can also be a way for people with BPD to push blame on someone else. For example, if they forget to complete a task, they might insist it was stupid or that the instructions they received weren’t clear. At times, people with BPD may openly share these views with others, but splitting can also be an internal behavior.
Symptoms of BPD Splitting
Since splitting is an unconscious defense mechanism, people often find it hard to recognize when they engage in the behavior. Recognizing the signs of splitting can make addressing and changing behavior easier.
Common splitting borderline personality disorder symptoms include:
- Sudden mood swings: When someone is in a splitting episode, it can cause rapid and dramatic changes in mood, unstable emotions, and impulsive behavior. They might instantly become furious or thrilled, even if they felt the opposite way before.
- Drastic changes in behavior: Splitting can lead to sudden behavioral changes. For example, someone might completely change their habits or throw themselves into a hobby they weren’t interested in previously.
- Idealization and devaluation: Someone who’s splitting may idealize a target or find ways to devalue them. They might shower a person with praise or insist that they’re terrible or worthless.
- Expecting others to take sides: Splitting causes people to see things in absolutes. They assume others see things the same way. They often expect others to choose sides and may react negatively if their perspective isn’t shared.
- Using extreme language: It’s common to use harsh positive or negative words when splitting. Someone might be evil and disgusting, or they could be angelic and perfect.
What Triggers Splitting in BPD?
Any situation that causes an emotional reaction can be a trigger for splitting. People with borderline personality disorder frequently struggle with emotional regulation, and splitting can be a way for them to counter feelings that they’re unable to control.
Some splitting borderline personality disorder triggers include:
- Criticism: BPD can make people extremely sensitive to criticism. Even a mild critique can make someone feel terrible or worthless. People with BPD may devalue critics to protect themselves from these negative emotions.
- Compliments: People with BPD need validation from others, which can cause them to react strongly to praise. They may feel a surge in confidence after a compliment or have intense positive feelings toward the person who complimented them.
- Failure: It’s not unusual for someone with BPD to see themselves as pathetic or worthless after a mistake. They may drop a class, quit a job, or abandon a hobby after any (perceived) failure.
- Success: Strong reactions to success are common when splitting. After succeeding, someone with BPD may see themselves as a genius or a prodigy.
- Feeling abandoned: Splitting can be a way for people with BPD to cope with their extreme fear of abandonment. They can develop intense negative feelings toward someone they believe abandoned or ignored them.
- New relationships: When a person with BPD meets someone new, they may become attached to them immediately. They might react negatively if the person is uncomfortable with their behavior, leading to short-lived relationships.
“Borderline personality disorder (BPD) splitting is a coping strategy often used by individuals with BPD to help them deal with stressful situations. They do this by identifying a person, place, or thing as either all good or all bad. This can be triggered when the individual is in an uncomfortable situation or meeting a new person. Reframing their thoughts allows them to cope more effectively in the moment. This is ultimately not a healthy way to deal with issues, and in therapy, they can find more effective ways to cope with their stress.”
— Bisma Anwar, Licensed Mental Health Counselor (LMHC), MA, MSc
The Impact of BPD Splitting
Splitting in borderline personality disorder can lead to instability. The changes that splitting brings on can be intense. BPD leads to impulsive or reckless behavior, and when coupled with splitting as a defense mechanism, it makes it incredibly difficult — or even impossible — to build secure relationships.
“The impact of splitting includes having less meaningful romantic relationships or friendships. The individual might struggle with having inconsistent or negative relationships. Therapy can be a way for individuals with BPD to work on their relationships in a healthy way, so they avoid splitting.”
— Bisma Anwar, Licensed Mental Health Counselor (LMHC), MA, MSc
On relationships
Not only can splitting make it hard to form relationships, but it also makes them difficult to maintain. Splitting can cause significant distress to both parties. It’s common to shift from idealization to devaluation quickly, which can lead to a long string of brief relationships. When relationships do last, it often leads to codependency.
Managing Splitting in BPD
Even though splitting is a defense mechanism, it can cause significant damage to relationships and a splitter’s well-being. Learning to cope with this BPD symptom can help people avoid instability and find balance in their life.
Learn to recognize splitting
When you’re aware of splitting, you can take steps to break the cycle of behavior. Tracking your behavior can help you see unhealthy patterns. If you can identify your triggers, you can spot splitting when it occurs.
Find ways to deal with stress and anxiety
Stress and anxiety can lead to splitting episodes. If you’re able to calm yourself when you’re feeling overwhelmed, you may be able to avoid splitting. Breathing exercises and meditation could help you to relax before your emotions take over.
Reach out for help
If splitting is something you or a loved one has been struggling with, you may need professional help. BPD therapy and BPD medication can help you to cope with symptoms and unhealthy defense mechanisms like splitting. Talkspace makes it easy to find a therapist to give you the support you need.
How to Know What Type of BPD You Have
Self-diagnosis is never recommended to diagnose any of the borderline personality disorder types. Unfortunately, there isn’t any one single test that can accurately determine if someone has BPD, let alone which type they may have. Thorough testing by a qualified mental health professional is the only reliable method of diagnosis. As noted, making a BPD diagnosis can be difficult given the possibly overlapping nature of symptoms. If you want to learn more about your BPD symptoms you can even take a BPD test as a first step. However, be sure to seek in-person or online therapy to get a proper diagnosis.
Identifying types of BPD can involve using a variety of testing and assessment measures, including the Personality Assessment Inventory (PAI) and the American Psychiatric Association’s (APA’s) Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). The DSM-5 offers a detailed list of criteria used to identify traits and symptoms that must be present in order to make an accurate diagnosis. Also included in the diagnostic process can be health assessments and interviews.
While there’s no clinical recognition in terms of diagnosing each individual BPD subtype, narrowing them down can help a mental health professional decide on the most effective treatment plan, which can be essential is overall BPD treatment success. Zeroing in on the precise types of BPD that need attention is the best way to gauge the most effective treatment modalities.
Using Millon’s BPD subtype concepts has the potential to help people living with borderline personality disorder figure out the most important areas of concern. Then, they can quickly focus on the most needed, most effective type of treatment. New investigations into the subtypes of BPD, as outlined by Millon, continue with the goal of finding better BPD treatment solutions for optimal care and possibly, one day, a cure.
When to Seek a Mental Health Professional
Knowing when to seek treatment from a mental health professional is often a personal decision, but a broad approach to take is that you should always look for treatment if your BPD symptoms begin to significantly affect your quality of life.
This includes if you’re having increased trouble at work, in your relationships, or in your day-to-day living. It goes without saying, you should seek treatment immediately if you start to have suicidal behavior or thoughts or self-destructive behavior or thoughts around harming yourself. As we mentioned before, early treatment almost always yields the best results.
The key lesson to learn here is that just because you’re living with BPD doesn’t mean you have to simply deal with your symptoms and suffer in silence. There are several effective ways to treat symptoms of BPD and improve your quality of life. Learning the signs and symptoms and how you can improve them is your first step.
It’s important to find a therapist who’s experienced in BPD treatment. You can talk with your primary care physician, talk to a mental health professional either through in-person or online therapy, or consult an online resource, such as the National Alliance on Mental Health, to get started.
