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A personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time and leads to distress or impairment.
So, what does that actually mean? People with a personality disorder have long-standing patterns of behaving, feeling and thinking in ways that differ significantly from most people. One such personality disorder is borderline personality disorder, which is characterized by a pervasive pattern of instability of interpersonal relationships, self-image and emotions, along with significant impulsivity. This disorder impacts an estimated 1.6% to 5.9% of U.S. adults[1].
However, there are effective treatment options available to help people with personality disorders live fulfilling, healthy and successful lives. Here’s what you need to know.
What Is Borderline Personality Disorder?
Borderline personality disorder (BPD) is a mental health disorder characterized by difficulty regulating emotions, instability in relationships, problems maintaining a stable self-concept and challenges managing behavioral impulses.
People with BPD experience an intensity of emotion greater than that of most people, and may take longer to return to their emotional baseline. They may make frantic efforts to avoid real or imagined abandonment, are more sensitive or reactive to perceived slights from others, and have a tendency to display self-harming or self-sabotaging behaviors such as cutting, gambling, reckless spending, disordered eating and/or alcohol or drug abuse. BPD tends to develop in late adolescence or early adulthood, and impacts women more often than men.
“People with borderline personality disorder have higher than average rates of self injury, suicidal behavior, substance use problems, anger problems and behaviors associated with anger,” says Shireen L. Rizvi, Ph.D, professor of clinical psychology at Rutgers University in Piscataway, New Jersey.
“Most of these behaviors are attempts to regulate or get rid of intense distressing emotions, and they work in the short term,” she adds. “They just also tend to cause lots of problems in the long run.”
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Causes of Borderline Personality Disorder
While BPD hasn’t been shown to have one definite cause, experts point to several contributing factors:
- Genetics: Family studies on BPD indicate that some people may be genetically predisposed to the condition, and research also suggests that BPD is a heritable disorder. BPD is about five times more common among first degree biological relatives of those with the disorder.
- Trauma: Many (but not all) people with BPD often have a history of trauma like childhood sexual abuse. Still, many people who experience trauma do not develop BPD.
- Neurological factors: Some research suggests that BPD may be associated with differences in the brain, particularly in the parts that control emotions and make decisions.
Borderline Personality Disorder Symptoms
Signs of BPD may include the following, according to the diagnostic criteria found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):
- An unstable or overly negative self-image; overt self-criticism
- A tendency to take the actions and needs of others personally and feel slighted and disproportionately angry
- Intense and unstable relationships marked by fear of abandonment and neediness
- Frequent and intense mood changes and a tendency to overreact to interpersonal slights
- Transient, stress-related paranoid thoughts
- Chronic feelings of emptiness
- Impulsivity and risk-taking in a couple of areas of life
- Suicidal ideation and self-harming behaviors
Connect With A Counselor
If you’re in crisis or having suicidal thoughts, call Mental Health America’s 24-hour hotline at 1-800-273-8255 or message its live online chat service for immediate support from a trained counselor. If you’re in immediate danger, call 911.
Borderline Personality Disorder vs. Bipolar Disorder
BPD is sometimes confused with bipolar disorder, but the two are distinct, different conditions, albeit with some overlapping symptoms.
Bipolar disorder is classified as a mood disorder and not a personality disorder. People with bipolar disorder experience periods of highs that are uncharacteristic of their usual behavior patterns (mania or hypomania) which alternate with episodes of depression. During manic or hypomanic episodes, their mood is elevated or irritable, and is accompanied with other symptoms including less need for sleep, racing thoughts, inflated self-esteem, high level of distractibility, increase in goal-oriented activity, and in some cases, disordered thinking such as delusions or hallucinations.
Consult A Sleep Medicine Specilaist
Visit with a sleep medicine specialist to evaluate your sleep issues, discuss various sleep options and more, including an at-home sleep study.
Borderline Personality Disorder Treatment
Anyone showing signs of BPD should see a mental health professional, such as a psychologist or a psychiatrist. Mental health professionals use specific diagnostic criteria to determine if an individual has this condition.
Effective BPD treatment depends on the needs of the individual but may include the following:
- Psychotherapy (or talk therapy) has been proven to reduce symptom severity, incidence of self-harm and suicidal outcomes in people with BPD, and may improve psychosocial function and depression[2]. Dialectical behavioral therapy in particular is a type of therapy developed to treat people with personality disorders.
- Medications, although there is not a specific one identified to treat BPD. Medication options depend on the individual and include antidepressants, mood stabilizers and atypical antipsychotics. Medication should be used in conjunction with psychotherapy, and isn’t always necessary for the successful treatment of BPD.
Additionally, short-term hospitalization may be warranted if a person with BPD is determined to be an immediate danger to themselves or others or if they cannot take care of themselves or tend to activities of daily living.
