Borderline personality disorder

BPD affects 2 in 100 adults, mostly young women. People with BPD often have other mental health conditions, including anxiety disorders, eating disorders, and substance use disorders.¹

A person with BPD may experience intense times of anger, depression, and anxiety that may last only hours or, at most, a day. A person with BPD may also be aggressive, hurt themself, and abuse drugs or alcohol. Her self-identity, which may include long-term goals, career plans or jobs, friendships, relationships with loved ones, or values, is not stable over time and often changes.

A person with BPD may also have a history of intense and unstable relationships. Sometimes people with BPD view themselves or others as fundamentally bad or unworthy. They may feel misunderstood or mistreated, bored, or empty.

People with BPD are often impulsive. They may spend too much money, binge-eat, or have risky sex. People with BPD may have other mental health illnesses, including bipolar disorder, depression, anxiety disorders, substance abuse, and other personality disorders. People with BPD may also be more likely to harm themselves and die by suicide.

Researchers are not sure exactly what causes BPD. But certain factors can increase a person’s risk of BPD:²

• Family history. If you have a parent or sibling with BPD, you are more likely to develop BPD.
• Trauma. Many people with BPD have been through traumatic life events, especially childhood sexual abuse. Others have had unhealthy or abusive relationships. However, some people with BPD do not have a history of trauma, and many people who have experienced traumas do not have BPD.¹
• Physical changes in the brain. Some people with BPD have physical changes in their brains, especially in areas that control impulsive behavior and emotions.

BPD can be difficult to diagnose. It often has symptoms that are the same as other mental health conditions. A mental health professional will ask about a person’s symptoms and personal and family medical histories, including any history of mental illnesses. It may take several doctor’s visits to diagnose BPD. There is no blood test that can show BPD.

Therapy, or talk therapy, is the best treatment for BPD.³ A type of therapy called dialectical behavioral therapy (DBT) specifically treats BPD.⁴ DBT involves talking one on one with a therapist, as well as with other people with BPD in a group setting. A team of therapists will also meet regularly to discuss treatment. DBT focuses on helping people with BPD to recognize and control their emotions. The therapist helps the person feel accepted in their emotions and teaches new ways to behave.⁴ This type of talk therapy can help women with BPD learn to express themselves and their emotions in healthy ways and to pay more attention to changes in mood. Family members of someone with BPD may also benefit from talk therapy.

Sometimes medicine can help with some of the symptoms of BPD, such as mood swings, anxiety, or depression. Talk to your doctor or nurse about which medicines might be able to help your symptoms.

1. National Institute of Mental Health. (2016). Borderline Personality Disorder.
2. Klaus, L., Zanarini, M.C., Schmahl, C., Linehan, M.M., Bohus, M. (2004). Borderline personality disorder. Lancet; 364(9432): 453–461.
3. Leichsenring, F., Leibing, E., Kruse, J., New, A.S., Leweke, F. (2011). Borderline personality disorder. Lancet; 377(9759): 74–84.
4. Chapman, A.L. (2006). Dialectical behavior therapy: current indications and unique elements. Psychiatry (Edgmont); 3(9): 62–68.