Borderline personality disorder (BPD) is a personality disorder whereby an individual experiences ongoing and pronounced changes in mood, behaviour, and self-image. These patterns often result in impulsive behaviours and relationship difficulties.

People with borderline personality disorder often experience episodes of depression, anxiety, and anger that can last from a few hours to several days.

How Can You Tell if Someone Has Borderline Personality Disorder?

People with borderline personality disorder often experience mood swings and changes in how they view themselves and others. This can result in pronounced and rapid shifts in interests and values.

Many people with borderline personality disorder also tend to see things in black and white rather than appreciating nuances. They may view a person as either entirely good or entirely bad, sometimes switching between the two. This behaviour is known as ‘splitting’ and can lead to unstable relationships.

Other signs and symptoms of borderline personality disorder include:

• Avoiding abandonment by abruptly ending relationships
• Quickly forming intimate relationships
• Feeling hurt, upset, or angry about cancellations or changes in plans
• Patterns of intense and unstable relationships with friends and family members that may involve switches from extreme closeness to extreme anger or dislike
• Unstable and distorted sense of self
• Impulsive and dangerous behaviours, like reckless driving, substance abuse, spending sprees, or binge eating
• Self-destructive behaviours
• Self-harm
• Suicidal thoughts and/or suicidal behaviour
• Extreme emotional swings
• Intense emotions
• Chronic feelings of emptiness
• Anger management issues or intense anger
• Difficulty trusting other people
• Feelings of dissociation, including feeling separate from themself, seeing their body from the outside, and feeling outside of reality

Not everyone with borderline personality disorder experiences these symptoms, as specific abandonment events may trigger symptoms.

For example, someone with borderline personality disorder may become extremely angry or upset when a loved one cancels plans. Recognising triggers can help those living with the disorder reduce symptoms of borderline personality disorder.

Borderline Personality Disorder and Other Mental Disorders

Many symptoms of borderline personality disorder are similar to symptoms of other mental disorders. Because of this, some people are misdiagnosed with borderline personality disorder or fail to obtain an accurate diagnosis.

People with borderline personality disorder may also develop other mental illnesses like depression or anxiety due to their experiences.

Diagnosis

Borderline personality disorder can be challenging to diagnose as it can be mistaken for other mental disorders, including:

• Post-traumatic stress disorder (PTSD)
• Bipolar disorder
• Attention deficit hyperactivity disorder (ADHD)
• Emotionally-unstable personality disorder

To reach a diagnosis, those who display borderline personality disorder symptoms should visit a mental health professional who has experience in diagnosing mental health disorders.

A diagnosis isn’t based on one sign or symptom alone but on a series of criteria as set out by the Diagnostic and Statistical Manual of Mental Disorders (DSM-7). For this reason, the mental health professional will conduct a comprehensive interview, review previous medical evaluations, and, if necessary, communicate with friends and family.

Co-Occurring Disorders

People living with borderline personality disorder often live with another mental illness. Co-occurring disorders can make borderline personality disorder particularly difficult to diagnose.

Some common mental health issues that may exist alongside borderline personality disorder include:

• Attention deficit hyperactivity disorder (present in 30-60% of borderline personality disorder clients)
• Alcohol or drug abuse
• Anxiety disorders
• Bipolar disorder
• Depression
• Eating disorders
• Other personality disorders

Suicide Prevention

Borderline personality disorder can be a severe mental health condition, especially as symptoms of the disorder include self-harm, suicidal thoughts, and suicidal ideations.

It’s important to take suicide seriously. If you think that your life or someone else’s life could be in danger, call 999 immediately or go to accident and emergency.

How Does Borderline Personality Disorder Develop?

Scientists still don’t know precisely how or why someone may develop borderline personality disorder. However, research suggests that genetic and environmental factors may play a role.

Factors that increase the risk of developing borderline personality disorder may include:

• Family history. People who have a close family member with borderline personality disorder may be at a greater risk of developing the disorder.
• Brain abnormalities. Research suggests that people with borderline personality disorder may have different balances of chemicals and functions in certain areas of the brain, especially those involved in impulsive behaviour and emotional regulation. However, it’s unclear whether these changes cause or result from the disorder.
• Environment. Many people with borderline personality disorder have experienced complex life events, including traumatic incidents, early life adversity, and exposure to hostility and conflict.

How Can You Treat Borderline Personality Disorder?

Although there is no cure for borderline personality disorder, treatment can help people manage and reduce symptoms so they can live fulfilling and productive lives. Borderline personality disorder treatment can also support people to maintain stable and healthy relationships and improve their quality of life.

There are several evidence-based methods for treating borderline personality disorder. Below, we have shared just a few.

Psychotherapy

Psychotherapy is a common and effective treatment for borderline personality disorder. If this is a suitable form of treatment, those with the disorder can attend individual therapy to work one-on-one with a therapist. They may also be introduced to group therapy sessions. Group therapy may help people with borderline personality disorder express themselves and interact well with others.

Dialectical behaviour therapy (DBT) is a type of psychotherapy developed for people with borderline personality disorder. DBT focuses on mindfulness, attention to the present moment, and awareness of situations and emotional states. DBT helps clients make positive changes to thought patterns and behaviours to improve relationships and quality of life.

DBT can help clients identify their fears of abandonment and other underlying issues and understand how they may manifest in symptoms like emotional instability and splitting. Throughout a course of treatment, clients develop healthier and more integrated world-views and minimise destructive behaviour.

Research suggests that DBT can be incredibly effective. A 2014 study found that after a year of outpatient DBT treatment, 77% of clients no longer met the criteria for borderline personality disorder diagnosis. Clients can participate in DBT as part of inpatient and outpatient programmes depending on the severity of the condition and their preferred recovery route.

Medications

Whilst doctors do not usually prescribe medication to treat borderline personality disorder, it can help manage specific symptoms or co-occurring disorders. Medication can help alleviate symptoms like:

• Depression
• Mood swings
• Anxiety

Medications can have different effects on different people. For this reason, medication should only be taken as prescribed by and under the supervision of a healthcare professional.

Inpatient Care

People with severe symptoms of borderline personality disorder may require inpatient care, especially if they are experiencing ongoing suicidal thoughts and ideations. Inpatient care offers a safe and supervised environment 24-hours a day where clients can focus on recovery.

Treatment and Recovery With Addcounsel

Addcounsel offers private and discreet treatment for mental health conditions like borderline personality disorder. We deliver our luxury services in our central London clinics, to your home, and online.

We treat one client at a time, offering a dedicated service to every client with unrivalled levels of care and anonymity. We put all our resources into each person’s recovery, combining clinical excellence with exceptional care.

If you are interested in our recovery programmes, book a consultation with our expert team. We can help make tomorrow a better day.