What Is Borderline Personality Disorder?

Does someone you know have intense moods and see life in extremes? Is she your friend one day, an enemy the next? She may have borderline personality disorder.

People with borderline personality disorder (BPD) feel emotions intensely and their emotions last longer: an angry mood could last hours or days. After an upset, it’s harder for them to calm themselves and get back to normal.

Up to 6 percent of American adults may have BPD, mainly women. However, it’s possible that men are just as likely to have BPD but are more often misdiagnosed with post-traumatic stress disorder or depression.

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What is borderline personality disorder?

People with borderline personality disorder must cope not only with their intensity but also changeability — they have wide mood swings. They’re impulsive — attracted to risk. They may go on spending sprees, drive recklessly, indulge in unsafe sex, or binge eat. Their relationships are turbulent, partly because they’re always afraid they’ll be rejected or abandoned. A BPD woman might be chronically suspicious that her partners are cheating on her, and drive them away with jealousy and anger. Her unstable romantic history then makes her even more vulnerable — she believes her new partner will leave her just like all the other ones did. At the same time, her own romantic feelings fluctuate wildly. One day she’s madly in love, the next day she can’t tolerate him.

It is characteristic of BPD people to blame others when things go wrong and feel victimized. The world is black and white — right and wrong, good and bad. They might create intense relationships quickly and then cut off all communication just as rapidly prompted by a small misunderstanding. Trust is hard to maintain.

Borderline personality disorder symptoms

Borderline personality disorder symptoms also include chronic feelings of boredom and emptiness, paranoid thinking, and feeling ungrounded, disconnected even from yourself.

People with this disorder are prone to hurting themselves — cutting, or attempting suicide. In one study, 3.8 percent of the patients completed suicide over six years. Don’t dismiss a BPD person’s talk of suicide as “drama.” BPD people are just as likely to truly want to die as someone with major depression.

The causes of BPD are not fully understood, but they include genetic and neurological factors along with personal history. Someone with a history of childhood trauma like abuse or neglect is more at risk. BPD is about five times more common among people with a close relative with BPD. Interestingly, the genes for BPD, although not yet identified, may also be related to attention deficit and hyperactivity disorder (ADHD). You’re at greater risk for BPD if your sibling has ADHD.

Borderline personality disorder treatment

Psychotherapy is essential for BPD patients, since they need coaching to manage their intensity. Dialectical behavioral therapy, a type of cognitive behavioral therapy, was developed for this group by Marsha M. Linehan, PhD who suffered from BPD herself. There is no one medication for this diagnosis; patients may be given mood stabilizers or low-dose antipsychotics. When they are under extreme stress, they are often hospitalized to prevent dangerous behavior. Someone with BPD may have other diagnosed disorders — depression, bipolar depression, or a substance use problem.

Family members and caregivers may need therapy themselves to manage the stress and learn what they can do to minimize conflict.

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