Borderline Personality Disorder

borderline personality disorder

Summary

Borderline personality disorder (BPD) is a condition that causes patients to have periods of unstable emotions that can seriously affect their quality of life. Patients with BPD have great difficulty controlling their emotions and impulses, and may experience frequent mood swings. As a result, patients tend to have unstable relationships and are distressed by emotional emptiness and fears of abandonment.

Patients with BPD may be calm for long periods of time before suffering episodes of extreme disruption that may last from a few hours to an entire day or longer. They may have a poor sense of self-identity and can suddenly shift their goals, values and opinions. Individuals also may alter plans regarding their career, lifestyle or type of friends. People with BPD sometimes view themselves as bad or unworthy, and tend to feel misunderstood or mistreated. They have a tremendous need for love that is matched by a fear of abandonment. Often, they will react with extreme rage or despair when they feel hurt by a loved one. 

About 2 percent of the general population has BPD, according to the American Psychiatric Association (APA). However, this is based on limited information.  In many cases, BPD is not immediately apparent to the patient. In fact, patients are more likely to seek help at the urging of a family member or friend. Patients who visit a primary or mental healthcare physician (e.g., psychiatrist) are likely to be asked a series of questions that may help the physician make a BPD diagnosis. BPD is most often diagnosed in adolescents and young adults, and women are far more likely to be diagnosed with BPD than men. It is treated with psychotherapy and sometimes antidepressants, antipsychotics and mood stabilizers. People who are diagnosed with BPD earlier in life frequently experience greater emotional stability beginning in their 30s or 40s. This is particularly true for people who seek treatment for the disorder.

About borderline personality disorder

Borderline personality disorder (BPD) is a serious mental health condition that causes patients to have unstable personal relationships, intense anger, emotional emptiness and fears of abandonment. About 2 percent of the general population has BPD, according to the American Psychiatric Association (APA). However, this is based on limited information.

Borderline personality gets its name from an earlier belief that the disorder shared characteristics of psychotic and neurotic (disturbed mental health) conditions. However, experts no longer view this definition as accurate. Instead, patients with BPD are said to have a problem regulating emotions, and are in a constant state of emotional turmoil. They may be calm and rational for long periods of time before experiencing sudden feelings of rage.

People with BPD sometimes view themselves as bad or unworthy, and tend to see themselves as misunderstood or mistreated. They may deny responsibility for their feelings and actions by using defense mechanisms such as “splitting.” During splitting patients elevate some people in their lives to a high status while totally devaluing others.  Patients may also use a defense mechanism called “projective identification,” in which they deny their own feelings and instead attribute them to someone else.

BPD affects people of all ages, but most often is diagnosed in adolescents and young adults. Women are far more likely to be diagnosed with BPD than men, and account for 75 percent of all cases, according to the APA.

People with BPD often show a lifelong tendency toward impulsiveness, strong emotions and intense relationships. In many cases, BPD that develops during young adulthood gradually diminishes as patients grow older. Greater stability frequently begins to appear in a patient’s 30s or 40s, particularly in those who seek treatment.

Many other mental health disorders are associated with BPD, particularly mood disorders (e.g., major depression, bipolar disorder). Other mental illnesses associated with BPD include:

  • Anxiety disorders (e.g., post-traumatic stress disorder)
  • Substance abuse
  • Other personality disorders
  • Attention deficit hyperactivity disorder(ADHD)
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