Borderline personality disorder is a mental condition characterized by a pattern of unstable relationships, emotional instability, distorted self-image, and impulsive behavior.
This illness begins during adolescence or early adulthood and could last for several years. If left untreated, borderline personality disorder (BPD) can cause a great deal of distress.
The National Institute of Mental Health has estimated that approximately 1.6 percent of adults have BPD in the United States.
Thankfully, this mental condition is not untreatable; with specialized treatment and support targeted at managing the symptoms, people with BPD can get better.
What causes BPD?
While the original cause of BPD is still unknown, mental health experts have suggested several factors that may contribute to the development of the disorder, including environmental factors, genetics, and serotonin abnormalities.
Many people who have been diagnosed with this condition have experienced childhood trauma, abuse, neglect, or were separated from their caregivers at a tender age. However, not everyone with BPD had experienced any of these while growing up.
Also, many people who have had these experiences while growing up do not develop BPD.
Genetics may also play a role in BPD. One research on twins and BPD published in the Journal of Personality Disorders implied that the illness has a substantial genetic component.
Another study by the American Psychiatry Association noted that people who have a parent or sibling with BPD stands the risk of developing it.
Serotonin is an essential hormone in the human body involved in regulating mood and social behavior. People with abnormalities in serotonin production may stand the risk of BPD.
What are the symptoms of BPD?
BPD manifests in different ways, interfering with one’s ability to achieve fulfillment in school, work, or relationships. However, mental health experts have categorized the symptoms into nine major groups for proper diagnosis.
A patient must meet at least five of these criteria to be diagnosed with BPD.
The nine symptoms of borderline personality disorder, according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) are:
- Fear of abandonment. People with BPD are always scared of being left alone or abandoned. Even something as trivial as a loved one going away for the weekend or arriving home late may trigger intense fear. This can result in frantic attempts to avoid imagined or real abandonment by keep the other person close. They may cling, beg, start fights, physically blocks their loved one from leaving, or even tracking the other person’s movements. However, this behavior tends to be misinterpreted and ultimately drives the other person away.
- Intense and short-lived relationships. People with BPD tend to have a pattern of unstable and intense relationships with family, partners, and friends characterized by a lot of arguments, conflicts, and break-ups. They either see their relationships as perfect or horrible, with no middle ground. One moment, they are idealizing someone, and the next moment, they feel the person doesn’t care enough or even see them as evil.
- Shifting self-identity. People with BPD tend to have an unstable sense of self. They usually don’t have a clear idea of who they are or what they want in life. Sometimes they feel good about themselves, but the next moment, they are feeling bad or hating themselves. This often leads to many ups and downs in their lives, frequently changing goals, values, friends, lovers, jobs, or even sexual identity.
- Impulsive or self-damaging behaviors. When you have BPD, you may engage in risky, sensation-seeking behaviors, especially when you’re upset. For example, you may binge eat, gamble, drive recklessly, shoplift, spend too much that you can’t afford, over do it with alcohol or drugs. You may also engage in risky sex or sabotage success by suddenly ending a positive relationship or quitting a good job.
- Self-harming behaviors. People with BPD tend to have a history of self-harming or suicidal behaviors, which is often a response to fear, rejection, or abandonment. Self-harming behaviors encompasses all attempts to inflict injury on one’s self without suicidal attempt such as burning or cutting. In contrast, suicidal behaviors include thinking about suicide, making suicidal threats or gestures, or physically attempting suicide.
- Extreme mood changes. Unstable emotions and moods are common in people with BPD. These mood swings tend to pass very quickly, lasting for a few minutes or hours and may include intense happiness, anxiety, irritability, or shame.
- Intense feeling of emptiness. People with BPD are often characterized by having an ongoing sense of emptiness as if there’s a void or dip hole inside them. At the extreme, they may feel as if they are “nobody” or “nothing.” They may try filling the void with things like food, drugs, or sex, but nothing truly feels satisfying.
- Explosive anger. People with BPD often struggle with short temper or intense anger. You find it hard keeping your temper in check and let loose at the slightest provocation, yelling, throwing things, or physically engaging in fights. It is essential to point out that this anger isn’t always displayed outwards. You may spend some time feeling angry at yourself.
- Stress-related Paranoia. Under stress, people with BPD often experience paranoia thoughts – usually about people trying to harm them. They may also struggle with severe dissociation, a feeling of being numb, spaced out, or detachment from your mind or body.
How is Borderline Personality disorder diagnosed?
It is essential to point out that you can’t diagnose this condition on your own. Therefore, if you think that you or a loved one may be experiencing BPD, its best, you seek medical help.
Since BPD often tends to get confused or overlaps with other conditions, you will need the help of a mental health professional to examine your symptoms and make a proper diagnosis.
What are the treatments for BPD?
One or more treatments may be recommended by your mental health expert, including medication, psychotherapy, or hospitalization.
There is no known medication to cure BPD, but your mental health professional may recommend medication in addition to psychotherapy treatment. For instance, they may prescribe
- Antianxiety medications to manage anxiety
- Antipsychotics to manage aggressive symptoms
- Antidepressants to treat depression
Psychotherapy is the primary treatment for BPD. Your mental health expert may recommend any of the following types: cognitive behavioral therapy (CBT), schema-focused therapy, and dialectical behavior therapy (DBT).
CBT assists you in recognizing and changing unhealthy behaviors, beliefs, and inaccurate perceptions you may be having about yourself or others. It shows you healthy ways to react when you feel insecure, angry, anxious, or suicidal.
Schema-focus therapy shows you how to view yourself and the world in more positive ways.
DBT teaches you how to identify, be aware of, and accept your behaviors and beliefs. You also learn positive responses to these behaviors.
Your doctor will only recommend hospitalization if your symptoms are severe. You may be hospitalized for treatment if you exhibit suicidal behaviors, suicidal thoughts, or thinking about causing harm to yourself or others.
Omega-3 fatty acids may relieve symptoms of aggression and depression in people with BPD. However, more research is needed to uncover the full benefits of omega-3 fatty acids.
BPD or borderline personality disorder is a mental condition that usually begins during adolescence or early adulthood. The condition is sometimes mistaken with or co-occurs with other conditions like bipolar disorder, substance abuse, and others.
The outlook for people with BPD varies as some people may experience lifelong challenges associated with the condition. Sometimes, you may struggle with self-harming behaviors or suicidal thoughts.
Adhering strictly to your physician’s prescribed treatment can help you manage the symptoms and lead a safe and fulfilling life.
- Borderline Personality Disorder (BPD) – HelpGuide
- Heritability of Personality Disorders in Childhood: A Preliminary Investigation – NIH
- Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition – PsychiatryOnline