Borderline Personality Disorder (BPD)

Borderline Personality Disorder (BPD) is a condition that is characterized by instability in moods, personal relationships, self-image, and behaviour. It is also associated with high rates of self-harm and suicide. This disorder negatively impacts an individual’s family and social life, career, long term planning, and sense of identity.

DISCLAIMER: This information is for educational purposes only and not to be used for self-diagnosis. If you or a loved one can relate to a number of features listed below, then please do use our therapist directory to find a psychiatrist, psychologist or therapist that is right for you to receive a professional diagnosis.

What are the primary symptoms/signs of the condition?

• Making active efforts to avoid real or imagined abandonment.
• Intense episodes of anger, depression, or anxiety that may last only hours or, at most, a few days. These may be associated with episodes of impulsive aggression, self-injury, and drug or alcohol abuse.
• Unusual thoughts and a sense of self can lead to frequent changes in long-term goals, career plans, jobs, friendships, identity, and values. 
• Sometimes people with BPD view themselves as fundamentally bad or unworthy. 
• They may feel bored, empty, or unfairly misunderstood or mistreated, and they have little idea who they are.
• Recurrent suicidal behavior.
• Short-term, stress-related paranoid thinking, or dissociation (“losing touch” with reality).
• People with BPD often have highly unstable patterns of social relationships. 
• Attitudes toward family, friends, and loved ones may suddenly shift from idealization (great admiration and love) to devaluation (intense anger and dislike). Thus, they may form an immediate attachment and idealize another person, but when a slight separation or conflict occurs, they may switch unexpectedly to the other extreme and angrily accuse the other person of not caring for them at all.
• Most people can tolerate the feeling of experiencing two contradictory states at one time. People with BPD, however, must shift back and forth between good and bad states. If they are in a bad state, for example, they have no awareness of the good state.
• Individuals with BPD are highly sensitive to rejection and react to mild separations with anger and distress. Even a vacation, a business trip, or a sudden change in plans can cause negative thoughts. These fears of abandonment seem to be related to difficulties feeling emotionally connected to important people when they are physically absent, leaving the individual with BPD feeling lost or worthless. 
• People with BPD have high rates of self-harm. Such fears of abandonment are associated with the struggles to emotionally connect to individuals in their physical absence. As a consequence, an individual feels lost or worthless.
• Suicide threats and attempts may occur along with anger at anticipated abandonment and disappointments.

Please Note: This information is for educational purposes only and not to be used for self-diagnosis. If you or a loved one can relate to a number of features listed below, then please do use our therapist directory to find a psychiatrist, psychologist or therapist that is right for you to receive a professional diagnosis.

What factors can be contributing causes? 

• Both environmental and genetic factors are thought to play a role in people being diagnosed with BPD.
• Studies show that many individuals with BPD report a history of abuse, neglect, or separation as young children.
• Researchers believe that BPD results from a combination of individual vulnerability to environmental stress, neglect, or abuse as young children, and a series of events that trigger the onset of the disorder as young adults. 
• Adults with BPD are also considerably more likely to be the victims of violence, including rape and other crimes. These incidents may result from harmful environments as well as the victims’ impulsivity and poor judgment in choosing partners and lifestyles.
• Neuroscience is revealing brain mechanisms that underlie the impulsivity, mood instability, aggression, anger, and negative emotion seen in BPD. 
  • Studies suggest impairments in the areas of brain circuitry that regulate emotion in people with BPD.
  • The brain’s amygdala, a small almond-shaped structure, is an important component of the circuit that regulates negative emotion. 
  • In response to signals from other parts of the brain indicating a threat, it combines the feelings of both fear and arousal. 
  • The impact of this may be more pronounced under the influence of stress or drugs like alcohol. 

What is the recommended treatment?

• Psychotherapy is the first-line treatment for BPD, and several forms of therapy, such as dialectical behavioural therapy (DBT), mentalization-based therapy (MBT), cognitive behavioural therapy (CBT), and psychodynamic psychotherapy, have been studied and proven to be effective ways to alleviate symptoms.
• Medication is often prescribed based on specific target symptoms shown by the individual patient. Antidepressant drugs and mood stabilizers may be helpful for depressed and/or unstable moods. Antipsychotic drugs may also be used when there are distortions in thinking.

• A general practitioner (GP) or psychologist can usually diagnose BPD by asking questions about a person’s medical history and symptoms.
• The GP/psychologist will also inquire about a patient’s physical health to ensure that the unstable mood is not caused as a result of other underlying medical conditions, or by factors such as drug or alcohol use.
• The GP/psychologist will then check the symptoms that the patient presents with against the standard criteria for BPD before making a diagnosis.

• BPD affects 2% of adults.
• The disorder is approximately 5 times more common among people with close biological relatives with BPD.
• 40-71% of BPD patients report having been sexually abused, usually by a non-caregiver.
• BPD is more common in women than in men, with 75% of cases diagnosed among women.
• People with borderline personality disorder account for 20% of psychiatric hospitalizations.
• Up to 10% of people with BPD commit suicide.

If you are experiencing any of these signs, here are some activities you can do at home until you are able to consult a professional

• Exercise
• Engage in creative outlets such as writing, painting, or music
• Keep a gratitude journal
• Talk to a family member or friend about how you are feeling
• Practice Mindfulness
• Practice Yoga
• Engage in a well-balanced diet
• Maintain a good sleep schedule 
• Recognise what you can and can’t handle