Borderline personality disorder (BPD) is a personality disorder that can complicate social relationships and affect the way that an individual relates to themselves and their own feelings. The symptoms of BPD can cloud judgment and trigger behaviors that make some life situations painful and harder to navigate.
What Is Borderline Personality Disorder?
Borderline personality disorder (BPD) is a personality disorder and mental illness that is characterized by the loss of emotional regulation and control. This can lead to dangerous impulsivity, distorted self-image, and unstable relationships. People with borderline personality disorder often experience chronic feelings of intense fear, anger, and anxiety and struggle to manage or control them. Most people with BPD are diagnosed in early adulthood, but some are diagnosed as early as the age of 12.
Borderline personality disorder is one of many personality disorders that are very painful and distressing to the people who have them and are difficult to treat. According to the National Institute Of Mental Health, personality disorders often coexist with other mental disorders, such as bipolar disorder, anxiety, or depression. This can complicate the diagnosis process as there are many overlapping symptoms between borderline personality disorder and other mental health disorders. Many people with BPD are often diagnosed for other conditions before receiving their BPD diagnosis. If you believe you have a mental health condition or multiple conditions and personality disorders, seeking the help of a licensed therapist or other mental health services will provide you with an accurate diagnosis and prevent potential harm from having to diagnose yourself.
Risk Factors For Borderline Personality Disorder
Although the exact causes of BPD are not completely clear, there are recognized risk factors that appear to contribute. According to the National Institute Of Mental Health, one of the most significant risk factors consists of how someone was raised by their family. Not all families are loving or harmonious, which can result in trauma, attachment issues, and adverse childhood experiences. Some examples of this include:
These are just a few examples of experiences that can lead to BPD. It is important to note that almost any adverse childhood experience or traumatic event puts someone at a higher risk of developing borderline personality disorder or other mental health conditions.
The next risk factor is brain structure and function. There is evidence that changes in brain function and structure in areas that control the regulation of emotions and impulses may be risk factors for BPD or a result of BPD.
As with almost any mental illness, family history is a significant risk factor. Other factors include adverse environments or social experiences.
These risk factors only contribute to the likelihood that an individual may develop the disorder. Someone with all the risk factors may never develop a problem, but awareness of risk factors can help in early intervention, as well as BPD online therapy.
Symptoms Of Borderline Personality Disorder
A diagnosis can only be given by a professional. Some symptoms of borderline personality disorder are not exclusive to this disorder. It is best to seek professional evaluation and mental health services if you suspect that you or a loved one has any health issue.
BPD is characterized by emotional extremes that can change quickly. People with BPD tend to view events and relationships as good or bad rather than in the shades of gray in the manner that others may perceive. The thought process of extreme categorizing results in emotional ups and downs. This emotional turbulence can coincide with behaviors that reflect the highs and lows. People with BPD also frequently have a fear of abandonment in their relationships, perhaps tied to their perception of extreme ends. This often prompts thoughts and feelings that create behaviors that may ultimately put a strain on those relationships, self-fulfilling that expectation.
According to the American Psychiatric Association’s Diagnostic and Statistical Manual Of Mental Disorders, the following symptoms and behaviors are common in those with BPD:
Furthermore, the thoughts that underlie BPD in a person can motivate behavior that sometimes does not fit with the reality of a situation. Reactions can seem exaggerated in proportion to the situation. The severity of symptoms and their frequency vary for each person.
An individual with borderline personality disorder can have any combination of the above symptoms. However, don’t simply use this list as a way to self-diagnose borderline personality disorder in yourself or your loved ones. Only, a licensed doctor or licensed clinical social worker can help someone better understand if the history of their symptoms constitutes a BPD diagnosis.
If you or someone you know is dealing with any combination of the symptoms listed here, it is a good idea to seek an appointment with a professional. A diagnosis can be helpful as a first step to understanding how a person’s symptoms can be alleviated. A trained professional can make the evaluation and provide BPD treatment options that will greatly improve symptom occurrence. Your chosen mental health care provider will help you obtain a diagnosis and provide treatment through a range of proven therapies and techniques.
Diagnosing Borderline Personality Disorder
Only a licensed professional can provide a diagnosis of borderline personality disorder. A licensed counselor, psychologist, or psychiatrist performs various evaluations to diagnose BPD.
The first part of diagnosis includes an interview by your therapist, psychologist, or doctor. During the interview, you'll be asked to discuss symptoms and any problems in your life that you perceive are related to them. The therapist will inquire about symptom severity and prevalence. Information during the clinical interview is used to help your clinician understand why, when, and how symptoms occur.
BPD symptoms are found across a range of other potential diagnoses. The interview and discussion are important to ruling out or including other potential diagnoses. This portion can also be helpful to identify any coinciding behaviors or complications.
You may be asked to have a medical examination to rule out potential health issues that may produce symptoms like what you describe to your clinician. Your therapist or psychologist may refer you to a medical provider to have testing and a medical exam done.
Family History, Social & Cultural Information
Family histories are gathered by clinicians to help in diagnosis and treatment planning. By understanding your family's medical and mental health history, as well as determining any adverse experiences you may have had early in life, clinicians can get a more complete view of the factors that play a role in your situation.
BPD has biological and environmental risk factors and contributions, and gathering information about your present living situation, your history with your family, as well as their mental health and medical history will be helpful in determining these factors. You and your doctor will try and sort out how they fit with what you are experiencing.
Proper diagnosis is the only way to ensure the best plan for treatment. The only way to receive the best possible outcome for treatment of borderline personality disorder is to find a licensed professional and receive testing and a diagnosis. With a diagnosis, these same professionals can put together a treatment plan that will provide a care plan that can ease your symptoms.
Therapy And Treatment Of Borderline Personality Disorder
Once a diagnosis is reached, treatment can begin. There are multiple options that help treat borderline personality disorder. Talking with a professional about treatment options is important to finding success. Everyone is different and may respond differently to various types of treatments.
This list of treatments and therapies is for reference only; the best plan will be one that is tailored to the specific needs of the individual by a licensed professional.
Psychotherapy with a licensed mental health professional is one of the best treatments for people with BPD. Therapy is an evidence-based treatment option that can provide people with borderline personality disorder with strategies to manage and regulate their emotions better and provide them with emotional support. Working with mental health professionals also helps a person with BPD work on the factors that worsen their mood swings, such as significant stress, traumatic life events, unstable relationships, and environmental factors, or reduce and manage the risky and harmful behavior that results, such as self-harming or attempting suicide. Furthermore, a therapist can also help with co-occurring disorders, such as eating disorders, post-traumatic stress disorder, or anxiety disorders.
Below are two common forms of psychotherapy that are known to help people with borderline personality disorder:
Many people with BPD also utilize medication for the management of their symptoms. However, medications for BPD do not cure BPD. Prescription medication can help treat specific symptoms, such as mood swings, anger, and depression. Regulating these symptoms may also make it easier for people with BPD to begin and commit to talk therapy and reduce self-destructive behaviors. This talk therapy will help them learn new coping skills which can move their thinking patterns away from painful extremes.
Borderline personality disorder varies in severity and may require multiple types of treatment depending on the individual. Diagnosis and treatment are best provided by a licensed professional who can explain treatment options and tailor them for success. If you or someone you know is struggling with symptoms of BPD, talk with your healthcare provider or reach out for therapy from the comfort of your own home with BetterHelp.
Turning to an online therapist for help managing the symptoms of BPD, like depression, can be very effective. Studies have shown that internet based interventions are just as effective for treating depression as in-person therapies. Even more, long-term benefits of continued symptom management and reduction has been shown to favor online treatment plans.
Talking with a therapist online can be a more manageable, long-term solution for the regulation of your symptoms. Meeting online allows flexibility in your schedule that could help you commit more fully and long-term to talk therapy treatments. Having therapy from the comfort of your home can make it easier to “show up” to therapy as you feel more comfortable in the space and with your therapist over a video call, phone call, or even messaging.
“Barbie has been my counselor for the past few months. She is AMAZING! I had never taken any therapy services before so I had my doubts on how this would be beneficial, I was wrong. Barbie has helped me not only understand why I’ve had anxiety and depression, but also create a process to keep it under control when it does occur. Crisis will happen in our lives, but that doesn’t mean we shouldn’t have a way to deal with our emotions when it does happen instead of crisis catching us by surprise. I highly recommend Barbie’s therapy services to anyone that is hesitant in trying therapy for the first time or if you want to find a new counselor. She’s an expert in her field and puts the interests of her patients first.”
Hoi Moy MS,LPC
“Rene was assigned as my counselor and I couldn't be happier with his support. I've been working with him for about 2 months now and he's helped me get through some really dark times. When I first signed up for BetterHelp, I was experiencing depression unlike any episode I've had before. Rene gave me the tools and advice I needed to get through those days and that I can use anytime I feel those thoughts creeping back. I look forward to our sessions and can't thank him enough for the support and motivation he's given me. I highly recommend working with Rene!”
Rene Brathwaite LPCMH,ICCDP-D,NCC
Some commonly asked questions on this topic include:
How do they diagnose BPD?
What are the 9 criteria for BPD?
What is BPD usually misdiagnosed as?
Is BPD still a diagnosis?
What does a BPD episode look like?
What triggers borderline personality disorder?
Do I have BPD or am I just sensitive?
Is BPD the same as bipolar?
Is BPD hard to diagnose?
How does a person with BPD act?
Is borderline personality disorder the same as bipolar?
Though borderline personality disorder (BPD) and bipolar disorder have overlapping and similar symptoms, they are two very different conditions. Borderline personality disorder is a personality disorder while bipolar disorder is a mood disorder.
Both mental health disorders are characterized by mood swings, but the intense emotions experienced in borderline personality disorder usually only last a few hours while the mood swings in bipolar disorder typically last a few days or weeks. Furthermore, the emotions these two illnesses experience differ. Someone with bipolar disorder will experience episodes of mania and depression while people with borderline personality disorder don’t experience these exact cycles but instead live with intense feelings of emptiness, desperation, anger, hopelessness, and loneliness. Furthermore, mood shifts in BPD are usually the result of an environmental stressor and do not involve any feelings of elation. Bipolar disorder involves manic episodes, which means that a person with this mental health condition occasionally experiences episodes of euphoria.
But even with these differences, these two illnesses overlap. In fact, some people with borderline personality disorder believe they have bipolar disorder instead. Therefore, it is understandable if you’re struggling to differentiate the two. If you believe you have one of these conditions, it is best to talk to a licensed mental health professional for an accurate diagnosis.
What are the 9 criteria for Borderline Personality Disorder?
According to the National Alliance For Borderline Personality Disorder, BPD can be officially diagnosed if five of the nine following criteria are met:
*(If you are struggling with substance use, reach out to the Substance Abuse And Mental Health Services Administration (SAMHSA) at (800)662-4357 for help and support.)
**(If you are experiencing thoughts of suicide, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255.)
However, do not just use this list as a way to self-diagnose. If you believe you have borderline personality disorder, please discuss your symptoms and concerns with a mental health professional.