Exploring Common BPD Symptoms In Women And How To Find Help

Borderline personality disorder (BPD) often comes with misconceptions and can have a negative reputation. However, as one of the most common personality disorders, BPD can impact people’s lives in a myriad of ways. One way to break the stigma surrounding BPD is to learn about how it presents, why symptoms occur, and how to find help. Healing from personality disorders is possible, and many support options are available for those impacted, including in-person and online therapy.

What is borderline personality disorder (BPD)? 

Borderline personality disorder is a cluster B personality disorder listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). It is listed alongside conditions like narcissistic personality disorder (NPD) and histrionic personality disorder (HPD). BPD diagnostic criteria are the same regardless of one’s gender. The following symptoms are listed in the DSM-5: 

• Frantic efforts to avoid real or imagined abandonment from loved ones (often a specific person) 
• Unstable relationships that swing between idealization and devaluation 
• A chronic sense of emptiness 
• Impulsive behavior that may be self-damaging, such as risky sex, unnecessary spending, substance misuse, or binge eating 
• Recurrent threats or thoughts of suicide or self-harm 
• Instability in mood, often lasting a few hours at a time and shifting frequently 
• Inappropriate and intense anger
• Stress and dissociation 
• A lack of identity or unstable self-image 

BPD is thought to develop in response to a mixture of genetic and environmental factors, which is often the case with personality and mood disorders. If you believe you or someone you love might be living with BPD, talk to a mental health professional about potential treatment options. 

Common BPD symptoms in women

Women may experience various presentations of BPD symptoms, perhaps due to societal pressures, stigma, and experiences that are unique to their gender. Below are some of the most common presentations. 

Asking for reassurance

Asking for reassurance can be seen as a behavioral coping mechanism developed in people with BPD to cope with the fear of abandonment. Although many people with BPD have a fear of abandonment, asking for reassurance may be more common in women due to how they are socialized in Western society. For instance, women are often expected to look to others for advice and reassurance rather than reassure themselves. 

People with BPD may frequently ask questions like, “Are you mad at me?” or “Do you still love me?” These questions are usually meant to determine whether there is a risk of losing that person. However, although the relief from reassurance can be helpful in the moment, it often doesn’t last very long. This short-lived reassurance may lead the person to ask questions like these multiple times a day, which can have the opposite of the desired effect and may push their loved ones away. 

Self-harm

Self-harm tends to be more common in women with BPD than in men. Women with BPD may self-harm in many ways, including by cutting, bruising, or burning themselves, among other methods. Self-harm often accompanies suicidal thoughts and threats, though the person may not have a specific plan or go through with the thoughts. Often, these actions are a way to cope with extreme emotional pain and are not “attention-seeking” behaviors. Even if one is self-harming to get attention or validation from others, they are still experiencing a symptom of a serious mental illness and deserve compassion and support.  

Difficulty accepting or setting boundaries

Women with BPD may have difficulty understanding the limits of others or may believe that another person’s boundaries are an attempt to abandon them. For example, if a partner asks for space, the individual with BPD might become terrified of losing them and believe that their partner hates them, even if there is no indication of a breakup or loss of connection. They might continuously try to enter someone else’s space or ask for reassurance, even when that person has requested time to themselves. 

Women with BPD may also struggle to set boundaries for themselves. Due to their unstable sense of identity, they might not know what boundaries would be helpful for them and could be more likely to enter relationships with people who take advantage of them or push them past their limits. Because they may also have low self-esteem, they might struggle to realize they deserve better when they’re in unhealthy relationships. 

How do symptoms of BPD in women differ from those in men? 

How to find support for BPD symptoms 

Borderline personality disorder can be managed and treated with therapy, support systems, and medication. Below are some ways to find these resources. 

Therapy 

The most highly recommended therapeutic modality for the treatment of BPD in women is dialectical behavior therapy (DBT). DBT was developed specifically by a woman with BPD for women with the condition, although men can also benefit from DBT. This modality is separated into four modules, including mindfulness practice, interpersonal skills, emotional regulation, and distress tolerance. Each skill module is meant to address different symptoms of BPD and other mental illnesses. For example, when one is having difficulty accepting a situation, the “radical acceptance” skill might be helpful. When one is struggling to care for their physical health, the “self-soothing” skill might work. 

Support groups for borderline personality disorder 

Having a healthy community and support system can help people with BPD develop a stronger sense of identity and their place in the world. Support groups can be a place to start, or one might try joining a DBT skills group where they can work on DBT skills alongside other people with BPD. Support groups can also be found on websites, social media, and online therapy platforms. 

Mental health medication 

No specific medication has been approved in the treatment of BPD. However, many trials have researched medications for the treatment of BPD and co-occurring disorders, such as depression and anxiety disorders. Still, each person is different, so it can be vital to talk to your doctor before starting, stopping, or changing any medication or medical treatment when aiming to get borderline personality disorder treated.

The BetterHelp platform is not intended to provide any information regarding which medication or medical treatment may be appropriate for you. The content provides generalized information that is not specific to any one individual. Do not take any action without consulting a qualified medical professional.

Can BPD in women be cured?

It is not possible to “cure” BPD. However, many people go into remission or no longer qualify for a BPD diagnosis following treatment. In remission, one may still experience deep emotions and stressful urges, but they have the skills to cope with these emotions and develop healthier relationships. Addressing BPD symptoms can be challenging, but improvement is possible. By learning more about the condition, holding yourself accountable, and being open to change, you may be able to manage symptoms effectively. 

How to improve your relationships with BPD 

BPD symptoms can significantly impact relationships. Below are some tips for fostering healthier relationships with loved ones: 

• Notice when you’re idealizing or devaluing (sometimes called “splitting”) in a relationship, and take space to journal or reflect on these thoughts instead of externalizing them 
• Listen to understand, not to respond 
• Be empathetic to the struggles of others, even when you’re experiencing difficulty yourself
• Respect other people’s limits on how often they can offer reassurance, conversation, and emotional support 
• Learn to self-soothe and comfort your inner child 
• Gain competence and confidence in your abilities to survive and thrive 

Finding extra mental health support

If you’re not sure where to go for support, you might also consider online therapy. With an online therapy platform like BetterHelp, clients can get help with various mental health conditions and symptoms from a licensed mental health professional. Through the platform, you can also access support groups, worksheets, goal-tracking tools, and journaling prompts. You can share your journal entries with your therapist and receive responses throughout the week when the therapist is available. 

Studies generally support the efficacy of online therapy for people with BPD and other mental health conditions, including other personality disorders, bipolar disorder, anxiety disorders, and eating disorders. A 2022 scoping review reported that participants typically had moderate to high satisfaction with the treatment they received across 11 different studies. More research is needed, but this study may be a promising first look at what might be available for mental health treatment for BPD from home.