Borderline personality disorder (BPD) is an often-misunderstood mental health condition that affects your mood, behavior, self-image, and relationships.
People frequently confuse borderline personality disorder (BPD) with other mental health disorders, such as bipolar disorder and dissociative identity disorder (formerly called multiple personality disorder).
BPD may come with significant stigma and misunderstanding. It also sometimes accompanies other mental illnesses, which can make it difficult to diagnose.
Someone with BPD can often experience intense emotions that can lead to behavior others perceive as extreme or irrational. They often have a pattern of multiple:
- job losses
- breakups and divorce
- estrangement from family members
- other relationship troubles
Trauma and genetics are two potential root causes of BPD. You can read more about causes of BPD here.
Life with BPD can come with some challenges. Still, there are ways you can learn to cope and improve your relationships.
If you have borderline personality disorder, you may often experience intense emotions that you have trouble controlling.
Think of the angriest rage or the most intense adoration you ever felt. People with BPD can feel overwhelmed by strong emotions.
Not only are the emotions difficult to handle, but they can influence the way you act, which may later regret. This can leave you feeling emotionally hurt and deeply affect your self-esteem.
A lack of self-control is what typically defines BPD and can seriously damage your personal relationships.
Others may avoid you or say they can’t be around you because of the things you do that they deem inappropriate or hurtful. People with BPD often fear abandonment or being alone.
Here are some common thoughts and behaviors of people with BPD:
- black-and-white thinking, called splitting, where you think people or situations are either good or bad with no in-between
- thinking that friends or partners will leave you, so you must reject them first
- getting very frustrated with others
- changing jobs, goals, plans, and hobbies often
- quitting before failing
- feeling no one can understand you
- having thoughts of self-harm or suicide
If you’re having thoughts of suicide or self-harm
People with BPD who are not getting treatment may engage in self-injurious behaviors, including:
- substance use
- spending beyond their means
- reckless driving
- sex with multiple partners that is harmful to themselves or others
- binge eating
If you’re living with BPD, you might be living with another mental health condition as well, including:
- bipolar disorder
- eating disorders
(Video) On the line: Living with borderline personality disorder
If you’re living with BPD, there are certain challenges you may be experiencing frequently. Here are some possible issues and how you might work through them.
Fear of abandonment
One of the symptoms of BPD is the fear of abandonment. This means you’re always on high alert in situations where you might feel left out.
For instance, say a friend cancels lunch, a partner is preoccupied with work, or you find out that a neighbor didn’t invite you to their latest get-together.
Many people might shrug off these issues, but people with BPD may experience intense feelings of abandonment that may influence them to take extreme actions out of hurt and anger.
For example, they might end the relationship with the friend who canceled lunch, start a fight with the partner over spending less time with them, or say something angrily to a neighbor. These interactions may escalate into outbursts.
If you experience feelings and situations like these, consider a treatment like dialectical behavior therapy (DBT), a type of psychotherapy that helps people with BPD.
With it, you can learn how to tolerate distress better and accept things you can’t control — like your partner’s work schedule or the neighbor’s guest list.
With DBT you can learn to regulate the emotions that crop up when you feel like you’ve been abandoned.
Zero shades of gray
Another symptom is black-and-white thinking.
For example, you might think all people are good or evil, a work idea is either great or a disaster, or your spouse is either right or wrong, without ever considering more moderate interpretations.
Consider avoiding words like “always” or “never” and “pass” and “fail” when you catch yourself having extreme thinking.
Instead, consider reframing the situation using words like “maybe,” “sometimes,” “compromise,” and “collaboration,” or simply allow yourself to say, “I don’t know the answer.”
Cognitive behavioral therapy (CBT) is another type of psychotherapy that may help you:
- sort out distorted thinking
- problem-solve in difficult situations
- learn to adopt a more flexible mindset
- develop confidence in your abilities
For these reasons, CBT can really help with black and white thinking.
Taking care of your physical health
People with BPD may also have chronic health issues, according to
Scientists aren’t sure where the link lies between BPD and chronic health disorders. Still, taking care of your health is a must if you have BPD.
This includes seeing a primary care doctor often and managing any chronic health conditions or chronic pain.
A healthcare professional can also help you develop a diet plan and exercise routines that work for your needs.
Along with the therapies DBT and CBT, you may consider other therapies for treating BPD, including:
- Transference-focused psychotherapy: helps people with BPD work on difficulties with work and relationships
- Systems Training for Emotional Predictability and Problem Solving (STEPPS): a type of CBT to help manage intense emotions
- Schema-focused therapy: a combination of several therapies that break patterns of negative thinking
- Supportive psychotherapy: works on improving self-esteem
- Mentalization-based therapy: helps you learn to recognize thoughts and their effect on your behavior
Currently, there are no Food and Drug (FDA) approved medications for BPD. Still, many people living with BPD have success with medications that treat anxiety, depression, and mood disorders. These medications include:
Sticking with treatment is crucial to making headway with the disorder. In addition, if you have other co-occurring mental health conditions, continuing with your therapy and medication may be even more important.
Self-care activities are also helpful. You cannot be at the top of your game if you’re not sleeping well, eating nutritious meals, getting exercise, and managing stress. Researchers say these lifestyle practices can help reduce symptoms of BPD.
Stress may trigger BPD symptoms, according to research.
That’s why learning to manage and pay particular attention to life stressors are especially important for you if you have BPD. Some treatments, like DBT, may help you manage stress.
In addition to seeking therapy, consider these tips for relieving stress.
- Keep a diary to track your mood, and consider journaling for stress relief.
- Know your triggers and have a strategy for getting support, like calling a friend or therapist.
- Create a care box you can turn to during stressful times. It could contain your favorite music, an inspirational book or poem, a stress ball, a blanket or T-shirt that brings you comfort, and a scented candle.
- Get outside in nature for a walk or to get fresh air.
- Make sure you get plenty of exercise, which provides endorphins that can naturally reduce stress.
Your outlook with BPD may depend on the severity of your condition as well as any co-existing conditions you have. It also depends on the treatments you use, how well they work, and whether you stick with your treatment plan.
If you think you might have BPD, there’s hope. A healthcare professional can diagnose the condition and help you treat it. With help, you can learn to manage the condition and your emotions, and improve your relationships.
Know that you can live a normal life with BPD.
People with BPD often have risk-taking behaviors, such as overspending, drug use, reckless driving, or self-harm due to a lack of inhibition. Although these behaviors can be dangerous, and potentially life-threatening, many people with BPD are high-functioning individuals.
Their wild mood swings, angry outbursts, chronic abandonment fears, and impulsive and irrational behaviors can leave loved ones feeling helpless, abused, and off balance. Partners and family members of people with BPD often describe the relationship as an emotional roller coaster with no end in sight.
being a victim of emotional, physical or sexual abuse. being exposed to long-term fear or distress as a child. being neglected by 1 or both parents. growing up with another family member who had a serious mental health condition, such as bipolar disorder or a drink or drug misuse problem.
With treatment, medication, and counselling, most individuals suffering from BPD can build a life worth living but the dynamics of the illness make emotion dysregulation a reoccurring obstacle that can sometimes cause major setbacks (legal issues, loss of sobriety, physical injury, etc.)
It is commonly believed that symptoms of Borderline Personality Disorder (BPD) lessen with age. For example, the DSM-IV states: “The impairment from the disorder and the risk of suicide are greatest in the young-adult years and gradually wane with advancing age” (1).
Also, many people achieve remission — their symptoms become much less intense, so much so that they no longer meet the criteria for diagnosis. The stigma around BPD is pervasive, but many people get better. With treatment, it's possible to go on to lead a happy and healthy life.