Borderline personality disorder (BPD) is a serious mental health illness that is one of ten personality disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). According to National Institute of Mental Health (NIH), BPD is characterized by “pervasive instability in moods, interpersonal relationships, self-image, and behavior.” This instability interferes with one’s ability to function in his or her daily life, long-term planning, as wells as an individual’s sense of identity. Individuals diagnosed with borderline personality disorder often experience swift mood swings, including intense episodes of depression, anger and/ or anxiety that could last as short as a couple of hours to as long as several days. The symptoms associated with BPD frequently result in highly unstable patterns of social relationships. This chronic condition is also associated with high rates of self-injury and suicidal behavior.

Signs and Symptoms

Every individual is different and will exhibit a somewhat unique set of BPD signs and symptoms. The Mayo Clinic provides several commonly reported signs and symptoms to include the following:

  • Intense fear of abandonment
  • Rapid changes in self-image and self-identity 
  • Impulsive, risky and/ or dangerous behavior (i.e. engaging in unprotected sex, substance abuse, reckless driving, gambling, etc.)
  • Suicidal ideation
  • Wide and extreme mood swings
  • Periods of stress-related paranoia
  • Self-inflicted social isolation
  • Ongoing feelings of emptiness
  • Irrational, inappropriate, and/ or intense bouts of anger

It is important to note that any combination of the above signs and symptoms could manifest as a result of BPD. The severity and length of time they persist will vary, as they will depend on each individual. 

Causes

While there is no singular reason behind why an individual develops borderline personality disorder, there are several contributing factors that have been noted as potentially increasing one’s susceptibility to BPD. These factors can include, but are not limited to the follow, as provided by the National Institute of Mental Health

  • Genetics: people with a family history (i.e. parent, sibling, etc.) with BPD may be at increased risk of developing borderline personality disorder. Psychology Today assert that BPD is approximately five times more common among people with close biological relatives with BPD. 
  • Environmental factors: growing up in an unstable, neglectful, and/ or abusive environment could increase one’s risk for developing BPD. 
  • Brain factors: some studies have indicated that individuals diagnosed with BPD have structural and/ or functional abnormalities, specifically in the areas of the brain that reign over one’s emotional regulation and impulse control. Furthermore, deviations from typical serotonin (hormone that works to stabilize one’s mood, happiness and feelings of well-being) production could increase one’s susceptibility to BPD. 

Treatment

The nuanced needs of an individual diagnosed with borderline personality disorder will inform his or her individualized treatment plan. Individualized treatment plans could comprise of a variety of therapeutic modalities some of which could include individual psychotherapy, group therapy, and/ or creative arts therapies. Dialectical behavior therapy (DBT), a form of cognitive behavioral therapy (CBT), was specifically designed to help treat individuals diagnosed with borderline personality disorder. Since it was developed in the late 1980s, it is highly common for DBT to be integrated into one’s treatment plan, as it has become the gold standard for treating BPD. Components such as nutritious eating habits, frequent self-care practices, engaging in regular exercise, obtaining ample sleep, and practicing various relaxation techniques (i.e. yoga, meditation, etc.) can also be included in one’s treatment plan. Recovery from BPD will require steadfast commitment, and will be a life-long process. With proper mental health treatment and support, an individual diagnosed with borderline personality disorder can go on to live a healthy and fulfilling life.