Borderline personality disorder, also known as BPD, is a mental health disorder that impacts your ability to regulate your emotions and feelings about yourself and those around you. It affects approximately 14 million Americans. To be clear, it's different from normal fluctuations of emotions and diagnosed variations like bipolar disorder.
People diagnosed with BPD experience long-term patterns of extreme and unstable emotions that impede their ability to function in everyday life. You can think of BPD as the extremes of everything -- either really good or really bad. The opinions and perceptions of things change extremely fast, leading to impulsiveness in relationships and actions.
Here's what to know about borderline personality disorder and seeking help.
What causes borderline personality disorder?
Experts don't fully understand what causes BPD, though current research suggests that genetic, social and environmental factors contribute. Some research investigating twins and families has found that personality disorders may be inherited, or familial relationships may predispose you to BPD.
The next factor is environmental and social influences, especially in early childhood. Traumatic life experiences, like a history of neglect, child abuse or abandonment, can contribute to BPD development. One of the most tangible markers for BPD is the fear of abandonment and the willingness to do anything to stop it. The behaviors taken are extreme, like self-harm or aggressive actions to physically keep a person there.
Finally, your brain structure may contribute to BPD. Research that studies brain images of those with BPD found that the amygdala and hippocampus -- brain structures crucial for emotional regulation and the fear response -- are smaller than in the average brain.
Signs and symptoms of borderline personality disorder
Borderline personality disorder isn't just a roller coaster of emotions. It fundamentally affects how you interpret your feelings about yourself, your behavior and your relationships with others. While the experience of BPD symptoms will vary by person, there are typical behavioral markers that help therapists diagnose the condition. The Diagnostic and Statistical Manual identifies the symptoms of BPD as:
- Having an intense fear of being abandoned by friends and family. For many with BPD, perceptions of being left or relationships ending are big triggers. They will frantically try to avoid both real and imagined abandonment.
- Significant mood swings can range from happiness to anxiety and irritability. These episodes can last a few hours or as long as a few days.
- A history of unstable personal relationships with friends and family members.
- Impulsive and risky behavior like binge drinking and eating, quitting a good job, reckless spending and drug use.
- Frequent changes in how someone views themselves. Goals and values may change as well.
- Self-harm behavior and suicidal threats.
- Periods of intense anger or bitterness, which can lead to physical fights.
How severely and how often someone may experience these symptoms will depend on the person.
Borderline personality treatment
The prognosis for borderline personality disorder is pretty good, and even better if you seek treatment. It's essential to see a licensed mental health professional who will complete a comprehensive medical examination.
A therapist can help create an effective treatment plan that includes psychotherapy, medication management or peer counseling. Psychotherapy methods are the primary treatment for BPD, including cognitive behavioral therapy, schema-focused therapy and dialectical behavior therapy. These therapy sessions help you build long-term coping skills you can use to manage your symptoms and reactions to situations.
Medications may also be a part of the treatment plan for BPD. Mood stabilizers or antidepressants can be prescribed to help offset the extreme mood swings of BPD, though no pill cures symptoms.
No matter what your treatment plan looks like, the goal of BPD treatments is to help you overcome emotional issues and manage the symptoms of the disorder.
Borderline personality vs. bipolar disorder
While on the surface, borderline personality disorder and bipolar disorder seem like the same thing because of their shared symptoms, they are two distinct disorders that cannot be lumped together. BPD is a personality disorder, while bipolar disorder is a mood disorder.
BPD is marked by instability in your emotions and actions, in how you perceive situations and in how others see you. When someone with bipolar disorder isn't in a manic or depressive episode, they have stability that those with BPD do not have.
Additionally, bipolar disorder is more responsive to medication because it is biologically based. BPD cannot be treated like bipolar disorder because additional psychological factors must be addressed.
Finding help for borderline personality disorder
Living with borderline personality disorder or being the family member of someone who has it can be stressful. When you're in the thick of it, finding help can seem unattainable, especially if you don't know where to start or how to find a therapist.
If you're looking for a therapist in your area, you can contact your primary care doctor, who will refer you to a mental health professional who's trained to help. When preparing for your appointment, write down your questions beforehand and make sure you have a list of your current medications on hand. You want to bring in as much information as you can. Don't be afraid to ask questions!
Also, it is more than OK to bring a spouse, friend or relative. You should feel empowered to do whatever you need to ensure you're comfortable and in the best position to get help. The prognosis with long-term talk therapy is good, but it improves the more willing you are to accept help.
Use the Substance Abuse and Mental Health Services Administration Behavioral Health, or SAMHSA, Treatment Services Locator to find the therapist in your area.
Self-care tips for borderline personality disorder
The fact is, borderline personality disorder isn't something you get rid of. But it doesn't have to rule your life and wreak havoc on your self-image and relationships. In addition to talk therapy and support from mental health professionals, there are things you can do on a daily basis to take care of yourself.
- Set realistic goals.
- When you have a big task, break it down into smaller, achievable steps.
- Make sure your family and friends know what situations or actions may trigger you. They may do things unintentionally, and setting expectations can help avoid those situations entirely.
- Allow yourself to seek out things that bring you comfort. That may be a place, people or a certain situation.
- Integrate exercise into your routine to help reduce stress.
Borderline personality disorder is a lifelong condition. You shouldn't expect your symptoms to go away or get better overnight. You'll see gradual improvements in your thoughts and actions with therapy and self-care.