Reviewed by Whitney White, MS CMHC, NCC., LPC
What Is Borderline Personality Disorder?
Borderline personality disorder (BPD) is a mental illness characterized by unstable moods, fickle self-image, and rocky relationships. Individuals with BPD often have an intense fear of abandonment that can throw a wrench into interpersonal relationships and cause paralyzing feelings of anxiety, dread, anger, paranoia, or depression. Emotional dysregulation in people with BPD can be just as debilitating as it can cause intense mood swings and difficulties with processing extreme emotions that can lead to impulsivity and emotional outbursts. These BPD symptoms will vary depending on the person, and no experience with BPD is universal. Still, these general signs of borderline personality disorder may tip you off to the fact that you or someone you know is living with BPD.
Though BPD is somewhat common as a mental health condition, it is still frequently misunderstood. BPD can be more than manageable when it is addressed with the proper treatment, which may include different forms of therapy and sometimes medication. It is important to seek guidance from licensed mental health professionals when seeking diagnosis, treatment options, and to seek guidance from a medical doctor about medication.
As with any mental health disorder, there is no singular cause of BPD as a whole. For most individuals, the onset of BPD is likely caused by a combination of factors.
Environmental factors are thought to be a large contributor to the onset of BPD. Early childhood experiences, especially ones involving caretakers or parents, seem to have the greatest connection. Stressful childhoods involving physical, sexual, or emotional abuse for a child by a caretaker can result in the development of behavioral or cognitive challenges that may result in BPD. However, BPD may not always come due to overt abuse or trauma -- persistent invalidation or neglect from caregivers in childhood can also cause BPD. Abandonment and instability in early childhood can create many difficulties that lend themselves to the development of problems like BPD.
It is also possible that genetics may play a role, though it’s not unlikely that this variable may be confounded due to environmental factors. Additionally, there is currently no evidence that there is a particular gene that causes or is linked to BPD.
BPD is most frequently diagnosed in adulthood -- though teens and children can certainly be diagnosed with the condition -- and its symptoms often reduce in severity over time as they get older.
Borderline personality disorder can sometimes result in other complications that may affect you in multiple life arenas in life, such as:
- Difficulties in the workplace, including job loss
- Difficulties in the realm of education
- Potential to be more likely to get into trouble due to impulsivity
- Conflicts in relationships, platonic and romantic alike
- The potential to enter into abusive relationships
These risks can, again, be mitigated with the proper treatment, however. Engaging in certain types of talk therapies can help you unravel unhealthy habits and distorted thought patterns that may contribute to or worsen these factors.
Symptoms of Borderline Personality Disorder
Though BPD can often be a frustrating disorder to deal with for individuals, it is more than manageable with the right diagnosis, treatment, and care. If you’ve found yourself wondering, “do I have BPD?” it may be helpful to go over a borderline personality disorder checklist:
- Persistent and recurring feelings of emptiness
- Mood swings and emotional instability
- Fear of abandonment and behaviors that display an effort to stave off abandonment
- Impulsivity and impulsive behaviors, such as reckless spending, risky sex, physically dangerous activities, substance use
- Feelings of hopelessness or worthlessness
- Paranoia, especially relating to relationships
- Dissociative episodes
- Intense and unstable relationships
- Black-and-white thinking (idealizing individuals or situations and then quickly demonizing them)
- Confused self-identity that may change quickly
- Intense anger that can be difficult to control
Conditions That May Be Confused With BPD
Unfortunately, treatment for BPD may be delayed by misdiagnosis. BPD is, in fact, one of the most commonly misdiagnosed mental health conditions in the world, probably because a larger cluster of traits contribute to BPD rather than one specific behavior. Additionally, many mental illnesses often have symptoms that seem the same as BPD from the outside but may have incredibly different nuances and causes. Some conditions that are commonly diagnosed in place of BPD include:
- Bipolar disorder
- Post-traumatic stress disorder (PTSD)
Furthermore, BPD may be comorbid (meaning co-occurring) with various other mental health issues, which can further confuse the picture. These can include:
- Bipolar disorder
- Post-traumatic stress disorder (PTSD)
- Substance use disorder
- Other personality disorders
- Eating disorders
- Anxiety disorders
- Sleep disorders
For this reason, it is very important that individuals who suspect they may be experiencing BPD seek out the opinion of a medical professional they trust. It may also be helpful to establish what other conditions you might be going through.
Identifying BPD in A Loved One
For many mental health conditions, it can be especially helpful to have a loved one who will help you to pinpoint some of your issues and challenges in day-to-day life, especially when seeking a diagnosis for the first time. We can all be blinded to our own cognitive distortions and emotional reactions. Someone to help to ground us, offer a rational opinion, and even urge us to pursue treatment may be critical.
When looking to see if you can identify BPD symptoms in a loved one, being very familiar with the signs listed above can make you much more able to recognize it. Additionally, having a knowledge of your loved one’s childhood or family history may help, though be wary -- a difficult childhood does not necessarily mean someone has BPD, and the reverse is also true.
Additionally, it is important to identify how you have felt since BPD is very much a mental health disorder that revolves around relationships and their importance. Do you often feel as though you are walking on eggshells? Do little things seem to set your partner off? Do they have intense emotional mood swings that you may have to tend to or mitigate? Do you feel that your relationship may be unusually intense for the length it has been going on? These are all important questions to keep in mind, as their answers may clue you into what BPD behaviors your partner may be exhibiting.
If you suspect your partner or loved one may have BPD, have an open conversation with them about it, but understand that the conversation may not necessarily go well. BPD can cause extreme feelings of sensitivity and aversion to criticism that may result in a large reaction from them. Avoid having the conversation in the middle of a fight or when your partner is not feeling particularly great. Remember to take care of yourself and try to understand that your partner’s reactions result from a great deal of experience, not necessarily a result of a vindictive streak or an active attempt to hurt you. While this is not an excuse for harmful behaviors, it is an explanation that can help you to set healthy boundaries that allow for both patience and can help to avoid negative stressors in your relationship.
In a relationship with someone with BPD, they may sometimes idolize you, then other times tear you down, or even blame you for self-harm to force you to stay. Regardless of any mental disorder happening behind the scenes, these are not healthy behaviors, and you are under no obligation to manage them. Sometimes the best thing you can do for yourself and for the other person is to get some distance. Online, these are support groups specifically for people in relationships or formerly in relationships with people with BPD. Seek out support for this very unique and sometimes damaging experience.
BPD is best treated with long term therapy, specifically various forms of psychotherapeutic treatments. The treatment that is best for you will depend on your symptoms, personality, and more. Working with a licensed mental health professional can help you determine what treatment approach may be best suited to you.
If you believe that you or a loved one may be experiencing BPD, consider taking our screening test to identify the symptoms and common behaviors. This test is not a diagnostic tool, but it can be a good starting point for having a conversation with a loved one, your medical or mental health provider about next steps.
BPD may often be misunderstood, but with education, awareness, support and treatment from licensed mental health professionals, can be successfully managed.