Borderline personality disorder (BPD) is a complex mental health disorder. As our knowledge of the human condition increases, our understanding of this condition and other personality disorders grows. With psychotherapy, people living with BPD can live productive lives.
When BPD was initially described, it was given the label ‘borderline’ because it was thought to be on the borderline between psychosis and other mental health issues. In the years since mental health experts believe the term ‘borderline’ does not adequately describe the condition. Though a more accurate term has yet to be widely accepted in the mental health community, some refer to the condition as unstable emotional personality disorder.
What’s the difference between BPD and bipolar disorder?
BPD is often confused with bipolar disorder. The two conditions share many similarities, but there are significant differences in how the disorders present in people and the treatment options.
Bipolar disorder is a depressive syndrome characterized by extreme episodes of mania preceded or followed by periods of depression. This can last for days or months. At times, symptoms of depression and mania co-occur. Bipolar disorder is treated with mood stabilizers and antipsychotic medication. While medication is sometimes used in the treatment of BPD, psychotherapy is considered the most efficient treatment method.
Also, people living with borderline personality disorder experience emotional instability almost daily, while those with bipolar disorder may have a consistent mood for long periods. It’s important to note that it is possible to experience borderline personality disorder in addition to bipolar disorder.
Signs and symptoms
You may receive a diagnosis of borderline personality disorder if you experience at least five of the following symptoms.
- You constantly worry about being abandoned and will go to any lengths to prevent it from happening.
- You find it hard to make and keep stable relationships. When you do connect to people, these relationships are intense but can end abruptly because of perceived anger or aggression.
- You have a distorted sense of self that is often changing.
- You have very intense emotions that can change quickly.
- You feel empty and alone a lot.
- You can’t control your anger.
- When you’re stressed, you may feel paranoid, imagine seeing or hearing things that others do not, or cannot remember things that have recently happened.
- You act impulsively and engage in hazardous activity like using drugs, having risky sex, or driving fast. You have suicidal thoughts or engage in self-harm.
People with borderline personality disorder do not exclusively feel many of these symptoms. It is important to meet with a mental health professional—a psychiatrist, psychologist, or clinical social worker—to discuss your symptoms and help guide your treatment.
The causes of borderline personality disorder are not entirely known. However, scientists agree that BPD stems from a combination of genetic and environmental factors. Research studies have shown that a person is five times more likely to have the disorder if a close family member, such as a parent or sibling, also has the disorder. Currently, investigators are studying genes that help regulate emotions and control of impulses to find possible links to BPD. Other factors that may cause BPD include:
- Social or culture. Being part of a community or culture in which unstable familial relationships are common may increase one’s risk of having borderline personality disorder.
- Brain abnormalities. Neurologic studies have shown that there are biological differences between the brains of people with and without BPD. The amygdala — the brain’s “fear-sensing” center — is more active in individuals with BPD, while the prefrontal cortex, which is associated with reasoning, may be less developed. Also, several hormones (such as oxytocin) and molecules in the brain (neurotransmitters such as serotonin) may play a role in BPD.
Scientists continue to study the biology of BPD. The results of their research could lead to new, more effective therapies for the disorder.
Suicide and BPD
Suicide is risk factor for people living with borderline personality disorder (BPD). If you or someone you know is exhibiting signs of suicide, please contact calling 911 for assistance in having individual evaluated for safety at a local hospital ER, contacting a mental health professional or call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for immediate assistance.
Signs to look out for include:
- Threatening to hurt or kill oneself or talking about wanting to hurt or kill oneself
- Looking for ways to kill oneself by seeking access to firearms, available pills, or other means
- Talking or writing about death, dying, or suicide when these actions are out of the ordinary for the person
- Feeling hopeless
- Feeling rage or uncontrolled anger or seeking revenge
- Acting reckless or engaging in risky activities—seemingly without thinking
- Feeling trapped - like there's no way out
- Increasing alcohol or drug use
- Withdrawing from friends, family, and society
- Feeling anxious, agitated, or unable to sleep or sleeping all the time
- Experiencing dramatic mood changes
- Seeing no reason for living or having no sense of purpose in life
Research has shown approximately 70 percent of people with borderline personality disorder will attempt suicide at least once in their lifetimes. About 10 percent complete the act. This suicide rate is higher than any other psychiatric disorder and the general population.