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Borderline personality disorder

Borderline personality disorder

Borderline personality disorder is a type of personality disorder that affects your thoughts, feelings and how you interact with others. Learn about the symptoms and causes and what treatment can help.

What is borderline personality disorder?

Borderline personality disorder (BPD) is also known as emotionally unstable personality disorder (EUPD).

It’s a type of personality disorder that affects how you interact with others and means that your thoughts, feelings and behaviour are different from what’s considered normal. It can have a huge impact on your relationships as well as how you feel about yourself.

Borderline personality disorder symptoms

BPD symptoms can be wide-ranging and different for each person. Your emotions, perceptions, behaviour and relationships can all be affected, including:

Difficulty controlling your emotions – it’s common to feel negative emotions like rage, emptiness and panic and have intense mood swings that can quickly switch between despair and feeling ok.

Upsetting thoughts – this can include thinking you’re a terrible person and needing lots of reassurance.

Abnormal experiences – some people may have psychotic episodes where they hear voices or hallucinate (seeing things that aren’t there). This is a sign that you need to get medical help if you haven’t already.

Impulsive behaviour – you may feel the need to self-harm or have suicidal thoughts – this is another important sign to get help. For some people, this drives them to reckless behaviour like taking drugs, spending sprees or having unprotected sex.

BPD and relationships

Difficulties in relationships are very common. If you have BPD, you might find it hard to make and keep a stable relationship.

You might feel anxious and needy, making dramatic gestures to feel reassured, like constantly texting someone or making threats about what you’ll do if they leave you. You may also feel smothered or controlled by others, making you reject or withdraw from them emotionally.

It’s quite common for these two states to lead to an ongoing cycle where you push people away and beg them to stay.

What causes BPD?

BPD affects people of all ages and genders, although more women are diagnosed with the disorder than men.

The exact cause of BPD is unclear, but experts believe that different factors can increase your risk of developing the condition like:

Brain chemicals – an imbalance in neurotransmitters (chemicals that control the brain’s functions) – particularly serotonin – is thought to be linked to the condition. Brain development – research found that many people with BPD have a part of the brain that is either smaller than expected or has unusual activity levels. Childhood trauma– disturbing events, sexual or physical abuse and neglect in childhood are commonly linked to people with BPD, Genetics – having a family member with a serious mental health condition is linked to BPD - but more research is needed to understand more about BPD and genetics.

How is BPD diagnosed?

The first step is to talk to your doctor about the symptoms you’ve been experiencing. They will do an initial assessment to see if other mental health issues, like depression, could be the cause.

You’re usually referred to a community mental health team (CMHT) if your doctor thinks you could have BPD, where a psychologist or psychiatrist will be able to assess you.

Diagnosis is made if you answer yes to five or more questions relating to:

  • How you feel about being on your own
  • The patterns your relationships tend to follow
  • Your self-image
  • Your feelings and emotions
  • How you cope in stressful situations

Treatment for BPD

If you’re diagnosed with BPD it’s a good idea to tell your family and trusted friends. This is because many symptoms of BPD affect relationships and treatment can be more effective if they’re involved.

BPD treatment usually involves talking therapy to help you gain better control over your thoughts and feelings. These may include:

Dialectical behaviour therapy (DBT) – designed especially for people with BPD, this aims to help you accept and validate your emotions and open up to new ideas and opinions. Mentalisation-based therapy (MBT) – treatment that encourages you to take a step back and examine your thoughts and beliefs before acting. Cognitive behavioural therapy (CBT) – helps you understand how your thoughts affect your behaviour and teaches you coping strategies for different situations. Other talking therapies – including therapeutic communities, where you work with other people who have mental health problems to support each other and recover as a group. Other effective treatments include art therapy and Cognitive Analytic Therapy (CAT).

Medication isn’t usually recommended to treat BPD, although it may be used to treat associated mental health conditions, like depression, anxiety or bipolar disorder.

Reviewed by:

Dr Rhianna McClymont

Lead GP at Livi

Last updated: