Borderline Personality Disorder Diagnosis and Treatment
Learn about borderline personality disorder and its causes, symptoms, and treatments.
Table of Contents
Understanding Borderline Personality Disorder
When it comes to mental health, feeling good about yourself and your relationships with others is important. Unfortunately, sometimes that’s easier said than done. For individuals suffering from borderline personality disorder, sometimes referred to as BPD, this can be incredibly difficult. If you think you or a loved one may be suffering from borderline personality disorder, find out more about the diagnosis and treatment below.
Borderline personality disorder (BPD) isn’t to be confused with bipolar disorder, though the abbreviation is the same. Borderline personality disorder impacts the way that you think about yourself and others. This leads to problems with everyday life for those suffering from mental health conditions.1
Individuals suffering from borderline personality disorder may cause intense fear of abandonment, as well as instability. In reaction to these feelings, inappropriate responses may occur, like anger or pushing others away.
Borderline personality disorder (BPD) isn’t to be confused with bipolar disorder, though the abbreviation is the same. Borderline personality disorder impacts the way that you think about yourself and others. This leads to problems with everyday life for those suffering from mental health conditions.1
Individuals suffering from borderline personality disorder may cause intense fear of abandonment, as well as instability. In reaction to these feelings, inappropriate responses may occur, like anger or pushing others away.
How Common is BPD?
At this point, it’s estimated that nearly 1.4% of people in the United States suffer from borderline personality disorder.2 Of these diagnosed individuals, roughly 75% are women. However, it’s believed that men may be suffering from BPD more often than was thought and that they’ve been misdiagnosed with PTSD or a depressive disorder.
Causes and Symptoms
There isn’t a pinpointed cause for borderline personality disorder at this point. While there are some assumed causes, cases of borderline personality disorder are diagnosed based on the symptoms that people are experiencing.
Potential Causes
Some of the potential causes of borderline personality disorder may include any of the following:3
- Genetics: It’s thought that BPD runs in families. If others in your family have been diagnosed with borderline personality disorder, it’s more likely that you’ll develop the disorder as well.
- Environmental Factors: Individuals who have experienced abuse or trauma are more likely to develop BPD. This includes sexual, emotional, or physical abuse and neglect or mistreatment by parents.
- Brain Abnormalities: It has shown that people suffering from BPD have brain abnormalities that affect how the parts of the brain that regulate emotions communicate.
Signs and Symptoms
When a person is suffering from borderline personality disorder, certain symptoms must be met to qualify for a diagnosis. Of the signs and symptoms, these are the most commonly seen in individuals suffering from BPD:
- Unstable relationships due to the inability to regulate feelings towards others (i.e., idealizing a person one moment then accusing them of not caring the next)
- Impulsive, self-destructive behaviors such as gambling, reckless driving, unsafe sex, spending sprees, binge eating, drug abuse, sabotaging success, or ending positive relationships
- Chronic feelings of emptiness, loneliness, and depression
- Intense fears of abandonment and going to extreme measures to prevent that from happening
- Constantly shifting feelings regarding self-image causing changes in goals and values
- Stress-related paranoia that leads to losing contact with reality for periods up to hours
- Self-injury or suicidal thoughts/threats
- Mood swings that may last anywhere from a few hours to a few days, including happiness, depression, irritability, anxiety, or shame
How to Get Diagnosed with BPD
Because there is so much that still needs to be learned about borderline personality disorder, getting diagnosed can be difficult. For the most part, diagnosis requires multiple steps, including some or all of the following.
- A detailed interview with a mental health provider where relationships and symptoms are discussed in-depth.
- A psychological evaluation to help rule out any other disorders presenting as BPD.
- Going over medical history and an exam to rule out any physical issues causing BPD-like symptoms to occur.
- A discussion of your signs and symptoms with a mental health provider to ensure that it’s BPD that a person is suffering from.
Borderline Personality Disorder Treatments
Borderline personality disorder isn’t well understood, so the treatments for BPD are varied. Many different treatments are available, with some working better than others depending on the person being treated.
Psychotherapy
There are several different forms of psychotherapy available to individuals suffering from BPD. A list of some possible treatments and a brief explanation is below.
- Dialectical Behavior Therapy (DBT): Therapy that attempts to identify and change negative thinking patterns and pushes for positive behavioral changes.
- Schema-Focused Therapy: The identification of unhelpful patterns and help in understanding them/resolving them.
- Mentalization-Based Therapy (MBT): Analysis of mental states and the underlying causes of them.
- Systems Training for Emotional Predictability and Problem-Solving (STEPPS): A 20-week program that combines skills training and cognitive-behavioral therapy.
- Transference-Focused Psychotherapy (TFP): Twice weekly therapy sessions that help stress the importance of social interactions in changing maladaptive behavior.
- Good Psychiatric Management: A once-weekly form of therapy that focuses on social adaptation.4
BPD Medications
There are no specific medications for borderline personality disorder at this point. However, in some instances, the use of antidepressants and anti-anxiety medications in combination with therapy has proven helpful for patients.
Hospitalization
Should the symptoms of BPD become a danger for the person suffering from the disorder, inpatient hospitalization may be required. This is to help the person avoid self-harm or possibly harming others while getting them started on the psychotherapy they need to begin recovery.
Coping and Support
Living with BPD can be difficult. If you or a loved one is suffering from borderline personality disorder, check out the following tips to help the symptoms of this disorder:
- Calm the emotional storm: Meditating or practicing mindfulness can help you keep your emotions centered, reducing BPD symptoms.
- Learn to control impulsivity and tolerate distress: Engaging in less harmful behaviors can lead to better relationships overall, reducing the amount of stress you experience.
- Improve your interpersonal skills: Practicing social behaviors can help you strengthen your existing relationships and make new ones.
- Don’t make assumptions: Assumptions about your relationships with others are often intrusive thoughts that can damage them.
- Keep up a healthy lifestyle: Staying healthy and staying fit can keep you happier, reducing the causes and symptoms of BPD.
Resources
- https://www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/symptoms-causes/syc-20370237
- https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Borderline-Personality-Disorder
- https://my.clevelandclinic.org/health/diseases/9762-borderline-personality-disorder-bpd
- https://pubmed.ncbi.nlm.nih.gov/29547739/
