Borderline personality disorder is a mental illness characterized by an ongoing pattern of varying moods and an “all or nothing” (i.e. splitting) frame of mind. Someone suffering with this illness may find it very difficult to make decisions, as well as being unsure of their own self-image. It is very common for someone suffering from this disorder to experience abrupt mood swings that can last for hours or even days.

They may experience happiness for long periods of time, experience a triggering event, and then immediately be engulfed with anger or hostility at the drop of a hat.

These intense mood swings make it very difficult for people with this disorder to develop and maintain healthy relationships with other people. People with this disorder tend to view things in extremes, such as all good or all bad. Their opinions about other people can also change rapidly. An person who is seen as a friend one day may be viewed as an enemy or as a traitor the next day. These shifting feelings can lead to intense and unstable relationships [1].

Borderline personality disorder is distinctly different than bipolar disorder. People who are borderline experience mood swings that typically don’t last very long, while people who are bipolar may experience intense happiness (mania) for long periods of time and then intense sadness (depression) for long periods of time.



According to NAMI.org, It’s estimated that about 1.6% of the adult U.S. population has borderline personality disorder, but that number may be as high as 5.9%. Nearly 75% of people diagnosed with borderline personality disorder are women. Recent research suggests that men may be equally affected by borderline personality disorder, but are commonly misdiagnosed with PTSD or depression [2].

Causes of Borderline Personality Disorder

According to Psychology Today, researchers believe that this disorder results from a combination of individual vulnerability to environmental stress, neglect, or abuse as young children and a series of different events that trigger the onset of the illness as young adults. Adults with this disorder are also more likely to be the victims of violence, including rape and other crimes. These incidents may result from dangerous environments, as well as the victims’ impulsivity and poor judgment in choosing partners and lifestyles [3].

Symptoms of Borderline Personality Disorder

Intense bursts of anger, sadness, or shame are common symptoms for someone suffering from this personality disorder. Difficulty with decision making and keeping healthy relationships are also very common. Below, you’ll find some of the main symptoms of this mental illness [4]:

  • Intense mood swings
  • Low self-worth
  • Relationship problems
  • Impulsive behavior
  • Fear of abandonment
  • Hurting yourself

Diagnostic Criteria

According to the DSM-5 (2000) [5]:

A prevalent pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of different contexts, as indicated by five (or more) of the following:

  1. Frantic efforts to avoid real or imagined abandonment. (Do not include suicidal or self-mutilating behavior covered in Criterion 5).
  2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
  3. Identity disturbance: markedly and persistently unstable self image or sense of self
  4. Impulsivity in at least two areas that are potentially self-damaging (e.g., excessive spending, substances of abuse, sex, reckless driving, binge eating). (Do not include suicidal or self-mutilating behavior covered in Criterion 5).
  5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
  6. Affective instability due to a marked reactivity of mood (e.g. intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
  7. Chronic feelings of emptiness
  8. Inappropriate, intense anger or difficulty controlling anger (e.g. frequent displays of temper tantrums, constant anger and reoccurring fights).
  9. Transient, stress-related paranoid ideation or severe dissociative symptoms

The DSM-5 is subject to change as new research is conducted. So, the forgoing borderline personality disorder diagnostic criteria may change slightly in the future.


Treatments for Borderline Personality Disorder

Talk therapy is a very effective method for treating this disorder. Some of the different types of therapy used to treat this illness are: dialectical behavioral therapy (DBT), mentalization-based therapy (MBT), schema-focused therapy, and transference-focused psychotherapy (TFP), among others. One of the best ways to treat this disorder is with DBT.

According to Mayo Clinic, DBT can include group or individual therapy that is designed specifically to treat this disorder. DBT uses a skills-based approach to teach you how to manage your emotions, tolerate distress, and improve relationships [6]. Talk to your doctor or therapist to see what the best course of action is for you to help treat your symptoms.


References

1) “Borderline Personality Disorder.” National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml
2) “Borderline Personality Disorder.” NAMI. https://www.nami.org/Learn-More/Mental-Health-Conditions/Borderline-Personality-Disorder
3) “Borderline Personality Disorder.” Psychology Today. https://www.psychologytoday.com/conditions/borderline-personality-disorder
4) “Borderline Personality Disorder – Topic Overview.” Web MD. https://www.webmd.com/mental-health/tc/borderline-personality-disorder-topic-overview#1
5) “DSM-5 and How it Affects the Diagnosis of BPD.” Optimum Performance Institute. https://www.optimumperformanceinstitute.com/bpd-treatment/dsm-5-and-how-it-affects-the-diagnosis-of-bpd/
6) “Borderline Personality Disorder.” Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/diagnosis-treatment/drc-20370242