• Borderline Personality Disorder



    Borderline personality disorder (BPD) is a mental health disorder. People with BPD may often have dramatic, emotional, erratic, and attention-seeking moods. This behavior disrupts family and work life, long-term planning, and the individual’s sense of self.


    The causes of BPD are not fully understood. It is thought to be a combination of brain chemistry, genetics, and environmental factors. People who develop BPD are probably born vulnerable to the illness. Certain experiences and types of stress may then further increase their chance of developing BPD. Many BPD sufferers are often found to have experienced childhood abuse, neglect, separation, sexual abuse, violence, or brain injury.
    Central Nervous System - Brain
    Brain face skull
    BPD is thought to develop from a combination of chemical imbalances in the brain and traumatic life experiences.
    Copyright © Nucleus Medical Media, Inc.

    Risk Factors

    BPD is more common in females. The following factors increase your chances of developing BPD:
    • A history of abuse, neglect, or abandonment as a child
    • A history of sexual abuse or violence
    • Inborn sensitivity to stress
    • Immediate family members with BPD


    The symptoms of BPD vary. People with BPD tend to be extremely sensitive to rejection. They may react with anger and be upset at even mild separation from friends or family. Symptoms often become more acute when people with BPD feel isolated and lonely or during times of particular stress.
    Traits that are common to people with BPD include:
    • Fears of being left alone—resulting in frantic behaviors to avoid being left alone
    • Extreme and unpredictable mood swings and difficulty managing emotions or regulating moods
    • Difficulty in relationships—characterized by dramatic swings or viewing people as all good or all bad
    • Unstable self-image
    • Impulsive behavior
      • Excessive spending
      • Promiscuity, risky sexual behavior
      • Gambling
      • Substance abuse
      • Binge eating
    • Repetitively injuring themselves through cutting, scratching, or burning
    • Feeling misunderstood, bored, and empty
    • Having deep-seated feelings of being flawed or bad in some way
    • Using defense mechanisms to avoid taking responsibility for behavior, or to blame others
    • Problems with anger management, manifested as periods of intense, uncontrollable and often unreasonable anger
    • Episodes of intense paranoia, dissociation, or thought patterns bordering on psychosis—often provoked by stress


    You will be asked about your symptoms and medical history. A physical exam will be done. If BPD is suspected, you may be referred to a psychiatrist who specializes in personality disorders.
    BPD can affect anyone. It is usually diagnosed in adolescents and young adults. A diagnosis of BPD may be made if a person has a history of the symptoms listed above. In addition, BPD patients almost always have other mental health problems such as:
    • Depression
    • Substance abuse
    • Eating disorders
    • Anxiety disorders
    • Bipolar disorder
    • Compulsive spending, gambling, or risky sexual behavior


    Treatment options have improved as BPD is better understood. Many BPD sufferers are helped by psychotherapy and medications.
    Talk with your doctor about the best treatment plan for you. Treatment options include the following:


    Individual, group, and family therapy form the basis of BPD treatment. Individual psychotherapy usually consists of 2-3 sessions a week for a period of years. Group therapy may focus on the same goals but take place in a group of fellow participants. The goal of therapy is to help the person with BPD:
    • Understand their behavior
    • Improve their ability to tolerate frustration, anxiety, loneliness, and anger
    • Control impulsive behavior
    • Improve social skills
    Family therapy may help family members deal with the effects of BPD. It can also provide additional support for the person with BPD.

    Cognitive Behavioral Therapy

    Cognitive therapy helps you to change patterns of thinking that are unproductive and harmful. For example, some people have unrealistic worries that they’re going crazy or might have a heart attack. Cognitive therapy also helps you identify possible triggers for panic attacks, such as a thought, a situation, or even something that could cause an increase in your heart rate. When you understand the difference between an actual panic attack and a trigger, you have more control over the trigger.


    Medication may be prescribed and adjusted based on your symptoms. Medication options may include:
    • Antidepressant drugs
    • Mood stabilizers
    • Antipsychotic drugs—may be used in low doses to control distorted thinking or anxiety


    There are no current guidelines to prevent BPD.


    Borderline Personality Resource Center—NewYork-Presbyterian, Weill Cornell Medical Center http://www.bpdresourcecenter.org

    National Mental Health Association http://www.nmha.org


    Borderline Personality Disorder http://www.borderlinepersonality.ca

    Canadian Psychological Association http://cpa.ca


    Borderline personality disorder. National Mental Health Association website. Available at: http://www.nmha.org/conditions/borderline-personality-disorder. Accessed November 11, 2014.

    What is borderline personality disorder?. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml. Accessed November 11, 2014.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.