Key Takeaways Key Takeaways

  • Borderline Personality Disorder (BPD) got its name due to its complex and variable nature, straddling the border between neurosis and psychosis.

  • BPD is characterized by unstable relationships, self-identity issues, impulsivity, and intense mood swings, setting it apart from other personality disorders.

  • BPD is relatively rare, affecting 1.4% of the U.S. adult population, with a higher prevalence among individuals assigned female at birth (AFAB).

What People With Borderline Personality Disorder Wish You Knew

This content has been updated from previous article on December 20, 2020.

Borderline Personality Disorder (BPD) earned its name due to its historical position on the “borderline” between neurosis and psychosis, reflecting its complex and variable nature. This terminology originated in the mid-20th century when clinicians noticed patients displaying symptoms that didn’t neatly fit into established diagnostic categories.

BPD belongs to the family of Personality Disorders, a group characterized by enduring and maladaptive behavior patterns. However, what sets BPD apart is its hallmark traits: unstable relationships, self-identity disturbances, impulsive actions, and intense mood swings. While sharing some features with other personality disorders, BPD has its unique profile and challenges, making it important for clinicians to distinguish it for accurate diagnosis and treatment.

It’s estimated that 1.4% of the adult U.S. population has BPD, making it a relatively rare condition, and nearly 75% of people diagnosed with BPD are people assigned female at birth (AFAB).

BPD looks unique in each person, and the full list of symptoms is lengthy. However, all borderline personality disorder symptoms can be grouped into nine types of symptoms.

The nine symptoms of borderline personality disorder are:

  • Paranoid or suspicious thoughts
  • Unstable relationships with romantic partners, friends, and family
  • Unhealthy anger patterns
  • Fear of abandonment, which are usually unfounded
  • Feeling like there’s a void inside
  • Extreme mood swings
  • Self-harming behaviors
  • Impulsivity, typically with self-destructive behaviors
  • An unclear sense of self

As you can imagine, living with these symptoms can be difficult, especially without treatment. Living with BPD is made harder when people stigmatize the disorder or harshly judge the person who lives with it. Not only can harsh judgment isolate someone with BPD, but it can even make their symptoms worse.

Whether you love someone with borderline or you simply want to be more informed about mental health, there are a few things people with borderline personality disorder want you to know.

BPD is Not The Same As Bipolar Disorder

People often confuse Borderline and Bipolar Disorder. Not only could they both be abbreviated to “BPD,” but they can also both cause significant shifts in mood. However, Bipolar Disorder is a Mood Disorder that causes manic and depressive episodes. Borderline Personality Disorder, on the other hand, is in a different classification of disorders.

Bipolar Disorder features manic and depressive episodes, with prolonged mood swings. Borderline Personality Disorder, on the other hand, exhibits rapid mood shifts triggered by interpersonal stressors. Impulsivity is more pronounced in BPD, leading to reckless behaviors, self-harm, and unstable relationships. BPD individuals grapple with unstable self-identity, paranoid thinking, and abandonment fears, while Bipolar individuals typically do not.

Some people with Borderline also live with Bipolar Disorder, and it can make diagnosis and treatment more complex. It’s essential for mental health professionals to conduct a thorough assessment to accurately identify and address both conditions.

Borderline is Not a Choice, Neither Are The Symptoms

Like all mental illnesses, nobody chooses to live with Borderline Personality Disorder. People may assume that the intense mood swings, impulsivity, and relationship difficulties seen in BPD are simply behaviors rather than symptoms of a genuine mental health condition. However, this couldn’t be further from the truth. Just like nobody would choose to be depressed, nobody chooses to have emotions that are so difficult to regulate. Such misconceptions can contribute to the harmful stigma that surrounds BPD and prevent individuals from seeking the necessary help and support. It’s essential to promote understanding and compassion to combat these misconceptions and provide proper assistance to those living with BPD.

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It’s Like Having an Exposed Nerve, But For Emotions

Imagine having third-degree burns on much of your body or having exposed nerves that send pain signals with the lightest breeze. BPD is like that, but for the emotional self. That’s why it can seem like someone with Borderline Personality Disorder has extreme emotional reactions to relatively small triggers. Emotions, whether positive or negative, are felt intensely and swiftly, often overwhelming the individual. Just as a touch can be excruciating to exposed nerves, everyday stressors or interpersonal interactions can trigger extreme emotional reactions in those with BPD.

People With BPD Aren’t “Just Being Dramatic”

When people with borderline personality disorder have extreme emotions, those around them often write it off as someone being “dramatic.” While it may seem that way on the outside, the pain that the person feels is real. While the trigger may seem small to you, the pain is big. People with BPD are reacting to the pain they feel.

Treatment Can Work for Borderline Personality Disorder

It’s a common misconception that individuals with Borderline Personality Disorder (BPD) will never be able to regulate their emotions. This belief is not only untrue but also unhelpful, as it undermines the potential for recovery and improvement for those with BPD.

One of the most well-established treatments for BPD is Dialectical Behavior Therapy (DBT). DBT focuses on teaching individuals specific skills to manage their emotions, improve relationships, and cope with distress in healthier ways. It has been shown to be highly effective in reducing self-destructive behaviors and improving emotional regulation among those with BPD.

Other therapeutic approaches, such as Schema Therapy and Cognitive-Behavioral Therapy (CBT), can also be beneficial for individuals with BPD, addressing specific emotional and relational challenges they face.

Medications, while not a primary treatment for BPD, may be prescribed to manage certain symptoms such as Depression, Anxiety, or mood swings that often co-occur with BPD.

Furthermore, early intervention and consistent, compassionate support from mental health professionals, family, and friends can significantly contribute to individuals with BPD learning to regulate their emotions and achieve stability in their lives.

Authored By 

LifeStance Health

LifeStance is a mental healthcare company focused on providing evidence-based, medically driven treatment services for children, adolescents, and adults.

Reviewed By

Nicholette Leanza, LPCC-S

Nicholette is a faculty member at John Carroll University’s Clinical Counseling program, and she is also the host of the LifeStance podcast, Convos from the Couch.