Borderline Personality Disorder
Borderline personality disorder is a mental health condition that affects the way people feel about themselves and others, making it hard to function in everyday life. It includes a pattern of unstable, intense relationships, as well as impulsiveness and an unhealthy way of seeing themselves. Impulsiveness involves having extreme emotions and acting or doing things without thinking about them first.
People with borderline personality disorder have a strong fear of abandonment or being left alone. Even though they want to have loving and lasting relationships, the fear of being abandoned often leads to mood swings and anger. It also leads to impulsiveness and self-injury that may push others away.
Borderline personality disorder usually begins by early adulthood. The condition is most serious in young adulthood. Mood swings, anger and impulsiveness often get better with age. But the main issues of self-image and fear of being abandoned, as well as relationship issues, go on.
If you have borderline personality disorder, know that many people with this condition get better with treatment. They can learn to live stabler, more-fulfilling lives.
Symptoms
Borderline personality disorder affects how you feel about yourself, relate to others and behave.
Symptoms may include:
A strong fear of abandonment. This includes going to extreme measures so you're not separated or rejected, even if these fears are made up.
A pattern of unstable, intense relationships, such as believing someone is perfect one moment and then suddenly believing the person doesn't care enough or is cruel.
Quick changes in how you see yourself. This includes shifting goals and values, as well as seeing yourself as bad or as if you don't exist.
Periods of stress-related paranoia and loss of contact with reality. These periods can last from a few minutes to a few hours.
Impulsive and risky behavior, such as gambling, dangerous driving, unsafe sex, spending sprees, binge eating, drug misuse, or sabotaging success by suddenly quitting a good job or ending a positive relationship.
Threats of suicide or self-injury, often in response to fears of separation or rejection.
Wide mood swings that last from a few hours to a few days. These mood swings can include periods of being very happy, irritable or anxious, or feeling shame.
Ongoing feelings of emptiness.
Inappropriate, strong anger, such as losing your temper often, being sarcastic or bitter, or physically fighting.
IF YOU HAVE THOUGHTS OF SUICIDE
If you have fantasies or mental images about hurting yourself, or you have thoughts about suicide, get help right away by taking one of these actions:
Call 911 or your local emergency number right away.
Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Services are free and confidential.
U.S. veterans or service members who are in crisis can call 988 and then press "1" for the Veterans Crisis Line. Or text 838255.
The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).
Call your mental health professional, doctor or another member of your healthcare team.
Reach out to a loved one, close friend, trusted peer or co-worker.
Contact someone from your faith community.
If you notice symptoms in a family member or friend, talk to that person about seeing a doctor or mental health professional. But you can't force someone to change. If the relationship causes you a lot of stress, you may find it helpful to see a therapist.
Treatment Options
With evidence-based treatment, many people with borderline personality disorder experience fewer and less severe symptoms, improved functioning, and better quality of life. It is important for people with borderline personality disorder to receive treatment from a licensed mental health professional.
It can take time for symptoms to improve after treatment begins. It is important for people with borderline personality disorder and their loved ones to be patient, stick with the treatment plan, and seek support during treatment.
Some people with borderline personality disorder may need intensive, often inpatient, care to manage severe symptoms, while others may be able to manage their symptoms with outpatient care.
Psychotherapy (sometimes called talk therapy) is the main treatment for people with borderline personality disorder. Most psychotherapy occurs with a licensed, trained mental health professional in one-on-one sessions or with other people in group settings. Group sessions can help people with borderline personality disorder learn how to interact with others and express themselves effectively.
Dialectical behavior therapy (DBT) was developed specifically for people with borderline personality disorder. DBT uses concepts of mindfulness or awareness of one’s present situation and emotional state. DBT also teaches skills to help people manage intense emotions, reduce self-destructive behaviors, and improve relationships.
Cognitive behavioral therapy (CBT) can help people with borderline personality disorder identify and change core beliefs and behaviors that come from inaccurate perceptions and problems interacting with others. CBT may help people reduce mood swings and anxiety symptoms and may reduce the number of self-harming or suicidal behaviors.
Medications
The benefits of mental health medications for borderline personality disorder are unclear and medications aren’t typically used as the main treatment for the illness. In some cases, a psychiatrist may recommend medications to treat specific symptoms or co-occurring mental disorders such as mood swings or depression. Treatment with medications may require coordinated care among several health care providers.
Medications can sometimes cause side effects in some people. Talk to your health care provider about what to expect from a particular medication. To find the latest information about medications, talk to a health care provider and visit the Food and Drug Administration website .
Therapy for caregivers and family members:
More research is needed to determine how well family therapy helps with borderline personality disorder. Studies on other mental disorders show that including family members can help support a person’s treatment. Families and caregivers also can benefit from therapy.
Family therapy helps by:
Allowing people to develop skills to understand and support a loved one with borderline personality disorder
Focusing on the needs of family members to help them understand the obstacles and strategies for caring for their loved one