Borderline Personality Disorder (BPD) is a severe emotional disorder that affects nearly 6 million Americans. People with BPD suffer from many consequences, including frequent mood swings, impulsivity, repeated self-harm attempts, severe negative emotions (such as anger and shame), a distorted self-image, chaotic relationships, and an extreme fear of abandonment.
Borderline Personality Disorder Symptoms: In Brief
Borderline Personality Disorder (BPD) causes severe emotional pain and emotional instability. The symptoms of BPD include:
- Frequently fearing being abandoned by loved ones accompanied by frantic efforts to avoid real or imagined abandonment.
- A pattern of unstable and intense interpersonal relationships, including frequent arguments, conflicts, breakups and feelings of disappointment and even hatred toward loved ones.
- Significant and persistent identity disturbance, including an unstable self-image and feeling unsure about who you are and what you believe in.
- Exhibiting impulsive behaviors that are potentially self-damaging in at least two areas (e.g., sex, substance abuse, reckless driving, binge eating, self injury, spending, etc.).
- Recurrent suicidal behavior, threats or self-mutilating behavior.
- Frequent and intense mood changes, such as feeling okay one minute and feeling sad, irritated or angry the next, that typically last between a few minutes and a few hours.
- Chronic and long-term feelings of emptiness or feeling emotionally dead.
- Inappropriate and intense anger or difficulty controlling anger.
- Stress-induced paranoid thoughts, such as feeling like you’re being picked on, feeling “zoned out” or numb, or feeling like people or things aren’t real.
Borderline Personality Disorder Symptoms: In Focus
- Frequently fearing being abandoned by loved ones accompanied by frantic efforts to avoid real or imagined abandonment.
What does this look like in practice? Someone with BPD might take an offhand remark about something and blow it out of proportion, taking it as a sign that they are being abandoned. For example, a partner might read about a job in another country and remark about how cool it sounds. The person with BPD might take this as a concrete sign that their partner wants out of the relationship and is about to leave them for good, and even leave the country.
How far does someone with BPD go to avoid abandonment? Everything depends on the individual, but it would not be unusual to see someone with BPD crying and clinging to their partner or friend as that person simply tried to leave for work. If the person was trying to go on a trip, the behavior could be even more dramatic—and if there had been a fight or some other conflict, the BPD sufferer may feel even more desperate.
- A pattern of unstable and intense interpersonal relationships, including frequent arguments, conflicts, breakups and feelings of disappointment and even hatred toward loved ones.
A person with BPD is likely to have a series of “love at first sight” incidents in their life. This is because they form intense attachments with people right away over perceived similarities and shared ideas. However, the superficiality of these kinds of bonds often leads to problems, and when turbulence comes, every little bump feels like a major hurdle to someone with BPD. The end result is virulent conflicts, and a pattern of making similar mistakes again and again, seemingly without achieving insight into any patterns.
This problem isn’t just concerning love or romantic relationships and people with BPD. It can impact family relationships, friendships, and even relationships at work or school. The common thread is intense attachments, a lack of stability, and inappropriate reactions to problems that snowball into conflicts.
- Significant and persistent identity disturbance, including an unstable self-image and feeling unsure about who you are and what you believe in.
Superficially it might appear that someone with BPD always thinks they are right, and can’t hear anyone else’s opinion, but this isn’t really what’s going on. One of the core problems for people with BPD is that they lack stability in their own identities, including their own core values. This kind of transient self-image leads them to feel unsure about themselves—and therefore, everything else, including people around them and their relationships.
They can’t help but approach the world from their own perspective—as we all do. So for someone with BPD, they can never feel sure of themselves. Their ideas change like the wind, and in dramatic, oppositional ways. This colors their ideas about other people because they feel that if they might go from loving someone to hating them in the blink of an eye, that might be true of anyone else, too, including the people who say that they love them. This is how having an unstable sense of self-eats away at one’s sense of everyone and everything else.
- Exhibiting impulsive behaviors that are potentially self-damaging in at least two areas (e.g., sex, substance abuse, reckless driving, binge eating, self injury, spending, etc.).
Impulsive, self-damaging behaviors can take on many guises. Impulsive unsafe sex is a common theme among people with BPD, and is sometimes accompanied by irrational feelings of being bonded as a result of the sexual activity. Spending sprees that are way out of control and far beyond any reasonable budget are also common among BPD sufferers. Unfortunately, these behaviors—unsafe, impulsive sex and wild spending—are also seen in others, such as people with bipolar disorder who are experiencing mania. For this reason, it’s not always crystal clear which kind of issues a person is grappling with.
Substance abuse and addiction are frequently a tremendous problem for people with BPD, both due to lack of impulse control, and the need to dull the sensation of intense, back and forth emotions. Self-injury is also a common theme among BPD sufferers and might take the form of cutting, both superficial and substantial, scratching until blood is drawn, punching or hitting oneself, hitting one’s head against the wall, etc. Binge eating is another form of BPD’s characteristic lack of control, as is reckless driving.
Look for a) out of control behavior, that b) tends to be risky or dangerous.
- Recurrent suicidal behavior, threats or self-mutilating behavior.
A step beyond self-harm, self-mutilating behaviors cause serious injury, and suicidal threats or behaviors can potentially end in death. Although it may be tempting to dismiss this kind of behavior as attention-seeking and disingenuous—especially if you’ve felt manipulated by the emotional outbursts of someone with BPD before—remember that suicidal threats and behaviors are always an emergency.
- Frequent and intense mood changes, such as feeling okay one minute and feeling sad, irritated or angry the next, that typically last between a few minutes and a few hours.
When we think of “mood swings,” most of us think of bipolar disorder first. However, although some people with bipolar disorder do have “rapid cycles” that allow them to have very quick mood swings, it’s actually BPD that is characterized by intense, frequent, rapid changes in mood. If someone you know is euphoric one minute and absolutely devastated the next, and that’s a normal kind of shift for them, it’s much more likely to be BPD than bipolar disorder.
Someone with BPD has mood swings that are so intense, they interfere with work, school, relationships, and life in general. They can go from 0 to 100 in minutes, and they may not know why, really. They may act on their feelings, whether they’re paranoid, depressed, elated, or otherwise—which is why they’re likely to act impulsively and in ways that are destructive. Finally, they are not able to make themselves feel better.
- Chronic and long-term feelings of emptiness or feeling emotionally dead.
Everyone feels sadness or loneliness sometimes. However, for people with BPD, a feeling of being empty, or altogether dead from an emotional standpoint, is chronic. They just can’t shake the sensation of emptiness, which can make them feel disconnected from reality at times. This is a void they may try to fill with relationships or impulsive behaviors, but it doesn’t go away.
- Inappropriate and intense anger or difficulty controlling anger.
Just as someone with BPD might take a chance meeting as a kismet-fueled encounter with a soulmate, they might also take the slightest unkindness or even failure to notice them as an act of war. They are likely to lose their temper over very small annoyances, especially when they are related to their relationships. Their friend may not have meant anything by sitting across from them rather than next to them, for example, but someone with BPD won’t see it that way—and can erupt into a screaming mess right there at the table.
- Stress-induced paranoid thoughts, such as feeling like you’re being picked on, feeling “zoned out” or numb, or feeling like people or things aren’t real.
It’s very, very difficult to live feeling like everyone is against you, or like no one in your life sticks around, and that’s how it feels to someone with BPD. Even if people tell you again and again that they love and care about you, it just doesn’t feel real to you. All of this stress can lead to paranoid thoughts and worries, and feeling like everyone is against you.
When this gets taken to the next level, it means dissociating with reality. The person might feel overloaded and numb. Nothing in life seems real anymore, including their closest friends and loved ones.
Causes of Borderline Personality Disorder
Nobody knows for sure what causes borderline personality disorder, but there are some theories. Most researchers and professionals believe that BPD is caused by a variety of factors that work together to increase a person’s risk for developing BPD. These factors include:
- Biological and genetic factors, such as gene and brain structure variations are sometimes present in patients with BPD. There are also studies that suggest BPD tends to run in families.
- Social factors, such as how the person interacted in their early development with their family, friends and other children.
- Psychological factors, such as the individual’s personality and temperament, which is shaped by their environment and how they learned to cope with stress.
- Environmental factors, such as distressing childhood experiences that typically involve caregivers. Physical and sexual abuse, neglect, emotional abuse and early separation from caregivers are common experiences amongst people with BPD.
Borderline Personality Disorder Treatment
The signs of Borderline Personality Disorder are hard to diagnose because it’s composed of many different elements. BPD can co-occur with depression, anxiety disorders, post-traumatic stress disorder, bipolar disorder, and other disorders that may hide or hinder a true BPD diagnosis. People with BPD may also try to cope with the symptoms by abusing drugs or alcohol, which can also hinder or hide a true BPD diagnosis.
Treatment of BPD typically involves long-term psychotherapy (“talk” therapy) with a therapist who is experienced at treating this kind of disorder. Dialectal behavior therapy is often the most effective form of psychotherapy treatment for patients with BPD. Sometimes medications such as antidepressants and mood stabilizers may also be prescribed to help with very specific and debilitating symptoms, such as depression and anxiety.
There are so many stigmas and shame attached to mental illness that people often don’t want to come forward with their symptoms and seek help. If you think that you suffer from BPD or know someone who may be, it’s important to seek help and support right away, especially if substance abuse is present. The symptoms of BPD are dangerous enough without the added stress and health risk of alcohol or drug abuse.
In addition to psychotherapy and pharmaceutical medications, some people have successfully eased their borderline personality disorder symptoms with holistic treatments, such as yoga, meditation and herbal/natural supplements.
About the author
