By We Level Up WA | Editor Yamilla Francese | Clinically Reviewed By Lauren Barry, LMFT, MCAP, QS, Director of Quality Assurance | Editorial Policy | Research Policy | Last Updated: May 22, 2023
What is Borderline Personality Disorder?
Borderline Personality Disorder (BPD) is a mental health disorder characterized by intense emotional instability, impulsive behaviors, and difficulties in interpersonal relationships. Individuals with BPD often experience extreme mood swings, have a fragile sense of self, and struggle with regulating their emotions. They may exhibit impulsive behaviors such as self-harm, substance abuse, reckless driving, or excessive spending.
Relationships with others may be tumultuous, marked by fear of abandonment, idealization, and devaluation. BPD can cause significant distress and impairment in various areas of life, including work, relationships, and overall well-being. It is a complex disorder that often requires comprehensive treatment approaches to manage symptoms and promote recovery.
Different Borderline Personality Disorder Treatments
Several different treatment approaches are available for Borderline Personality Disorder (BPD). These approaches aim to alleviate symptoms, improve emotional regulation, and enhance overall functioning. Here are some of the commonly used treatments:
- Dialectical Behavior Therapy (DBT): DBT is one of the most widely recognized and researched treatments for BPD. It combines individual therapy, group skills training, phone coaching, and therapist consultation to help individuals develop skills in emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness.
- Schema Therapy: Schema therapy focuses on identifying and modifying deeply ingrained patterns or schemas that contribute to BPD symptoms. It helps individuals explore and challenge maladaptive beliefs about themselves and others while fostering healthier coping strategies and improving interpersonal relationships.
- Mentalization-Based Treatment (MBT): MBT focuses on enhancing the individual’s ability to understand their own thoughts, emotions, and motivations, as well as those of others. It aims to improve mentalizing abilities essential for managing relationships and regulating emotions effectively.
- Transference-Focused Psychotherapy (TFP): TFP emphasizes the exploration of the individual’s feelings and thoughts within the therapeutic relationship. The focus is on understanding and resolving relationship conflicts to improve overall functioning and reduce BPD symptoms.
- Cognitive-Behavioral Therapy (CBT): CBT for BPD helps individuals identify and challenge negative thoughts and behaviors, develop healthier coping strategies, and improve problem-solving skills. It often includes elements of emotion regulation and interpersonal skills training.
- Medication: While medication does not directly treat BPD, it can help manage associated symptoms such as depression, anxiety, or impulsivity. Antidepressants, mood stabilizers, and antipsychotic medications may sometimes be prescribed, but they are typically used with therapy.
It’s important to note that treatment for BPD is often most effective when it combines multiple approaches and is tailored to the individual’s specific needs. A comprehensive treatment plan may involve a combination of therapy, medication, and support from a multidisciplinary team to address the various aspects of BPD symptoms and promote long-term recovery.
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Borderline Personality Disorder Facts
Individual talk therapy may successfully treat BPD. In addition, group therapy and books about borderline personality disorder can sometimes be helpful. Medications have less of a role in the treatment of BPD. However, they can occasionally treat depression, other diseases that may coexist with this condition, and mood swings.
BPD was originally believed to be incurable. However, this isn’t the case because we know that BPD can be effectively treated. Therapy helps many BPD patients who are distressed to feel better.
Dialectical Behavioral Therapy
Psychologist Marsha Linehan developed dialectical behavioral therapy (DBT). This treatment teaches you to deal with challenging and overwhelming emotions. The most popular method of treating BPD is DBT. Each skill set aids in the reduction of BPD symptoms.
Dialectical behavioral therapy imparts four key skill sets to its patients:
- Interpersonal effectiveness.
- Emotional regulation.
- Distress tolerance.
Mentalization-based therapy helps you develop an awareness of your inner state. In mentalization-based treatment, fostering empathy for other people’s experiences is a key goal.
According to research published in 2018, this therapy may dramatically lessen the severity of BPD symptoms and co-existing diseases while enhancing the quality of life. However, the authors point out that additional study is still required.
No single medication is effective for BPD, but medications may relieve some symptoms.
As an illustration, medicines may support mood stabilization. Discuss your symptoms with a doctor if you believe medication could help you.
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Borderline Personality Disorder Statistics
The most effective way to treat BPD is through an interprofessional team composed of psychiatrists, psychologists, pharmacists, mental health nurses, and social workers. According to recent studies, 1.6% of people in the United States have BPD. It might seem like a modest percentage, but considering how big the United States is, you may realize that 1.6% represents a sizable portion of the population. One of the hardest mental health diseases to treat is borderline personality disorder.
According to estimates, BPD affects 1.4% of adult Americans.
Women make up about 75% of those with BPD diagnoses.
According to surveys, borderline personality disorder affects 20% of patients in inpatient psychiatric facilities.
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Borderline Personality Disorder Symptoms
Borderline Personality Disorder (BPD) is characterized by a wide range of symptoms that significantly impact an individual’s emotional well-being, interpersonal relationships, and overall functioning. Here are some common symptoms of Borderline Personality Disorder:
- Emotional instability: People with BPD often experience intense and rapidly shifting emotions. They may have difficulty regulating their emotions, leading to frequent and intense mood swings, such as feeling intensely happy one moment and then becoming extremely angry or depressed shortly after.
- Fear of abandonment: Individuals with BPD often intensely fear being abandoned or rejected by others. This fear can lead to frantic efforts to avoid real or imagined abandonment, such as clinging to relationships or exhibiting impulsive behaviors.
- Unstable self-image: BPD can cause individuals to have an unstable sense of self, leading to feelings of emptiness, identity confusion, and a lack of clear goals or values. They may struggle with self-worth and tend to define themselves based on the opinions of others.
- Impulsive behaviors: People with BPD may engage in impulsive behaviors, such as substance abuse, reckless driving, binge eating, or self-harming behaviors like cutting or suicidal gestures. These behaviors are often used to cope with intense emotions or gain a sense of control.
- Unstable and intense relationships: Individuals with BPD often have difficulties maintaining stable and healthy relationships. They may tend to idealize others initially, only to devalue later and push them away. This pattern of intense, stormy relationships can cause significant distress and disruption in their lives.
- Chronic feelings of emptiness: People with BPD may experience a persistent sense of emptiness or feel disconnected from themselves and others. This can contribute to feelings of loneliness, boredom, and a search for external sources of validation or fulfillment.
- Self-destructive behaviors: BPD is associated with self-destructive behaviors, including self-harm, suicidal thoughts, or suicide attempts. These behaviors often result from intense emotional pain and ineffective coping mechanisms.
It’s important to remember that everyone with BPD may experience these symptoms to varying degrees, and each individual’s experience is unique. If you or someone you know is experiencing these symptoms, seeking professional help for an accurate diagnosis and appropriate treatment is crucial.
Splitting in Borderline Personality Disorder (BPD) is a cognitive and emotional pattern characterized by the tendency to perceive people, situations, or oneself in extremes—good or all bad—with little room for middle ground or nuance. It involves a polarized and dichotomous thinking style, where individuals with BPD struggle to see the complexity or shades of gray in relationships or circumstances.
When splitting, individuals may idealize someone, viewing them as perfect, flawless, or the source of all happiness and validation. This idealization can quickly shift to devaluation, where the same person is perceived as entirely negative, flawed, or the cause of all problems and distress. The shift can occur abruptly without reason, leading to volatile and unstable relationships.
Splitting can lead to intense emotional reactions, impulsive behaviors, and difficulty maintaining stable and healthy connections with others. It often arises from a fear of abandonment, a fragile sense of self, and difficulties integrating conflicting emotions or experiences. The oscillation between extremes can contribute to the interpersonal challenges and emotional instability associated with BPD.
Treatment approaches such as dialectical behavior therapy (DBT), and schema therapy can help individuals with BPD recognize and address splitting tendencies. By increasing awareness of this cognitive distortion and learning skills to regulate emotions and tolerate ambiguity, individuals can work towards a more balanced and integrated perception of themselves and others.
What is Quiet BPD?
Quiet BPD, also known as “quiet borderline” or “emotionally unstable personality disorder, quiet type,” is a term used to describe a subtype of Borderline Personality Disorder (BPD) where individuals may exhibit fewer external or overt signs of the disorder. While the core symptoms of BPD are still present, they may be expressed in more subtle or internalized ways compared to the typical presentation of BPD.
Individuals with quiet BPD often experience intense emotions, fear of abandonment, unstable self-image, and difficulties with interpersonal relationships, similar to those with other forms of BPD. However, they may be more inwardly directed in their emotional turmoil and less likely to express their distress through outwardly visible behaviors, such as self-harm or explosive anger.
Quiet BPD can manifest as intense feelings of emptiness, chronic self-doubt, excessive people-pleasing, self-isolation, and a heightened fear of rejection. The internal struggle may lead to a greater tendency to internalize negative emotions and engage in self-blame or self-destructive thoughts. This can sometimes result in a delayed or missed diagnosis, as the absence of more visible symptoms can make recognizing the presence of BPD challenging.
It’s important to note that the term “quiet BPD” is not an official diagnostic category but rather a descriptive term used to highlight the variations in the presentation of BPD. Regardless of the outward expression of symptoms, individuals with quiet BPD still require proper assessment, diagnosis, and treatment to address their emotional difficulties and improve their overall well-being.
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Best Treatment For Borderline Personality Disorder
The optimal treatment for Borderline Personality Disorder (BPD) is comprehensive and customized to meet the specific needs of each individual. Various evidence-based Borderline Personality Disorder therapies:
- Dialectical Behavior Therapy (DBT): DBT is a widely acknowledged treatment for BPD that incorporates individual therapy, group skills training, phone coaching, and therapist consultation. It emphasizes the development of emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness skills.
- Schema Therapy: This approach assists individuals in identifying and modifying deep-rooted maladaptive beliefs and patterns contributing to BPD symptoms. Combining cognitive, behavioral, and experiential techniques, it addresses underlying schemas and promotes healthier coping strategies.
- Mentalization-Based Treatment (MBT): MBT aims to enhance an individual’s capacity to comprehend their own thoughts, emotions, and motivations, as well as those of others. It fosters improved mentalizing abilities, crucial for managing relationships and regulating emotions effectively.
- Transference-Focused Psychotherapy (TFP): TFP focuses on exploring and resolving conflicts within the therapeutic relationship. It helps individuals gain insight into their patterns of relating to others, improve emotional regulation, and develop healthier ways of interacting.
- Cognitive-Behavioral Therapy (CBT): CBT for BPD centers around identifying and challenging negative thoughts and behaviors. It assists individuals in cultivating healthier coping strategies, enhancing problem-solving skills, and addressing dysfunctional thinking patterns.
It is worth noting that medication can be beneficial in managing specific BPD symptoms such as depression, anxiety, or impulsivity. However, medication is generally used with psychotherapy and should be prescribed and monitored by a qualified psychiatrist.
The most effective treatment approach typically involves a combination of therapies tailored to the individual’s unique requirements and preferences. Consulting with a mental health professional experienced in treating BPD is recommended to determine the most suitable treatment plan.
Medication can be a useful component of the treatment plan for Borderline Personality Disorder (BPD), particularly in managing specific symptoms or co-occurring conditions. While no medication is specifically approved for BPD, certain medications may be prescribed to target specific symptoms associated with the disorder. It is important to note that medication should be prescribed and monitored by a qualified psychiatrist or healthcare professional. Here are some medications that may be considered:
- Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) and other antidepressants may be prescribed to address symptoms of depression, anxiety, and mood swings commonly seen in BPD. These medications can help stabilize mood, reduce impulsivity, and alleviate symptoms of associated disorders like depression or anxiety.
- Mood stabilizers: Medications such as lithium or anticonvulsants (e.g., valproate, lamotrigine) may regulate mood swings, impulsivity, and emotional instability. They can help in reducing irritability, aggression, and impulsivity.
- Antipsychotics: Atypical antipsychotic medications may be prescribed in some cases to address symptoms like severe mood swings, psychotic-like symptoms, or disordered thinking. They can help stabilize emotions and reduce agitation or impulsivity.
It is important to note that medication is typically used with psychotherapy, such as dialectical behavior therapy (DBT) or other evidence-based approaches. Medication alone is unlikely to provide comprehensive treatment for BPD.
The decision to use medication should be based on thoroughly evaluating an individual’s symptoms and medical history and carefully considering potential benefits and side effects. It is crucial to work closely with a qualified healthcare professional to determine the most appropriate medication and dosage for an individual’s needs. Regular monitoring and communication with the prescribing doctor are essential to assess the effectiveness of the medication and make any necessary adjustments.
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Popular Borderline Personality Disorder FAQs
What Is BPD? BPD Meaning
BPD disorder stands for Borderline Personality Disorder. It is a mental health condition characterized by intense emotional instability, impulsive behaviors, and difficulties in interpersonal relationships. Individuals with BPD often experience rapid mood swings, have a fragile sense of self, and struggle with regulating their emotions. The term “borderline” originated from early beliefs that the disorder bordered on psychosis, but it is now understood as a distinct personality disorder.
Can a Borderline Personality Disorder Test (BPD Test) Diagnose You?
There is no specific test that can diagnose Borderline Personality Disorder. A qualified mental health professional, such as a psychiatrist or psychologist, typically makes a diagnosis based on a thorough evaluation of symptoms and clinical assessment. To make an accurate diagnosis, the professional will consider various criteria outlined in diagnostic manuals, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
What Is Borderline Personality Disorder in Short?
Borderline Personality Disorder (BPD) is a mental health disorder characterized by intense emotional instability, impulsive behaviors, and difficulties in interpersonal relationships. People with BPD may experience rapid mood swings, fear of abandonment, have an unstable self-image, and engage in impulsive behaviors. It is a complex condition that often requires comprehensive treatment approaches to manage symptoms and promote recovery.
What is BPD Splitting?
BPD splitting, black-and-white or dichotomous thinking, is a cognitive distortion commonly associated with Borderline Personality Disorder. It refers to a tendency to see people, situations, or oneself in extreme and polarized terms, good or all bad, with little room for shades of gray or nuance. This cognitive pattern can contribute to unstable and intense relationships, as individuals with BPD may quickly shift between idealizing and devaluing others.
Do I Have BPD?
Only a qualified mental health professional can accurately diagnose Borderline Personality Disorder. If you suspect you may have BPD or are experiencing symptoms that concern you, it is recommended to seek professional help. A mental health evaluation and assessment by a psychiatrist or psychologist can comprehensively understand your symptoms and determine an appropriate diagnosis.
What are the Symptoms Of BPD In Females?
Borderline Personality Disorder (BPD) symptoms are generally similar for males and females. However, it’s important to note that individual experiences may vary. Common symptoms of BPD in females may include intense emotional instability, fear of abandonment, self-destructive behaviors, identity disturbances, chronic feelings of emptiness, difficulties in interpersonal relationships, and impulsivity. It is crucial to consult with a mental health professional for a proper evaluation and diagnosis.
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Search We Level Up WA Borderline Personality Disorder Treatment & Resources
- National Institute of Mental Health (NIMH) – Borderline Personality Disorder: Treatment Overview Website: https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml#part_153949
- Substance Abuse and Mental Health Services Administration (SAMHSA) – Borderline Personality Disorder Treatment Website: https://www.samhsa.gov/conditions/borderline-personality-disorder/treatment
- MedlinePlus – Borderline Personality Disorder: Treatment Website: https://medlineplus.gov/borderlinepersonalitydisorder.html#cat_90
- National Alliance on Mental Illness (NAMI) – Borderline Personality Disorder Treatment and Support Website: https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Borderline-Personality-Disorder/Treatment-and-Support
- Office on Women’s Health – Borderline Personality Disorder: Treatment Website: https://www.womenshealth.gov/mental-health/mental-health-conditions/borderline-personality-disorder/treatment
- National Library of Medicine – Borderline Personality Disorder: Treatment Options Website: https://www.ncbi.nlm.nih.gov/books/NBK557524/
- Centers for Medicare & Medicaid Services (CMS) – Borderline Personality Disorder: Treatment Coverage Website: https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=282
- U.S. Department of Veterans Affairs – Borderline Personality Disorder: Treatment Options Website: https://www.mentalhealth.va.gov/borderline-personality-disorder.asp#treatment
- Health Resources and Services Administration (HRSA) – Borderline Personality Disorder: Treatment Resources Website: https://findahealthcenter.hrsa.gov/search-results?field=Borderline+Personality+Disorder
- National Institute on Drug Abuse (NIDA) – Comorbidity: Borderline Personality Disorder and Substance Use Disorders Website: https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/borderline-personality-disorder