Borderline personality disorder

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 26, 2016
StartDiseasesBorderline personality disorder

Personality disorders are mental disorders that affect a person’s feelings, thinking, mood, behavior, and relationships. Borderline personality disorder, or BPD, is one type of personality disorder with severe symptoms.


Definition & Facts

Borderline personality disorder involves a person experiencing emotional instability, impulsive behavior, self-image distortion and unstable relationships that affect the quality of his or her life. People with BPD need the company of other people and experience great loneliness. However, their emotional behavior, which may include an inability to control anger and mood swings, may push others away. Typically, this condition affects adolescents and people in their early adulthood. However, the condition may improve gradually as the patient grows older and is highly treatable with therapy.

Symptoms & Complaints

BPD causes various symptoms, which affect the individual’s quality of life. Individuals suffering from BPD may experience paranoia resulting from stress and may also experience short-term or long-term dissociation. The condition may cause the patient to get angry quickly over petty issues, resulting in physical violence in severe cases.

The patient may also engage in impulsive behavior which poses danger to his life. Such behavior include abruptly quitting one's job which affects one's financial status; gambling; careless driving; unprotected sexual intercourse, which exposes the individual to contracting sexually transmitted diseases or infections; and extravagant spending.

Other symptoms include threatening to commit suicide or harm oneself if certain demands are not met, the intense phobia of abandonment or rejection, and unstable intense relationships, which may involve idealization and devaluation; that is, idealizing somebody one moment and later thinking that that same person is worthless.

It is important to seek medical attention when the symptoms of BPD appear so that the individual can receive early diagnosis and treatment. This helps prevent severe possible complications including failure to complete education, suicide, self-harm, and imprisonment due to violence.


The condition is believed to result from many different factors including both genetic factors and environmental factors. Brain abnormalities are also believed to cause BPD. BPD may be linked to abnormal levels of serotonin, which is a mood-regulating hormone. According to scientific research on BPD and twins, people can inherit the condition from their parents.

Environmental factors may cause BPD by influencing the way a person behaves. A person's chance of developing BPD is increased if he or she experienced emotional abuse during childhood, if he or she was raised or surrounded by impulsive people, if one or more family members has the condition, or if he or she experienced emotional instability during childhood.

Diagnosis & Tests

Diagnosis is based upon the patient providing to the doctor or mental health professional the symptoms he or she experiences, any drugs taken, and the patient’s medical history. It may be helpful when the patient first visits the doctor or mental health professional for him or her to be accompanied by a close friend or relative, who is in a position to give relevant information about the patient’s condition in case the patient is not able to do so.

The diagnostic process will involve the doctor or mental helath professional asking the patient questions, and conducting a review of his or her emotional and behavioral history. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, a patient must depict at least five out of the nine symptoms of BPD specified by the manual.

Treatment & Therapy

The treatment of BPD mainly involves psychotherapy. In some cases, the doctor may recommend that the therapy be accompanied with medications to ensure effective treatment of the condition. Psychotherapy is a general term for mental disorder treatment that involves talking to a mental health specialist, such as a psychiatrist or psychologist. It can teach patients essential skills for managing BPD.

The types of psychotherapy applicable in the treatment of BPD include dialectical behavior therapy which is a form of cognitive behavioral therapy, mentalization-based therapy, schema therapy, transference focused therapy, and general psychiatric management.

Medications that may help in alleviating the symptoms of BPD include antipsychotics, mood-stabilizing drugs and antidepressants. It is advisable to know the benefits and side effects related to these medications before using them. Such knowledge can be obtained from the doctor. However, none of these medications has the approval of the Food and Drug Administration as of 2016.

Prevention & Prophylaxis

The causes of BPD are complex and controversial, so a medically agreed upon standard for preventing it is difficult. For instance, BPD resulting from genetic factors may not be preventable. However, BPD can be prevented from escalating with early diagnosis and treatment.