Borderline personality disorder (BPD) is a serious mental illness. It causes a person’s moods, relationships, self-image, and behavior to be unstable from one day to the next. This can hurt family and work life, the ability to make long-term plans, and the person’s sense of self-identity. Women are more likely than men to have BPD. Researchers are still learning about BPD, its causes, and its symptoms. There are treatments for BPD.
What is BPD?
BPD is a serious mental illness. It causes unpredictable or unstable moods and affects a person’s self-image and relationships.
Who gets BPD?
BPD affects 2 in 100 adults, mostly young women. People with BPD often have other mental health conditions, including anxiety disorders, eating disorders, and substance use disorders.1
What are the symptoms of BPD?
A person with BPD may experience intense times of anger, depression, and anxiety that may last only hours or, at most, a day. A person with BPD may also be aggressive, hurt themself, and abuse drugs or alcohol. Her self-identity, which may include long-term goals, career plans or jobs, friendships, relationships with loved ones, or values, is not stable over time and often changes.
A person with BPD may also have a history of intense and unstable relationships. Sometimes people with BPD view themselves or others as fundamentally bad or unworthy. They may feel misunderstood or mistreated, bored, or empty.
People with BPD are often impulsive. They may spend too much money, binge-eat, or have risky sex. People with BPD may have other mental health illnesses, including bipolar disorder, depression, anxiety disorders, substance abuse, and other personality disorders. People with BPD may also be more likely to harm themselves and die by suicide.
Researchers are not sure exactly what causes BPD. But certain factors can increase a person’s risk of BPD:2
Family history. If you have a parent or sibling with BPD, you are more likely to develop BPD.
Trauma. Many people with BPD have been through traumatic life events, especially childhood sexual abuse. Others have had unhealthy or abusive relationships. However, some people with BPD do not have a history of trauma, and many people who have experienced traumas do not have BPD.1
Physical changes in the brain. Some people with BPD have physical changes in their brains, especially in areas that control impulsive behavior and emotions.
How is BPD diagnosed?
BPD can be difficult to diagnose. It often has symptoms that are the same as other mental health conditions. A mental health professional will ask about a person’s symptoms and personal and family medical histories, including any history of mental illnesses. It may take several doctor’s visits to diagnose BPD. There is no blood test that can show BPD.
How is BPD treated?
Therapy, or talk therapy, is the best treatment for BPD.3 A type of therapy called dialectical behavioral therapy (DBT) specifically treats BPD.4 DBT involves talking one on one with a therapist, as well as with other people with BPD in a group setting. A team of therapists will also meet regularly to discuss treatment. DBT focuses on helping people with BPD to recognize and control their emotions. The therapist helps the person feel accepted in their emotions and teaches new ways to behave.4 This type of talk therapy can help women with BPD learn to express themselves and their emotions in healthy ways and to pay more attention to changes in mood. Family members of someone with BPD may also benefit from talk therapy.
Sometimes medicine can help with some of the symptoms of BPD, such as mood swings, anxiety, or depression. Talk to your doctor or nurse about which medicines might be able to help your symptoms.
Did we answer your question about BPD?
For more information about BPD, call the OWH Helpline at 1-800-994-9662 or check out the following resources from these organizations:
The Office on Women's Health is grateful for the medical review 2016 by:
The National Institute of Mental Health (NIMH)
The Substance Abuse and Mental Health Services Administration (SAMHSA)
Danielle Johnson, M.D., FAPA, Psychiatrist, Medical Staff President, Chief of Adult Psychiatry, Director, Women’s Mental Health Program, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati
Cassidy Gutner, Ph.D., Assistant Professor, Department of Psychiatry, Boston University School of Medicine; National Center for PTSD, Women’s Health Sciences Division, VA Boston Healthcare System, U.S. Department of Veterans Affairs
Mark A. Lumley, Ph.D., Professor and Director of Clinical Psychology Training, Department of Psychology, Wayne State University, and his Stress and Health Laboratory team: Jennifer Carty, Heather Doherty, Hannah Holmes, Nancy Lockhart, and Sheri Pegram
Mark Chavez, Ph.D., Chief, Eating Disorders Research Program, NIMH
Kamryn T. Eddy, Ph.D., and Jennifer J. Thomas, Ph.D., Associate Professors of Psychology, Department of Psychiatry, Harvard Medical School; Co-Directors of the Eating Disorders Clinical and Research Program, Massachusetts General Hospital
Kendra Becker, M.S., Clinical Fellow in Psychology, Department of Psychiatry, Massachusetts General Hospital
Michael Kozak, Ph.D., Division of Adult Translational Research and Treatment Development, NIMH
Alicia Kaplan, M.D., Assistant Professor of Psychiatry, Temple University School of Medicine and Drexel University College of Medicine, and Staff Psychiatrist, Division of Adult Services, Department of Psychiatry, Allegheny Health Network, Allegheny General Hospital
All material contained on these pages are free of copyright restrictions and may be copied, reproduced, or duplicated without permission of the Office on Women’s Health in the U.S. Department of Health and Human Services. Citation of the source is appreciated.