Borderline personality disorder
Borderline personality disorder
Borderline personality disorder (BPD) is an emotional disorder that causes emotional instability, leading to stress and other problems.
With borderline personality disorder your image of yourself is distorted, making you feel worthless and fundamentally flawed. Your anger, impulsivity and frequent mood swings may push others away, even though you desire loving relationships.
If you have borderline personality disorder, don't get discouraged. Many people with borderline personality disorder get better with treatment and can live happy, peaceful lives.
Borderline personality disorder affects how you feel about yourself, how you relate to others and how you behave.
When you have borderline personality disorder, you often have an insecure sense of who you are. That is, your self-image or sense of self often rapidly changes. You may view yourself as evil or bad, and sometimes may feel as if you don't exist at all. An unstable self-image often leads to frequent changes in jobs, friendships, goals and values.
Your relationships are usually in turmoil. You often experience a love-hate relationship with others. You may idealize someone one moment and then abruptly and dramatically shift to fury and hate over perceived slights or even minor misunderstandings. This is because people with the disorder often have difficulty accepting gray areas — things seem to be either black or white.
Borderline personality disorder symptoms may include:
When to see a doctor
If you notice these things about yourself, talk to your doctor or a mental health provider. The right treatment can help you feel better about yourself and help you live a more stable, rewarding life.
If you notice these things in a family member or friend, talk to him or her about seeing a doctor or mental health provider. But keep in mind that you can't force someone to seek help. If the relationship is causing you significant stress, you may find it helpful to see a therapist yourself.
As with other mental disorders, the causes of borderline personality disorder aren't fully understood.
Factors that seem likely to play a role include:
Most likely, a combination of these issues results in borderline personality disorder.
Personality is shaped by both inherited tendencies and environmental factors, or your experiences during childhood. Some factors related to personality development can increase your risk of developing borderline personality disorder. These include:
Also, borderline personality disorder is diagnosed more often in women than in men.
Borderline personality disorder can damage many areas of your life. Intimate relationships, jobs, school, social activities and self-image all can be negatively affected. Repeated job losses and broken marriages are common. Self-injury, such as cutting or burning, can result in scarring and frequent hospitalizations. Suicide rates among people with BPD are high.
In addition, you may have other mental health disorders, including:
Because of risky, impulsive behavior, you are also more vulnerable to unplanned pregnancies, sexually transmitted diseases, motor vehicle accidents and physical fights. You may also be involved in abusive relationships, either as the abuser or the abused.
Preparing for your appointment
If you have a pattern of difficult relationships or personality traits that seem common to borderline personality disorder, call your doctor. After an initial appointment, your doctor may refer you to a mental health provider, such as a psychiatrist.
Use the information below to prepare for your appointment and learn what to expect from your doctor.
What you can do:
For symptoms common to borderline personality disorder, some basic questions to ask your doctor or a mental health provider include:
In addition to the questions that you've prepared in advance, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
What you can do in the meantime
Tests and diagnosis
Personality disorders are diagnosed based on signs and symptoms and a thorough psychological evaluation. To be diagnosed with borderline personality disorder, you must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published and updated by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.
For borderline personality disorder to be diagnosed, at least five of the following signs and symptoms must be present:
A diagnosis of borderline personality disorder is usually made in adults, not in children or adolescents. That's because what appear to be signs and symptoms of borderline personality disorder may go away with maturity.
Treatments and drugs
Borderline personality disorder treatment may include psychotherapy, medications or hospitalization.
Because treatment can be intense and long term, you face the best chance for success when you consult mental health providers with experience treating borderline personality disorder.
Coping and support
Living with borderline personality disorder can be difficult. You may realize your behaviors and thoughts are self-destructive or damaging yet feel unable to control them. Treatment can help you learn skills to manage and cope with your condition.
Other things you can do to help manage your condition and feel better about yourself include:
Remember, there's no one right path to recovery from borderline personality disorder. The condition seems to be worse in young adulthood and may gradually get better with age. Many people with the disorder find greater stability in their lives during their 30s and 40s. As your inner misery decreases, you can go on to sustain loving relationships and enjoy meaningful careers.
Last Updated: 2010-05-19
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