Borderline personality disorder
Borderline personality disorder
Borderline personality disorder (BPD) is a mental health disorder that generates significant emotional instability. This can lead to a variety of other stressful mental and behavioral problems.
With borderline personality disorder, you may have a severely distorted self-image and feel worthless and fundamentally flawed. Anger, impulsiveness and frequent mood swings may push others away, even though you may desire to have loving and lasting relationships.
If you have borderline personality disorder, don't get discouraged. Many people with this disorder get better with treatment and can live satisfying lives.
Borderline personality disorder affects how you feel about yourself, how you relate to others and how you behave.
Signs and symptoms of borderline personality disorder may include:
When you have borderline personality disorder, you often have an insecure sense of who you are. Your self-image, self-identity or sense of self often rapidly changes. You may view yourself as evil or bad, and sometimes you 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 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 borderline personality disorder often have difficulty accepting gray areas — things seem to be either black or white.
When to see a doctor
If you notice signs or symptoms in a family member or friend, talk to that person about seeing a doctor or mental health provider. But you can't force someone to seek help. If the relationship causes 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. Experts agree, though, that the disorder results from a combination of factors. Factors that seem likely to play a role include:
Personality is shaped both by inherited tendencies and environmental factors, as well as experiences during childhood. Some factors related to personality development can increase the risk of developing borderline personality disorder. These include:
Also, borderline personality disorder is diagnosed more often in young adults and adult women than in men.
Borderline personality disorder can damage many areas of your life. It can negatively affect intimate relationships, jobs, school, social activities and self-image. 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 infections, 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, basic questions to ask your doctor or a mental health provider include:
Don't hesitate to ask questions during your appointment if you don't understand something.
What to expect from your doctor
In the meantime, if you have suicidal thoughts
Tests and diagnosis
Personality disorders are diagnosed based on:
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 teenagers. That's because what appear to be signs and symptoms of borderline personality disorder may go away as children get older and become more mature.
Treatments and drugs
Borderline personality disorder treatment may include psychotherapy, medications or hospitalization.
Because treatment can be intense and long term, you have the best chance for success when you consult mental health providers who have 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 you feel unable to control them. Treatment can help you learn skills to manage and cope with your condition.
You can help manage your condition and feel better about yourself if you:
Remember, there's no one right path to recovery from borderline personality disorder. Usually, the best results come from a combination of treatment strategies.
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 distress and sense of misery decreases, you can go on to maintain loving relationships and enjoy meaningful careers.
Last Updated: 2012-08-17
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