Definition: 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.
Causes: 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:
Genetics. Some studies of twins and families suggest that personality disorders may be inherited or strongly associated with other mental disorders among family members.
Environmental factors. Many people with borderline personality disorder have a history of childhood abuse, neglect and separation from caregivers or loved ones.
Brain abnormalities. Some research has shown changes in certain areas of the brain involved in emotion regulation, impulsivity and aggression. In addition, certain brain chemicals that help regulate mood, such as serotonin, may not function properly.
Test & Diagnostic:
Personality disorders are diagnosed based on:
Thorough interview with your doctor or mental health provider
Psychological evaluation
Complete clinical history
Signs and symptoms
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:
Intense fear of abandonment
Pattern of unstable relationships
Unstable self-image or sense of identity
Impulsive and self-destructive behaviors
Suicidal behavior or self-injury
Wide mood swings
Chronic feelings of emptiness
Anger-related problems, such as frequently losing your temper or having physical fights
Periods of paranoia and loss of contact with reality
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.
Symptoms:
may include:
Impulsive and risky behavior, such as risky driving, unsafe sex, gambling sprees or illegal drug use
Awareness of destructive behavior, including self-injury, but sometimes feeling unable to change it
Wide mood swings
Short but intense episodes of anxiety or depression
Inappropriate anger and antagonistic behavior, sometimes escalating into physical fights
Difficulty controlling emotions or impulses
Suicidal behavior
Feeling misunderstood, neglected, alone, empty or hopeless
Fear of being alone
Feelings of self-hate and self-loathing
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.
Treatments: Borderline personality disorder treatment may include psychotherapy, medications or hospitalization.