This article covers

‍- What is borderline personality disorder?  
- Causes of borderline personality disorder
- The symptoms of borderline personality disorder 
- Treating borderline personality disorder
- List of useful resources 
- How Mindsum can help?

What is borderline personality disorder?

‍Borderline personality disorder (BPD) is a type of personality disorder, where the person has difficulties in their mood and relationships with others.  

It is normal for any person to experience difficult emotions and problems in relationships sometimes, but for the person with BPD this tends to be extreme.

It can be quite hard for a mental health professional to confirm a diagnosis of BPD in children or young people, as they are still developing. But, if the symptoms are persistent at a young age and can only be explained by the BPD criteria, it could possibly be diagnosed.

Causes of borderline personality disorder

‍There is no specific cause for BPD. It is likely due to a combination of genetics and environmental influences.

People with BPD grow up with different experiences, but a history of trauma and neglect is quite common. These experiences might cause the person to develop unhelpful beliefs about themselves and others around them. These might include:

- Feeling invalidated or unsupported as a child
- Family instability
- Severe neglect
- Emotional, sexual, or physical abuse
- Losing a parent

Not all people with BPD will have a traumatic history. Some people might still have BPD despite growing up in an environment without stressful situations. For this reason, it is difficult to know exactly what might cause BPD.  

The symptoms of borderline personality disorder

BPD is a complex disorder that can include a variety of symptoms. Some people may experience a set of symptoms that is different from another person with BPD. If the person has at least 5 (or more) of the following symptoms, they can be diagnosed with BPD:
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- Constant feeling of emptiness
- Going through extreme emotions (e.g., anger, sadness, anxiety, irritability) from day to day or within a few hours
- Constant worrying about being abandoned by others
- The lack of strong sense of self (e.g., they change depending on who is around)
- Impulsive behaviour that could cause harm (e.g., reckless driving, binge eating, substance use)
- Suicidal feelings or self-harm
- Intense anger that is difficult to control
- A pattern of constantly having problems in relationships with others
- Paranoid delusions or detaching from emotions and others around, during times of high stress
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“Benjamin is 23 years old. Growing up, he was a victim of severe neglect. Despite enjoying periods of intense and pleasant interactions in relationships, he eventually starts doubting people’s intentions and gets very upset at any sign that they might leave him. In the past, he threatened his partner using self-harm. When feeling upset he will go for a fast drive, often under the influence of alcohol. He can feel good and confident one moment and angry or sad the next. He reports feeling quite empty most of the time. He is thinking about talking to a professional that can help him to cope better.”

Treating borderline personality disorder

‍Psychological therapies are known to be the most effective treatment for BPD. This usually takes place on a long-term basis. These therapies might include:

Dialectical behaviour therapy

‍Dialectical behaviour therapy (DBT) is a specialised therapy developed for people with BPD. It focuses on helping the person to develop acceptance towards their emotions and to become more flexibility in the way they view situations and/or others. This might be delivered individually or in a group setting, depending on the person’s preference.

Mentalisation-based therapy

‍Mentalisation-based therapy (MBT) is also used to treat people with BPD. This focuses on helping people to understand their own mental states and those of others, and how this relates to behaviour. This type of therapy can help those with BPD to develop a better understanding of situations before reacting.

Other psychological therapies

‍There are many other types of psychological therapies that could be used to treat BPD. These might include cognitive behavioural therapy, cognitive analytic therapy, schema-focused therapy, interpersonal psychotherapy, psychodynamic therapy, and art therapies.

Medication

‍Medication is not recommended for the symptoms of BPD. However, the person with BPD can be prescribed medication for the treatment of other mental illnesses (e.g., anxiety, depression) they might have, alongside BPD.  Medication might also be prescribed in crisis situations, to help the person calm down.

Admission to hospital

‍In crisis situations, the person might need to admit to the acute psychiatric or emergency services, if they are self-harming or experiencing psychotic symptoms. This is where they will receive care that is focused on helping them calm down and ensuring their safety.  

‍Useful resources

NHS

You can get more information about BPD on the NHS website. Click here to access the link.

Young Minds

You can find information for young people about BPD on the Young Minds website. Click here to access the link.

Mind

You can find information about BPD on the Mind website. Click here to access the link.

Samaritans

The Samaritans offer a free helpline that is available 24 hours a day for support. Click here to access the link to their website.