What Is Borderline Personality Disorder?

Borderline personality disorder, or BPD, is a behavioral-health condition characterized by emotional turbulence, violent mood swings, gnawing self-doubt, and difficulty in maintaining long-lasting relationships. The lashing-out at others is often rooted in fears of abandonment and isolation. BPD can be further complicated by related psychological or behavioral conditions, including anxiety, depression, substance abuse, and suicidal tendencies. Borderline personality disorder typically manifests in early adulthood and is more common in women than men. The good news is that recent advances in psychotherapy and other treatment options are showing promise in managing BPD. 

If you or a loved one is battling with unstable emotions and a sense of self-loathing, the psychiatric specialists at Baptist Health may be able to help.

What Causes Borderline Personality Disorder? 

The cause or causes of borderline personality disorder are unknown. It is generally thought that both hereditary and environmental factors are involved. Contributing factors possibly include:

• Brain structure: There is some evidence that BPD may have a partial cause in brain structure. The parts of the brain involved in emotional governance and impulse control show signs of operating differently in persons with BPD. Of course, this may be a consequence rather than a cause of the disorder. 
• Family history: Individuals with a close family member suffering from a personality disorder are more likely to manifest BPD, hinting at a genetic basis of some sort. 
• Childhood trauma: Many persons diagnosed with borderline personality disorder report being seriously abused or neglected as children. That said, there is no strong link between the two, because some persons with BPD did not experience childhood trauma and some persons who did, never develop a personality disorder. 

Risk factors are suggestive but uncertain; there is nothing to indicate that developing BPD is preordained either by one’s genes or one’s upbringing. 

How Is Borderline Personality Disorder Diagnosed?

Because BPD’s symptoms are common to other personality disorders, your physician or mental-health provider may find diagnosing this condition to be tricky. Here are some steps he or she is likely to take:

• Symptoms documentation: Your physician or mental-health provider will want a complete list of symptoms, which can be obtained during a detailed question-and-answer session.
• Family medical history: Because of the prevalence of mental-health conditions in some families, your physician will want to know your medical history. 
• Physical exam: A physical exam is important as a means of ruling out an underlying physical or medical cause of your condition. 
• Psychological evaluation: You might be asked to fill out a questionnaire with the purpose of documenting medical and behavioral evidence for BPD. Your physician can use this information, in conjunction with the criteria published in the Diagnostic and Statistical Manual of Mental Disorders, to make his or her diagnosis. 

Most of the individuals diagnosed with BPD are young adults. One positive aspect of this condition is that it tends diminish naturally as people grow into middle and old age.

How Is Borderline Personality Disorder Treated?

There are two primary forms of treatment for borderline personality disorder: psychotherapy and medications. The former is useful in helping individuals cope with their condition; the latter, in curtailing some of the more extreme forms that BPD can take. 

Psychotherapy

Types of psychotherapy employed to treat borderline personality disorder include:

• Dialectical-behavior therapy (DBT): DBT offers practical solutions for dealing with the day-to-day problems faced by individuals with a personality disorder. It emphasizes emotional control, tolerance for feelings of distress, and the need to stabilize relationships. DBT is provided in group and individual settings. 
• Mentalization-based therapy (MBT): MBT is a form of talk therapy that helps identify the emotions at play in a given situation, and alternative responses to those emotions, including positive rather than negative behaviors. 
• Schema-focused therapy: Schema therapy focuses on behaviors that may have had survival value early in life, but that need to be altered to meet the demands of a person’s current living situation. 
• Transference-focused psychotherapy (TFP): TFP is designed to help BPD patients improve their interpersonal relationships, based on the developing relationship the patient has with his or her psychotherapist. It is also known as psychodynamic psychotherapy. 
• Systems training for emotional predictability and problem-solving (STEPPS): STEPPS is supplemental to psychotherapy, and involves group activities with family members, friends, and significant others that reinforce the major thrust of whatever therapeutic approach is being utilized.  

Psychotherapy is most effective when supported by a good case-management program. 

Medications

Medication is prescribed when the symptoms of BPD, or a related condition such as depression, are severe enough to warrant it. Included are various antidepressant and antipsychotic drugs. 

What Are the Complications of Borderline Personality Disorder? Does It Ever Get Better?

Left undiagnosed or untreated, borderline personality disorder can have serious and lasting ramifications on a person’s life. Job losses, legal hassles, failed marriages and divorces, abusive relationships, and hospitalizations due to reckless behavior or self-harm are common results, as are related psychological conditions, such as depression, anxiety, and eating disorders.

Fortunately, strides are being made in treating BPD. With proper diagnosis and an effective psychotherapy program, many individuals suffering from a personality disorder are finding that they can get on with life. The keys are developing a good treatment plan and committing to it for the long run. You will be aided in this by the fact that the impact of BPD on your life tends to lessen over time, as you age out of young adulthood. 

Learn More About Borderline Personality Disorder at Baptist Health

Borderline personality disorder is a difficult thing to face. Just remember: the caring providers at Baptist Health are on your side. If you’re looking for treatment options or more information about BPD, please contact a behavioral health provider with Baptist Health today.