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Borderline personality disorder, often referred to as BPD, is a mental health condition that affects millions of people worldwide. This disorder is characterized by emotional instability, difficulty maintaining relationships, and a distorted self-image. People with BPD are also at risk of self-harm and suicide, and they often struggle with addiction and eating disorders. Because the symptoms of borderline personality disorder may include anger, anxiety, and depression, without a proper diagnosis, patients may not receive the care and support they need.
There are many effective therapeutic and pharmaceutical treatment options for borderline personality disorder. But before starting treatment, it is important to learn more about BPD — understand its causes, symptoms, and triggers — and figure out how this disorder affects the life of the person diagnosed with it, as well as the lives of their loved ones. This guide will help you familiarize yourself with borderline personality disorder and offer valuable insights into this complex condition.
What Is Borderline Personality Disorder?
Borderline personality disorder is a mental health disorder that impacts the way an individual thinks and feels about themselves and those around them. This disorder was officially recognized in the 1980s, although many mental health professionals believe it remains underdiagnosed and misunderstood to this day. It is estimated that around 2% to 4% of the population of the United States has BPD.
While BPD is not as widely discussed as depression or anxiety, its prevalence is comparable to many well-known mental health disorders. The name of the disorder refers to the difficulty in regulating emotions — a person with BPD may feel happy and excited one minute and become angry or sad the next without any obvious triggers. This erratic behavior can negatively affect all aspects of an individual’s life, giving them and the people who care about them countless reasons for concern.
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Common Symptoms of Borderline Personality Disorder
Before you or a person close to you is diagnosed with BPD, you may notice the following signs of borderline personality disorder:
- Mood swings. While it is normal to feel differently based on your circumstances, sudden changes in the way you feel that do not correspond to your reality and last for several hours or days are a reason for concern.
- Fear of abandonment. People with BPD are often terrified of being left alone. They may go to great lengths to prevent separations, whether those separations are real or imagined.
- Impulsive behavior. Reckless driving, substance abuse, binge eating, unprotected sex, and gambling — if you are acting on impulse and engaging in dangerous activities, this may be linked to BPD.
- Unstable relationships. BPD often remains undiagnosed when people close to the individual fail to recognize the symptoms. A person may be seen as manipulative or irrational, and the people around them may decide to cut off contact for their own well-being.
| Symptom Category | How It Presents | Impact on Daily Life |
|---|---|---|
| Emotional Instability | Rapid mood shifts, intense reactions disproportionate to the situation | Difficulty functioning at work, strained personal relationships, chronic stress |
| Fear of Abandonment | Panic when alone, frantic efforts to avoid real or perceived rejection | Clingy or controlling behavior that pushes others away |
| Impulsivity | Reckless spending, substance use, binge eating, risky sexual behavior | Financial problems, health consequences, legal issues |
| Unstable Self-Image | Shifting goals, values, and sense of identity; chronic feelings of emptiness | Difficulty making decisions, lack of direction, low self-worth |
| Self-Harm and Suicidal Behavior | Cutting, burning or other forms of self-injury; suicidal ideation | Medical emergencies, hospitalization, long-term physical and emotional scars |
Causes of Borderline Personality Disorder
It is believed there are three main reasons why a person develops BPD:
- Genetics. If someone in your family was diagnosed with BPD, there is a higher chance that you will have this disorder as well. Sharing your family history with your therapist or psychiatrist can help ensure a proper diagnosis.
- Brain structure. Studies have shown that people with BPD have different brain activity. In particular, the parts of the brain responsible for emotional regulation and decision-making are affected.
- Environment. In many cases, BPD stems from childhood trauma. Physical and emotional abuse, neglect, and bullying — adverse experiences a person goes through when they are young can echo throughout their life and contribute to BPD and other mental health disorders.
Complications of Untreated Borderline Personality Disorder
Diagnosing and treating BPD should be a priority for the patient and their loved ones. If this disorder remains untreated, it can lead to serious problems:
- Interpersonal issues. BPD makes it difficult for a person to maintain relationships, whether they are close to someone or barely know them. Erratic behavior and fear of abandonment can eventually lead to isolation and loneliness.
- Physical health. BPD is linked to various medical conditions, including heart disease. If a person engages in risky behavior such as substance misuse or disordered eating, they may face additional long-term health consequences.
- Suicidal thoughts. There is a strong connection between BPD and suicide — on average, approximately 10% of people with BPD end up taking their own lives. If you have been hurting yourself or someone you care about has mentioned suicide, reach out to a mental health professional immediately.
Treatment Options for Borderline Personality Disorder
BPD is treatable. With the right combination of professional support and personal commitment, individuals with this disorder can experience significant improvement. Here are the primary treatment options to consider.
| Treatment Type | How It Works | Best For |
|---|---|---|
| Cognitive Behavioral Therapy (CBT) | Identifies negative thought patterns and replaces them with rational, balanced thinking | Individuals struggling with distorted self-image, impulsive reactions, and anxious thinking |
| Dialectical Behavior Therapy (DBT) | Teaches emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness | People with intense emotional instability, self-harm behaviors, and relationship difficulties |
| Medication Management | Targets specific symptoms with antipsychotics, antidepressants, or sleep aids as needed | Individuals whose anxiety, mood instability, or sleep disruption requires pharmaceutical support |
| Schema Therapy | Addresses deeply rooted patterns formed in childhood that drive current emotional and behavioral issues | People whose BPD is closely tied to early trauma and unmet developmental needs |
| Lifestyle Adjustments | Incorporates supportive relationships, trigger avoidance, nutrition, exercise and substance-free living | Anyone looking to complement clinical treatment with daily habits that support stability. |
Therapy
Several types of psychotherapy were designed specifically to treat BPD. Cognitive behavioral therapy helps you identify negative thought patterns and replace them with rational thinking. Dialectical behavior therapy teaches you how to control and manage your emotions through skills like mindfulness, distress tolerance and interpersonal effectiveness. Both approaches have strong evidence supporting their effectiveness for BPD.
Medication
There is no single medication that will cure BPD. However, a psychiatrist may prescribe drugs that target the specific symptoms you are experiencing — for instance, antipsychotics to address anxiety, antidepressants to improve mood, and sleep aids to help you rest at night. Medication works best when combined with ongoing therapy.
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Lifestyle Changes
You can make adjustments on your own or together with your therapist to see what works best for you. Surround yourself with supportive people who understand your struggles. Learn to identify and avoid triggers that worsen your symptoms. Eat nutritious food, reduce or eliminate alcohol and substance use, and practice regular physical activity to help manage stress.
You Deserve Support That Understands the Full Picture — Nashville Mental Health Is Here
Borderline personality disorder is a serious condition, but it is also a treatable one — especially when the right support is in place. If you or someone you love is experiencing symptoms of BPD, early diagnosis and consistent treatment can lead to meaningful, lasting improvement. You do not have to navigate this alone.
Nashville Mental Health provides compassionate, evidence-based treatment for individuals living with borderline personality disorder, anxiety, depression, trauma, and other mental health conditions. Our team offers personalized care — including therapy, medication management, and comprehensive treatment planning — in an environment built on understanding and clinical expertise.
Contact Nashville Mental Health today to schedule a consultation and take the first step toward stability, healing, and a life that feels like your own again.
FAQs
1. What is borderline personality disorder?
Borderline personality disorder is a mental health condition that affects a person’s emotions, behavior, and relationships. It is characterized by emotional instability, fear of abandonment, and impulsive actions. People with BPD often experience rapid mood shifts, difficulty maintaining stable relationships, and a distorted sense of self-image that can interfere with daily functioning.
2. What are the main symptoms of borderline personality disorder?
The symptoms of BPD include intense mood swings, an unstable self-image, chronic feelings of emptiness, an intense fear of being left alone, and harmful behaviors such as substance abuse and self-injury. These symptoms typically appear in adolescence or early adulthood and can vary in severity depending on the individual and whether they are receiving treatment.
3. What causes borderline personality disorder?
There are several factors that contribute to the development of BPD. Genetics plays a role, as the disorder tends to run in families. Brain structure and function — particularly in areas responsible for emotional regulation and decision-making — are also involved. Environmental factors such as childhood trauma, neglect, and lack of emotional support during formative years are among the most significant contributors.
4. How is borderline personality disorder diagnosed?
Only a qualified mental health professional can diagnose BPD. A therapist or psychiatrist will conduct a thorough evaluation that includes discussing symptoms, personal history, and family background with the patient or their guardian. Because BPD symptoms overlap with other conditions like depression and bipolar disorder, an accurate diagnosis is essential for developing an effective treatment plan.
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5. Is it possible to treat borderline personality disorder?
Yes, people with BPD can experience significant improvement with time and proper care. Therapy — particularly dialectical behavior therapy and cognitive behavioral therapy — is considered the most effective treatment. Medication can help manage specific symptoms, and lifestyle changes such as building a support system, avoiding triggers, and maintaining physical health all contribute to long-term recovery and emotional stability.
