Borderline personality disorder (BPD) is a mental health condition that impacts the way people think, feel, and act. Because of these changes in cognition, emotion, and behavior, someone with BPD might experience difficulties in many areas of life, including relationships with family members and friends. BPD is a serious condition that affects up to 1.6 percent of the population—the majority of whom are young women.
The name borderline personality disorder comes from the early belief that this mental health disorder was on the “borderline” between a psychotic mental illness and a mood disorder, such as depression or bipolar disorder. People with BPD are sometimes extremely sensitive to rejection, often reacting strongly even when someone they care about is not rejecting them but simply busy or preoccupied. When people with BPD receive negative feedback, it can be difficult for them to move past their anger and hurt feelings. They may have thoughts of self-harm or suicide because of these strong emotions.
People with BPD might also exhibit impulsive or reckless behaviors, such as making risky sexual decisions. They may binge eat, abuse substances such as drugs or alcohol, shop too much, engage in risky spending, and gamble. These problems can lead to further health issues down the road.
Borderline personality disorder was once thought to be untreatable. While it is still not certain if BPD can be completely cured, the disorder is treatable. Therapy and medication are two methods that can help people with BPD cope better in their lives. Families of loved ones diagnosed with BPD may also benefit from learning about the condition in order to better understand a loved one’s behaviors and emotions.
A person can diagnose with borderline personality disorder when an individual exhibits at least five of the following symptoms in a persistent pattern for at least one year:
• Frantic efforts to avoid real or imagined abandonment by friends or family members. Symptoms include anger, feeling abandoned or lost, extreme worry about being left alone, panic attacks when a loved one leaf, and rapidly shifting moods.
• A pattern of unstable relationships with others where they may idealize a person in a whirlwind romance or be intensely angry with someone perceived as a threat or rejection. The individual fears he or she will be left alone to deal with the emotions behind this anger when the other person does reject them.
• Frantic efforts to avoid abandonment, where the person will act impulsively to create drama in order to keep others close by. These “dramatic” behaviors sometimes include self-harm or suicide attempts.
• A pattern of unstable emotions, where they experience extreme mood swings that can vary dramatically within a matter of hours or days. One day, the person might feel like they’re on top of the world and should be able to accomplish anything they set their mind to; the next day, all hope is lost, and it seems like nothing will ever go right again. These mood swings may be associated with severe depression or anxiety.
• Intense anger problems, where the person may be easily angered, prone to outbursts or physical fights, and unable to effectively express emotions.
• Self-harming behavior, such as cutting. Some people do this impulsively without even being aware they are doing it. Others self-harm as a way of coping with emotional pain.
• Inappropriate, intense anger or problems controlling anger, such as violent rages or repeated physical fights.
• A pattern of reckless behavior that is potentially self-damaging, such as large debts, promiscuous sexual behavior, substance abuse, reckless driving, and binge eating.
• Intense and unstable moods that may alternate between feeling extremely happy, sad, angry, or anxious.
• Short but intense periods of paranoid thoughts. People with BPD may experience moments where they feel like everyone is out to get them, and they are constantly trying to keep themselves safe from harm. In some cases, the person might have a psychotic episode related to these feelings.
• Thoughts of self-harm or suicide, where the person has thoughts about hurting themselves or dying. Some people even make specific plans for how they will commit suicide. People with BPD may attempt to take their own lives because of intense emotional pain, pressure from others to act a certain way, the desire to “punish” other people who have hurt them, or a desire to end their own lives.
If you want to better understand borderline personality disorder, it can be helpful to have an idea about the causes of BPD. Currently, there is no causal explanation for why people develop this disorder. There are many ideas related to what might cause BPD, but so far, none of them have been definitively shown to be true.
Some professionals believe BPD is caused by a combination of neurological and environmental factors, such as the way a person’s brain functions or how they were raised. In some cases, it has been passed down through families, which might explain why certain people are more likely to develop this disorder than others.
In addition, it is important to note that BPD can often be triggered by specific events, such as a sexual assault or the loss of a loved one.
Borderline personality disorder symptoms usually begin to appear in early adolescence or as young as the teenage years. However, symptoms might not start appearing until later in life, and people with BPD can go for years without realizing they have the disorder. It is estimated that as many as 10% of people with BPD attempt to commit suicide, and between 5% and 10% of those who die by suicide are believed to have BPD.
If you recognize these symptoms in someone you know, it can be challenging to determine if they meet the criteria for a diagnosis of BPD. If you think that someone you love might have this disorder, it is important to talk about your concerns with a medical professional in order to get a formal diagnosis and appropriate treatment.
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