Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a personality disorder that affects up to 5.9 percent of Americans, more than bipolar disorder and schizophrenia. Individuals with BPD have a distorted self-image and difficulty controlling emotions. The cause of BPD is believed to be a complicated mix of genetics, environment (such as a history of neglect, separation or abuse) and an imbalance of mood-regulating chemicals, including serotonin, in the brain.

While BPD can affect any one of us, it's most often diagnosed in adolescents and early adulthood, and in women more often than in men.

Signs & Symptoms

BPD commonly begins in early adulthood and is primarily characterized by persistent unstable moods, thoughts, behaviors, relationships and self-image. Sufferers have an intense fear of real or imagined abandonment and impending rejection. Symptoms may also include:

Constant demand for attention
Making unreasonable demands
Self-dramatizing
Mood swings, episodes of depression, anxiety or anger
Chronic feelings of boredom, emptiness, worthlessness
Self-damaging impulsivity including over-spending, sex, substance abuse, gambling or binge eating
Self-destructive behaviors including substance abuse, reckless behavior
Self-injury including cutting, burning or scratching
Threatening or attempting suicide

For more information, visit Mental Health America's factsheet about borderline personality disorder.

Therapies

While drug therapies may help alleviate associated mood swings, anxiety or impulsive behaviors, the most common and effective treatment for BPD is long-term, outpatient psychotherapy ("talk" therapy).

Two forms of psychotherapy, dialectical behavior therapy (DBT) and transference-focused psychotherapy (TFP) are commonly used to treat BPD patients. DBT is a form of cognitive-behavioral treatment that focuses on skills training, problem solving, behavior modification and validation. Sessions may be one-on-one or in a group setting. TFP focuses on relationships, beginning with correcting how the patient perceives the emotions and structure of the patient-therapist relationship and then transferring that to relationships with significant others.

In severe cases, patients may be hospitalized for intense treatment.