Borderline personality disorder is a mental illness that severely impacts a person’s ability to regulate their emotions. This loss of emotional control can increase impulsivity, affect how a person feels about themselves, and negatively impact their relationships with others. Effective treatments are available to manage the symptoms of borderline personality disorder.
People with borderline personality disorder may experience intense mood swings and feel uncertainty about how they see themselves. Their feelings for others can change quickly, and swing from extreme closeness to extreme dislike. These changing feelings can lead to unstable relationships and emotional pain.
People with borderline personality disorder also tend to view things in extremes, such as all good or all bad. Their interests and values can change quickly, and they may act impulsively or recklessly.
Other signs or symptoms may include:
Not everyone with borderline personality disorder may experience all of these symptoms. The severity, frequency, and duration of symptoms depend on the person and their illness.
People with borderline personality disorder have a significantly higher rate of self-harming and suicidal behavior than the general population.
People with borderline personality disorder who are thinking of harming themselves or attempting suicide need help right away.
If you or someone you know is in immediate distress or is thinking about hurting themselves, call the National Suicide Prevention Lifeline toll-free at 1-800-273-TALK (8255). You also can text the Crisis Text Line (HELLO to 741741) or use the Lifeline Chat on the National Suicide Prevention Lifeline website.
Researchers aren’t sure what causes borderline personality disorder, but studies suggest that genetic, environmental, and social factors may increase the risk of developing it. These factors may include:
Although these factors may increase a person’s risk, it doesn’t mean it is certain that they’ll develop borderline personality disorder. Likewise, people without these risk factors may develop the disorder in their lifetime.
A licensed mental health professional—such as a psychiatrist, psychologist, or clinical social worker—who is experienced in diagnosing and treating mental disorders can diagnose borderline personality disorder based on a thorough interview and a discussion about symptoms. A careful and thorough medical exam also can help rule out other possible causes of symptoms. In diagnosing the illness, providers will discuss a person’s symptoms and ask about family medical histories, including histories of mental illness.
Borderline personality disorder is usually diagnosed in late adolescence or early adulthood. Occasionally, a person younger than age 18 may be diagnosed with borderline personality disorder if symptoms are significant and last at least a year.
What other illnesses can co-occur with borderline personality disorder?
Borderline personality disorder often occurs with other mental illnesses, such as post-traumatic stress disorder (PTSD). These co-occurring disorders can make it harder to diagnose and treat borderline personality disorder, especially if symptoms of other illnesses overlap with symptoms of the disorder. For example, a person with borderline personality disorder also may be more likely to experience symptoms of major depression, PTSD, bipolar disorder, anxiety disorders, substance abuse, or eating disorders.
Borderline personality disorder historically has been viewed as challenging to treat. But with newer, evidence-based treatment, many people with this disorder experience fewer and less severe symptoms, improved functioning, and better quality of life. It is important for patients with borderline personality disorder to receive treatment from a licensed mental health professional. Other types of treatment, or treatment from a provider who is not appropriately trained, may be ineffective or dangerous.
Many factors affect the length of time it takes for symptoms to improve once treatment begins. It is important for people with borderline personality disorder and their loved ones to be patient and receive support during treatment.
Seek—and stick with—treatment.
Studies funded by the National Institute of Mental Health (NIMH) indicate that individuals with borderline personality disorder who don’t receive adequate treatment are more likely to develop other chronic medical or mental illnesses and are less likely to make healthy lifestyle choices.
Psychotherapy, sometimes called “talk therapy,” is the first-line treatment for people with borderline personality disorder. Most psychotherapy occurs with a licensed, trained mental health professional in one-on-one sessions or with other individuals in group settings. Group sessions may help teach people with borderline personality disorder to interact with others and express themselves effectively.
Two examples of psychotherapies used to treat borderline personality disorder are:
Read more on NIMH’s Psychotherapies health topic page.
Because the benefits of prescription medication for borderline personality disorder are unclear, medications aren’t typically used as the primary way to treat the illness. However, in some cases, a psychiatrist may recommend medications to treat specific symptoms or co-occurring mental disorders such as mood swings or depression. Treatment with medications may require coordinated care from more than one medical professional.
Medications also can sometimes cause side effects in some people. Talk to your provider about what to expect from a particular medication. Read more in NIMH’s Mental Health Medications health topic.
Some people with borderline personality disorder experience severe symptoms and need intensive, often inpatient, care. Others may use some outpatient treatments but never need hospitalization or emergency care.
Having a relative or loved one with the disorder can be stressful, and family members or caregivers may unintentionally act in ways that can worsen their loved one’s symptoms.
Although more research is needed to determine how well family therapy helps with borderline personality disorder, studies on other mental disorders show that including family members can help support a person’s treatment. Families and caregivers also can benefit from therapy.
Family therapy helps by:
If you’re not sure where to get help, a health care provider can refer you to a licensed mental health professional, such as a psychiatrist or psychologist with experience treating borderline personality disorder. If you need help starting the conversation, check out the Tips for Talking With Your Health Care Provider fact sheet.
Other resources include:
Here are some ways to help a friend or relative with the disorder:
Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.
Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. We have new and better treatment options today because of what clinical trials uncovered years ago. Be part of tomorrow’s medical breakthroughs. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you.
To learn more or find a study, visit:
Article courtesy of the National Institute of Mental Health.