May is Mental Health Awareness Month – Mental Health Post a Day in May – May 12 – Borderline Personality Disorder

Borderline Personalty Disorder

I have even been diagnosed with this, as well…


Borderline personality disorder (BPD) is a serious mental disorder marked by a pattern of ongoing instability in moods, behavior, self-image, and functioning. These experiences often result in impulsive actions and unstable relationships. A person with BPD may experience intense episodes of anger, depression, and anxiety that may last from only a few hours to days.

Some people with BPD also have high rates of co-occurring mental disorders, such as mood disorders, anxiety disorders, and eating disorders, along with substance abuse, self-harm, suicidal thinking and behaviors, and suicide.

While mental health experts now generally agree that the label “borderline personality disorder” is very misleading, a more accurate term does not exist yet.

Signs ans Symptoms

People with BPD may experience extreme mood swings and can display uncertainty about who they are. As a result, their interests and values can change rapidly.

Other symptoms include

  • Frantic efforts to avoid real or imagined abandonment
  • A pattern of intense and unstable relationships with family, friends, and loved ones, often swinging from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)
  • Distorted and unstable self-image or sense of self
  • Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating
  • Recurring suicidal behaviors or threats or self-harming behavior, such as cutting
  • Intense and highly changeable moods, with each episode lasting from a few hours to a few days
  • Chronic feelings of emptiness
  • Inappropriate, intense anger or problems controlling anger
  • Having stress-related paranoid thoughts
  • Having severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality

Seemingly ordinary events may trigger symptoms. For example, people with BPD may feel angry and distressed over minor separations—such as vacations, business trips, or sudden changes of plans—from people to whom they feel close. Studies show that people with this disorder may see anger in an emotionally neutral face and have a stronger reaction to words with negative meanings than people who do not have the disorder.

Some of these signs and symptoms may be experienced by people with other mental health problems—and even by people without mental illness—and do not necessarily mean that they have BPD. It is important that a qualified and licensed mental health professional conduct a thorough assessment to determine whether or not a diagnosis of BPD or other mental disorder is warranted, and to help guide treatment options when appropriate.

Tests and Diagnoses

Unfortunately, BPD is often underdiagnosed or misdiagnosed.
A licensed mental health professional experienced in diagnosing and treating mental disorders—such as a psychiatrist, psychologist, or clinical social worker—can diagnose BPD based on a thorough interview and a comprehensive medical exam, which can help rule out other possible causes of symptoms.

The licensed mental health professional may ask about symptoms and personal and family medical histories, including any history of mental illnesses. This information can help the mental health professional decide on the best treatment. In some cases, co-occurring mental illnesses may have symptoms that overlap with BPD, making it difficult to distinguish BPD from other mental illnesses. For example, a person may describe feelings of depression but may not bring other symptoms to the mental health professional’s attention.

Research funded by NIMH is underway to look for ways to improve diagnosis of and treatments for BPD, and to understand the various components of BPD and other personality disorders such as impulsivity, relationship problems, and emotional instability.

Risk Factors

The causes of BPD are not yet clear, but research suggests that genetic, brain, environmental and social factors are likely to be involved.

  • Genetics. BPD is about five times more likely to occur if a person has a close family member (first-degree biological relatives) with the disorder.
  • Environmental and Social Factors. Many people with BPD report experiencing traumatic life events, such as abuse or abandonment during childhood. Others may have been exposed to unstable relationships and hostile conflicts. However, some people with BPD do not have a history of trauma. And, many people with a history of traumatic life events do not have BPD.
  • Brain Factors. Studies show that people with BPD have structural and functional changes in the brain, especially in the areas that control impulses and emotional regulation. However, some people with similar changes in the brain do not have BPD. More research is needed to understand the relationship between brain structure and function and BPD.

Research on BPD is focused on examining biological and environmental risk factors, with special attention on whether early symptoms may emerge at a younger age than previously thought. Scientists are also studying ways to identify the disorder earlier in adolescents.

Treatments and Therapies

BPD has historically been viewed as difficult to treat. However, with newer and proper treatment, many people with BPD experience fewer or less severe symptoms and an improved quality of life. Many factors affect the length of time it takes for symptoms to improve once treatment begins, so it is important for people with BPD and their loved ones to be patient and to receive appropriate support during treatment. People with BPD can recover.

If you think you have BPD, it is important to seek treatment.

NIMH-funded studies indicate that BPD patients who never recovered may be more likely to develop other chronic medical conditions and are less likely to make healthy lifestyle choices. BPD is also associated with a high rate of self-harm and suicidal behavior.

If you are thinking about harming yourself or attempting suicide, tell someone who can help right away.

Call your licensed mental health professional if you are already working with one. If you are not already working with a licensed mental health professional, call your personal physician or go to the nearest hospital emergency room.

If a loved one is considering suicide, do not leave him or her alone.

Try to get your loved one to seek immediate help from his or her doctor or the nearest hospital emergency room, or call 911. Remove any access he or she may have to firearms or other potential tools for suicide, including medications, sharp edges such as knives, ropes, or belts.

If you or a loved one are in crisis:

Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential.

The treatments described below are just some of the options that may be available to a person with BPD. However, the research on treatments is still in very early stages. More research is needed to determine the effectiveness of these treatments, who may benefit the most, and how best to deliver treatments.


“Psycotherapy or “talk therapy” is the main treatment for people with BPD . Current research suggests psychotherapy can relieve some symptoms, but further studies are needed to better understand how well psychotherapy works.

Psychotherapy can be provided one-on-one between the therapist and the patient or in a group setting. Therapist-led group sessions may help teach people with BPD how to interact with others and how to express themselves effectively. It is important that people in therapy get along with and trust their therapist. The very nature of BPD can make it difficult for people with this disorder to maintain a comfortable and trusting bond with their therapist.

Types of psychotherapy used to treat BPD include:

  • Cognitive Behavioral Therapy (CBT): CBT can help people with BPD identify and change core beliefs and/or behaviors that underlie inaccurate perceptions of themselves and others and problems interacting with others. CBT may help reduce a range of mood and anxiety symptoms and reduce the number of suicidal or self-harming behaviors.
  • Dialectical Behavior Therapy (DBT): This type of therapy utilizes the concept of mindfulness, or being aware of and attentive to the current situation and moods. DBT also teaches skills to control intense emotions, reduce self-destructive behaviors, and improve relationships. DBT differs from CBT in that it integrates traditional CBT elements with mindfulness, acceptance, and techniques to improve a person’s ability to tolerate stress and control his or her emotions. DBT recognizes the dialectical tension between the need for acceptance and the need for change.
  • Schema-Focused Therapy: This type of therapy combines elements of CBT with other forms of psychotherapy that focus on reframing schemas, or the ways people view themselves. This approach is based on the idea that BPD stems from a dysfunctional self-image—possibly brought on by negative childhood experiences—that affects how people react to their environment, interact with others, and cope with problems or stress.
  • Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a type of group therapy that aims to educate family members, significant others, and health care professionals about BPD and gives them guidance on how to interact consistently with the person with the disorder using the STEPPS approach and terminology. STEPPS is designed to supplement other treatments the patient may be receiving, such as medication or individual psychotherapy.

Families of people with BPD may also benefit from therapy. The challenges of dealing with a loved one with BPD on a daily basis can be very stressful, and family members may unknowingly act in ways that worsen their relative’s symptoms. Some therapies include family members in treatment sessions. These types of programs help families develop skills to better understand and support a relative with BPD. Other therapies focus on the needs of family members and help them understand the obstacles and strategies for caring for a loved one with BPD. Although more research is needed to determine the effectiveness of family therapy in BPD, studies on other mental disorders suggest that including family members can help in a person’s treatment.

Other types of psychotherapy may be helpful for some people with BPD. Therapists often adapt psychotherapy to better meet a person’s needs. Therapists may also switch from one type of psychotherapy to another, mix techniques from different therapies, or use a combination of psychotherapies. For more information, please see the NIMH webpage on Psychotherapies.


Medications should not be used as the primary treatment for BPD as the benefits are unclear. However, in some cases, a mental health professional may recommend medications to treat specific symptoms, such as mood swings, depression, or other disorders that may occur with BPD. Treatment with medications may require care from more than one medical professional.

Because of the high risk of suicide among people with BPD, health care providers should exercise caution when prescribing medications that may be lethal in the event of an overdose.

Certain medications can cause different side effects in different people. Talk to your doctor about what to expect from a particular medication.

Other Treatments

Some people with BPD experience severe symptoms and require intensive, often inpatient, care. Others may use some outpatient treatments but never need hospitalization or emergency care. Although in rare cases, some people who develop this disorder may improve without any treatment, most people benefit from and improve their quality of life by seeking treatment.

(NIMH – National Institue of Mental Health – Last Revised: August 2016)

I will be posting something important about mental illness every day throughout the month of May on my blog in honor of Mental Health Awareness Month.

Please keep visiting my blog My Loud Bipolar Whispers and look for statistics or other beneficial information related to mental illness to increase awareness, educate, reduce mental illness stigma and reduce suicides.

It is crucial and imperative for all of us to get involved and save lives.

So, please visit my blog every day, but especially every day throughout the month of May.

Thank you. Hugs and blessings to all of you always and forever.



  1. IMHO and experience there is too much diagnosis and not enough options for treatment. Psychiatrist have suggested that I may have had bipolar disorder even recurrent depression. At one stage I was about to be prescibed lithium and they changed their mind – thank goodness. Several years later I’m told my recurrent depression is the result of chemical imbalance and I needed mirtazapine for life. Thank goodness I had side effects and gradually stopped taking it. A therapist helped me to see my problem was how I was dealing with my life (environment). Long term medication was never going to be the answer; I needed to change how I interacted with my environment: I did and there are no side effects from that!!!!

    Liked by 1 person

  2. I agree that there are definitely not enough treatment options and help and support for people with bipolar and other mental illnesses​. I tried to go off my meds once and I became severely manic/insane so I know I need some meds.and have bipolar and PTSD… I definitely have bipolar, PTSD, anxiety and BPF. I have always been very sensitive to medications and through many years of great pain and illness I finally found there are only two meds that work for me and that I can safely take…. One helps with anxiety as my anxiety is very severe and has been since I was in my teens… So I still have symptoms but I am finally doing better than I ever have. Some people do have true diagnosis and require medications besides learning how to live and cope with mental illness. True clinical mental illness cannot be treated with behavior changes alone and needs something to treat the brain disease it is. I am happy behavior changes worked for you but it will not and cannot work that way for many.


  3. Wonderfully informative. Especially since a fellow blogger has made a suggestion that I may have BPD even though currently diagnosed with bipolar. I see my doc in month and will be discussing this possibility. Thank you for this

    Liked by 1 person

    1. You are very welcome and I am very happy you liked it. I hope it helped you. You can have both BPD and bipolar as well. I have been diagnosed with both BPD and bipolar but bipolar is my primary. I think it is a great idea to talk to your Pdoc about it. Thank you for reading my post and your comment. I appreciate it greatly. Good luck. I hope you get some helpful and informative answers with your Pdoc. Hugs and blessings. ❤. Sue

      Liked by 1 person

  4. Hi, I have recovered from Borderline Personality Disorder after years of self destruction. Multiple suicide attempts (unsuccessful) thankfully and the scars on my body still show all the self-harm. Also this Disorder had caused my family and friends a lot of heartache. I am currently writing a blog “My Recovery from Borderline Personality Disorder and how to live with Bipolar disorder 11”. It is actually turning into more of a story running up to my diagnosis.
    Mo Doyle

    Liked by 1 person

    1. Thank you for your comment. I am very happy you have recovered from BPD. You are strong and a Survivor. I am very excited to check out your site and interested in reading your memoir. I have similar symptoms as you. I always blamed my symptoms on my Bipolar and PTSD however it was most likely the combination of all of my diagnoses of Bipolar, PTSD, BPD and my anxiety disorder. I too am writing my memoir. Thanks for the read and your​ comments. I am so happy to read and learn from other bloggers. Hugs and blessings. Sue.


      1. Thanks Sue, as my dad use to say, “Each day in every way I am getting better and better”. I try and each day I learn something new and it helps in my recovery. Mo Doyle X

        Liked by 1 person

      2. I love what your Dad used to say. I should try to remember that. Your dad sounds like a very smart man… And you also sound like a smart survivor. I am very happy you are doing well. Hugs ❤❤❤ Sue


      3. Thanks Sue. My dad died very heroically suffering from Motor Neurone Disease in 1990. He lost the ability to speak, his ability to swallow and a gradual loss of all muscle. His brain functioned perfectly which I can only imagine was so frustrating as he could not use his body but his brain and mind was perfect. Gladly when he was diagnosed he was given a time span of 5 years to live and unfortunately there was and still is no cure or medication to treat this disease, but he fought it bravely. He wrote each of his children and my mother letters of his love for us individually while he still had the use of his arms. I treasure my letter and my dad died within 3 years of his diagnosis. Thankfully his faith gave him his strength and his words of “Each day in every way I’m getting better and better” will always stick with me as he knew he was dying but I suppose he didn’t give up. Cheers Sue X

        Liked by 1 person

      4. So sorry for your loss of your father. You are blessed to have such a wonderful father. I love how he wrote all of his children and your mom letters. That was such a beautiful thoughtful anf loving idea to do. Maybe he meant each day he is getting better and better becasue each day he is getting closer to being with God to live with God in heaven for eternity… or it meant his mind and heart are becoming more prepared… whatever it meant it was beautiful. Thanks for your story. Have a beuatiful and healthy day. Love and hugs… Sue.


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