Borderline Personality Disorder.

Borderline Personality Disorder (BPD) is a condition that causes difficulties regulating emotion. People with BPD experience emotions intensely and for prolonged periods of time. It’s also more difficult for them to return to a stable baseline after an episode—roughly 2% of adults in the US experience BPD. Unfortunately, BPD is often misdiagnosed as PTSD or depression because it shares many similar symptoms to these conditions.

What Is Borderline Personality Disorder?

Also called emotional dysregulation disorder, BPD is a common mental disorder characterized by unstable behaviors and moods. Symptoms include emotional instability, insecurity, impulsivity, and impaired relationships. In most cases, BPD starts in early adulthood. The condition worsens in young adults and gradually gets better with age.

The causes of BPD remain unknown, but scientists believe it’s a combination of:

  • Genetics
  • Hereditary factors
  • Environmental factors
  • Exposure to traumatic life events
  • Brain function, particularly portions of the brain related to emotional control and decision-making

Criteria for BPD Diagnosis

The DSM, published by the American Psychiatric Association, sets the criteria for a BPD diagnosis. There are no definitive medical tests to diagnose a borderline personality disorder, and diagnosis is not based on one specific symptom. A mental health professional best diagnoses BPD following clinical interviews that include reviewing previous medical evaluations, interviews with friends and family, and talking to prior clinicians.

Symptoms Unique to Borderline Personality Disorder

BPD symptoms include mood swings, emotional instability, and insecurity. However, some unique symptoms of borderline personality disorder. In order to be diagnosed with BPD, a person must exhibit five or more of the following:

  • Chronic feelings of worthlessness and emptiness
  • Steady emotional instability in reaction to daily events
  • Efforts to avoid real or imagined abandonment from friends and family
  • Impulsive behavior that can be self-damaging
    Inappropriate, difficult to control, or intense anger that includes displays of temper and recurrent physical fights
  • A pattern of unstable and intense social relationships characterized by extremes between idealization and devaluation
  • Suicidal behavior or self-harming behavior
  • Stress-related paranoid ideation
  • Severe dissociative symptoms

Treating Borderline Personality Disorder

While there’s no cure for BPD, it can be treated and managed with psychotherapy and medications. Most people experience the best results with a combination of medication, psychotherapy, and peer support. People with co-occurring conditions should find a treatment plan that addresses these conditions. These are the most common treatment options:


Therapy is considered a key element in BPD treatment because it addresses the emotional dysregulation that characterizes the condition. Several psychotherapies have proven effective at helping with this condition, including dialectical behavioral therapy (DBT), cognitive-behavioral therapy (CBT), and mentalization-based therapy (MBT).


There isn’t a single medication used to treat BPD. Instead, most medications help treat some BPD symptoms, including depression and anxiety.

Peer Support

Most people struggling with BPD may benefit from seeking peer support from group therapy or local support groups. These can provide them a safe and secure space to discuss their emotions, hear other perspectives, and focus on recovery.

In some cases, hospitalization might be needed primarily when the person is exhibiting self-harm or suicidal behavior. Short-term hospitalization might be required during times of extreme stress to ensure safety.

Borderline Personality Disorder and Substance Abuse

About 50% of those with borderline personality disorder also have a history of substance abuse. Because people with BPD often experience feelings of emptiness and disconnection, they may turn to substances like alcohol or cocaine to cope with their symptoms. However, the effects of drugs on these symptoms are only temporary.

When borderline disorder co-occurs with substance use disorders, the effects and symptoms of both are magnified. People are more likely to engage in destructive behaviors, experience mood swings, and suffer from major depressive episodes.

Those with borderline personality disorder struggle to trust and form relationships, so seeking treatment goes against their instincts. These paranoiac symptoms might heighten if co-occurring with substance abuse.

However, if you or someone you know is dealing with BPD, please know there’s help available for these conditions. Reach out to your primary health care provider or speak with an addiction specialist to learn more about the different treatment options available. Recovery from co-occurring mental health and substance use disorders is possible.


Start your journey to recovery today.

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