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Borderline personality disorder, also referred to as BPD for short, is one of the most severe types of mental illnesses. The disorder can manifest in many ways and vary in intensity but is characterized by unstable and intense mood swings along with impulsivity, fear of abandonment, and severe paranoia. So where does the term “borderline” come from? Keep reading to learn the origins of why this mental illness is called borderline personality disorder and how the definition has continued to evolve.

The History of Borderline Personality Disorder

Border personality disorder was officially added to the Diagnostic and Statistical Manual of Mental Disorders in 1980. However, the mental illness was known well before then and is where the origins of the name lie. 

The term “borderline” was first applied in 1938 by Adolph Stern, a psychoanalyst, to a group of patients whose mental illness symptoms did not fall into either psychosis or neurosis, two of the primary classifications of psychiatric conditions at the time (modern psychologists now recognize three main classifications). Psychotic disorders are those which render an individual to lose touch with reality due to delusions, hallucinations, or severe emotional turbulence. Bipolar disorder and schizophrenia are examples of psychotic disorders. Neurotic disorders are ones that cause mental distress but not the loss of reality. They include anxiety, depression, and obsessive disorders.

The term ‘borderline’ continued to be applied as the still-nascent field of modern psychiatry found it easier to determine what borderline personality disorder wasn’t, rather than what it was. In 1953, Rober Knight declared the condition a ‘borderline state’ due to symptoms often overlapping or bordering that of schizophrenia. ‘Borderline’ came to be a catch-all that was more colloquialism than proper or meritable diagnosis. 

It wasn’t until 1975 that another psychoanalysis, Otto Kernberg, defined the cluster of behaviors that comprise contemporary definitions of border personality symptoms and coined the term ‘borderline personality organization. Kernberg’s work gave structure to the disorder and led to further review which led to reliable assessments and measurable criteria being developed, helping borderline personality disorder to be recognized as a distinct type of mental illness.  

The concept of personality disorders was introduced into modern psychiatry by Emil Kraepelin (originally referred to as “psychopathic personalities”) at the beginning of the 20th century and the medical name for borderline personality disorder as its currently known was added to the DSM-III based on his psychoanalytical concepts.

Borderline Personality Disorder Symptoms vs. Schizophrenia Symptoms

Both in the early days of psychology and today, borderline personality disorder is often mistaken for schizophrenia. The mistaken idea is not without foundation, however. Several symptoms overlap between the two disorders. Borderline personality disorder and schizophrenia can also be comorbid, occurring simultaneously.

The primary difference between the two disorders is that borderline disorder, being a personality disorder, involves abnormal patterns of odd or eccentric behavior that affect their ability to maintain relationships and their overall functioning with the external world. Schizophrenia is a psychotic disorder that affects an individual’s perception of reality which in turn, can cause them to think and act in erratic ways. As such, another key difference is that individuals with BPD do not suffer impaired cognitive functioning as those with schizophrenia do.

Borderline personality disorder symptoms

  • Intense and drastic mood swings that can last for a few hours to several days.
  • Frequently losing one’s temper, sarcasm, or getting into physical fights
  • Intense anger often disproportionate to the situation
  • Intense fear of abandonment which often results in going to extreme measures to avoid separation or rejection
  • Stress-related paranoia
  • Temporary loss of contact reality lasting a few minutes to a few hours
  • Rapidly shifting self-identity/struggling with self-image
  • Impulsive and risky behavior
  • Suicidal behavior, most often in response to a sense of fear of separation or rejection
  • Feeling of emptiness  

Schizophrenia symptoms

  • Hallucinations
  • Delusions
  • Thought disorders
  • Abnormal symptoms
  • Loss of motivation/interest or enjoyment in daily activities
  • Very low energy
  • Dull voice and limited facial expression
  • Avoids social interactions or is socially awkward
  • Difficulty procession, applying for remembering information
  • Difficulty paying attention

Treating Borderline Personality Disorder 

Due to a lack of understanding about this complex mental illness, there are many misconceptions and stigmas that persist from the disorder’s earliest days. Psychotic disorders were widely believed to be untreatable, and bipolar disorder’s association with schizophrenia led to a stigma of untreatability that persists today. 

However, psychotherapy or “talk therapy” and its various modalities have been found to help individuals manage symptoms and modify their behavior and medications can help keep occurring symptoms of depression, impulsivity, and anxiety in check. If you or a loved one struggles with bipolar disorder, find a mental health rehab today to speak to a professional.  

https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2009.08121825