What Is Borderline Personality Disorder?

Borderline personality disorder is a mental illness characterized by a long-standing, debilitating pattern of shifting moods, self-image, and behaviors. Also called unstable emotional personality disorder, this condition causes people to feel and act explosively, impulsively, and erratic. If you think that you or your loved one may be suffering from BPD, contact us for help at 1st Step Behavioral Health in South Florida.

The term “borderline” signifies that people with this illness are on the “borderline” of diagnosis with other mental health disorders. About 1.4% of US adults struggle with BPD. Three out of four of them are women, but some studies suggest that many men diagnosed with depression or PTSD may actually have BPD. At least 20% of psychiatric hospitalizations and 10% of outpatients involve people with borderline personality disorder.

Although BPD is a prevalent mental disorder, it is widely misunderstood in our society. People with the disease may appear to be dramatic, manipulative, demanding, or needy. However, these individuals are desperately trying to handle intense fear and emotional pain in dysfunctional ways.

What Are Signs and Symptoms of Borderline Personality Disorder?

People with borderline personality disorder experience overwhelming feelings of insecurity concerning themselves and how they relate to others. They may take drastic actions to avoid real or imagined abandonment by those who are close to them. Personal relationships fluctuate between idealization (intense feelings of closeness) and devaluation (hatred or disgust).

BPD is also marked by reckless behaviors including unsafe sex, excessive spending, and reckless driving. Sometimes, people with the illness have dissociative, “out of body” types of feelings. They may feel empty, irritable, and even psychotic under severe stress. Seemingly mundane happenings can trigger these thoughts and behaviors.

Borderline personality disorder is typically diagnosed by a mental health professional who would consider a person’s medical history and interviews with family and friends. A diagnosis requires the presence of at least five symptoms that persist to the point of severely impeding daily functioning. An article in The American Journal of Psychiatry classifies BPD symptoms into acute and temperamental manifestations. Some people exhibit only a few of them while others show many.

Acute Symptoms

  • Affective instability
  • Serious identity disturbance
  • Quasi-psychotic thought
  • Substance abuse or dependence
  • Self-mutilation
  • Sexual deviance
  • Manipulative suicide efforts
  • Feelings of entitlement or demanding behaviors
  • Serious treatment regressions
  • Countertransference problems

Temperamental Symptoms

  • Chronic, major depression
  • Chronic hopelessness or helplessness
  • Chronic anger; frequent outbursts of anger
  • Chronic anxiety
  • Chronic feelings of emptiness or loneliness
  • Impulsiveness
  • Paranoia
  • Unusual perceptual experiences
  • Intolerance of being alone
  • abandonment or annihilation worries
  • Counterdependency
  • Dependency or masochism

BPD and Suicide

Many people believe that BPD symptoms will eventually subside without treatment. However, this condition is linked to higher rates of self-harming behaviors and suicide than any other mental illness. About 70% of people with BPD attempt suicide at least once, and about 10% complete the act.

If you or someone you know is expressing suicidal tendencies, please call 911 right away. The National Suicide Prevention Lifeline is also available at 1-800-273-8255 for immediate assistance. Look out for these signs:

  • Threats to hurt or kill oneself
  • Seeking for pills, guns, or other means to kill oneself
  • Talking or writing about death or suicide
  • Increasing substance misuse
  • Withdrawal from family, friends, and society
  • Having no sense of purpose, seeing no reason to stay alive
  • Excessive sleep or sleep deprivation

What Are Risk Factors for Borderline Personality Disorder?

Researchers are not certain about what causes BPD. But they believe that genetics, brain function, and environmental factors can affect the risk of developing the illness. People with close relatives who have BPD could be at higher risk. Preliminary studies suggest that hormones may also influence the development of this disease.

  • Genetics: Research suggests that people are five times more likely to develop borderline personality disorder if a close relative has it.
  • Brain Function: Neuroimages show that people with the disease have a smaller hippocampus and other areas of the brain related to emotion and stress responses.
  • Environment: Empirical evidence shows that family life instability and childhood trauma from abandonment and physical, emotional, or sexual abuse may increase the risk of developing BPD.
  • Hormones: Studies have noted that altered estrogen levels affect the serotonin system, triggering mood disorders in BPD. 

BPD and Dual Diagnosis at 1st Step Behavioral Health in Florida

People who deal with BPD often struggle with other mental disorders such as addiction. Two out of three of these individuals have misused a substance such as alcohol or drugs at some point, usually attempting to self-medicate. BPD and substance use disorder have similar symptoms, making diagnosis difficult for both conditions. Typically, one disease gets diagnosed first and the other is uncovered later.

If you or someone you know is suffering from co-occurring disorders such as BPD and substance use disorder (SUD), it is critical to obtain treatment from professionals trained in dual diagnosis treatment. Targeting only one illness drastically reduces the chances of full recovery and long-term sobriety. The team here at 1st Step Behavioral Health is licensed and equipped to treat BPD and addiction simultaneously.

How Does BPD Differ from Bipolar Disorder?

BPD and bipolar disorder share many commonalities, but their symptoms and treatment options are different. Bipolar disorder is a mental illness marked by cycles of extreme mania and depression. Sometimes, mania and depression occur together. 

Individuals with bipolar disorder experience mania-depression cycles that extend for days or months; people with BPD experience emotional volatility almost every day. Bipolar disorder is primarily treated with medications while psychotherapy is the preferred protocol for treating BPD. It is possible for a person to struggle with both syndromes; up to 1 out of 5 bipolar patients deal with BPD.

What Treatment Options Does 1st Step Behavioral Health Offer for BPD?

Borderline personality disorder used to be considered difficult to treat. Fortunately, evidence-based therapies have demonstrated remarkable effectiveness in helping to alleviate symptoms and enhance the quality of life for people with the condition. It is essential to obtain help from trained providers such as the team here at 1st Step Behavioral Health. Therapy with our qualified, experienced professionals can make a big difference in your treatment and long-term recovery.

Psychotherapy

At 1st Step, your treatment plan will include psychotherapy, the primary treatment currently recommended for BPD. This non-medicinal method helps us deal with our patients on physical, mental, and emotional levels to get to the root of their issues. Psychotherapy is also called “talk therapy” because our counselors encourage patients to talk about their feelings, thoughts, and illness. We use several types of psychotherapy at our center:

Medications

While there is no medication that specifically targets BPD, some pharmaceuticals may be beneficial for treating co-occurring disorders. Mood stabilizers and antipsychotics are commonly included in treatment plans for managing anxiety and depression. Antipsychotics typically prescribed include haloperidol, olanzapine, and flupenthixol. Mood stabilizers include lamotrigine, topiramate, and valproate semisodium.

Is There Hope for Recovery from Borderline Personality Disorder?

Mounting evidence from follow-up studies gives hope that many people with BPD can experience remission or full recovery from the illness. Large-scale studies have reported high remission rates after at least two years of follow-up. Severe symptoms such as self-mutilation tend to abate more rapidly and return less often than temperamental symptoms such as chronic depression. Favorable outcomes depend largely on factors such as individual competence, psychosocial history, normal personality traits, and co-occurring disorders.

Borderline Personality Disorder Is A Legitimate Illness

The culture is slowly accepting the urgency of acknowledging and treating mental illness as a serious disease with the same level of concern given to cancer or heart disease. The brain is an organ like the lungs, heart, and liver; dysfunction in any of these areas impacts the ability to live a healthy, fulfilling life. Proper diagnosis, early intervention, and evidence-based treatment are crucial for rehabilitation and lasting recovery.

A growth on the skin might be cancerous; chest pain might be signaling a heart attack. If these issues remain unchecked and untreated, they could escalate with painful, tragic consequences. Please don’t disregard the signs of borderline personality disorder. Instead, reach out for help today.

Get Help for Borderline Personality Disorder at 1st Step Behavioral Health

Borderline personality disorder is a complex syndrome, but evidence indicates that many people respond positively to proper treatment. You can change your life and learn to control your emotions. Get the help and hope you need for a better life here at 1st Step Behavioral Health in South Florida. Start your journey of recovery with 1st Step Behavioral Health; reach out today.

Reviewed for Medical & Clinical Accuracy by Brittany Polansky

Brittany PolanskyBrittany has been working in behavioral health since 2012 and is a Primary Clinician at our facility. She is an LCSW and holds a master’s degree in social work. She has great experience with chemical dependency and co-occurring mental health diagnoses as well as various therapeutic techniques. Brittany is passionate about treating all clients with dignity and respect, and providing a safe environment where clients can begin their healing journey in recovery.