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Borderline personality disorder

Borderline personality disorder is a mental health condition that affects the way people feel about themselves and others, making it hard to function in everyday life. It includes a pattern of unstable, intense relationships, as well as impulsiveness and an unhealthy way of seeing themselves. Impulsiveness involves having extreme emotions and acting or doing things without thinking about them first.

People with borderline personality disorder have a strong fear of abandonment or being left alone. Even though they want to have loving and lasting relationships, the fear of being abandoned often leads to mood swings and anger. It also leads to impulsiveness and self-injury that may push others away.

Borderline personality disorder usually begins by early adulthood. The condition is most serious in young adulthood. Mood swings, anger and impulsiveness often get better with age. But the main issues of self-image and fear of being abandoned, as well as relationship issues, go on.

If you have borderline personality disorder, know that many people with this condition get better with treatment. They can learn to live stabler, more-fulfilling lives.

Borderline personality disorder affects how you feel about yourself, relate to others and behave.

Symptoms may include:

When to see a doctor

If you’re aware that you have any of the symptoms above, talk to your doctor or other regular healthcare professional or see a mental health professional.

If you have thoughts about suicide

If you have fantasies or mental images about hurting yourself, or you have thoughts about suicide, get help right away by taking one of these actions:

If you notice symptoms in a family member or friend, talk to that person about seeing a doctor or mental health professional. But you can’t force someone to change. If the relationship causes you a lot of stress, you may find it helpful to see a therapist.

As with other mental health conditions, the causes of borderline personality disorder aren’t fully known. In addition to environmental factors — such as a history of child abuse or neglect — borderline personality disorder may be linked to:

Factors related to personality development that can raise the risk of getting borderline personality disorder include:

Borderline personality disorder can damage many areas of your life. It can negatively affect close relationships, jobs, school, social activities and how you see yourself.

This can result in:

Also, you may have other mental health conditions, such as:

Personality disorders, including borderline personality disorder, are diagnosed based on a:

A diagnosis of borderline personality disorder usually is made in adults — not in children or teenagers. That’s because what may appear to be symptoms of borderline personality disorder in children or teenagers may go away as they get older and mature.

Borderline personality disorder is mainly treated using psychotherapy, which also is known as talk therapy. But medicine may be added. Your doctor also may recommend that you stay in the hospital if your safety is at risk.

Treatment can help you learn skills to manage and cope with your condition. You also should be treated for any other mental health conditions that often occur along with borderline personality disorder, such as depression or substance misuse. With treatment, you can feel better about yourself and have a stabler, more fulfilling life.

Talk therapy

Talk therapy is a basic treatment approach for borderline personality disorder. Your mental health professional may adjust the type of therapy to best meet your needs.

Talk therapy seeks to help you:

Management of borderline personality disorder mainly focuses on making sense of moments that are emotionally hard by thinking about what happened in your relationships that led to those moments. Good mental health management tends to include a combination of individual therapy, group therapy, family education and medicines for related conditions.

Types of talk therapy that have been found to be effective include:

Medicines

The Food and Drug Administration hasn’t approved any drugs specifically to treat borderline personality disorder. But some medicines may help with symptoms. And some medicines can help with conditions that occur with borderline personality disorder, such as depression, impulsiveness, aggression or anxiety. Medicines used to treat these conditions may include antidepressants, antipsychotics or mood-stabilizing drugs.

Talk to your doctor or mental health professional about the benefits and side effects of medicines.

Hospitalization

At times, you may need to be treated in a psychiatric hospital or clinic. Staying in the hospital also may keep you safe from harming yourself or help you talk about thoughts or behaviors related to suicide.

Recovery takes time

Learning to manage your emotions, thoughts and behaviors takes time. Most people improve greatly, but some people always struggle with some symptoms of borderline personality disorder. You may have times when your symptoms are better or worse. But treatment can make it easier to function and help you feel better about yourself.

You have the best chance for success when you work with a mental health professional who has experience treating borderline personality disorder.

Symptoms related to borderline personality disorder can be stressful and challenging for you and those around you. You may be aware that your emotions, thoughts and behaviors are harmful to yourself. But you may feel that you don’t know how to manage them.

In addition to getting professional treatment, you can help manage and cope with your condition if you:

You may start by seeing your primary care doctor or other healthcare professional. After the first appointment, your doctor may refer you to a mental health professional, such as a psychologist or psychiatrist. Here’s some information to help you prepare for your appointment.

What you can do

Before your appointment, make a list of:

Take a family member or friend along, if possible. Someone who has known you for a long time may be able to share important information with the doctor or mental health professional, with your permission.

Basic questions to ask at the appointment include:

Don’t hesitate to ask questions during your appointment.

What to expect from your doctor

A doctor or mental health professional is likely to ask you some questions, such as:

Be ready to answer questions to make sure there’s time to go over any points you want to focus on.

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