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Borderline personality disorder

Borderline personality disorder (BPD) is a mental condition in which a person has long-term patterns of unstable or turbulent emotions. These inner experiences often result in impulsive actions and chaotic relationships with other people.

Causes

Cause of BPD is unknown. Genetic, family, and social factors are thought to play roles.

Risk factors include:

  • Either real or fear of abandonment in childhood or adolescence
  • Disrupted family life
  • Poor communication in the family
  • Sexual, physical, or emotional abuse

BPD tends to occur more often in women. Symptoms may get better after middle age.

Symptoms

People with BPD are often uncertain about who they are. As a result, their interests and values can change rapidly. They also tend to view things in terms of extremes, such as either all good or all bad. Their views of other people can change quickly. A person who is looked up to one day may be looked down on the next day. These suddenly shifting feelings often lead to intense and unstable relationships.

Other symptoms of BPD include:

  • Intense fear of being abandoned
  • Can't tolerate being alone
  • Feelings of emptiness and boredom
  • Displays of inappropriate anger
  • Impulsiveness, such as with substance use or sexual relationships
  • Self-injury, such as wrist cutting or overdosing

Exams and Tests

BPD is diagnosed based on a psychological evaluation. The health care provider will consider how long and how severe the person's symptoms are.

Treatment

Individual talk therapy may successfully treat BPD. Group therapy can sometimes be helpful.

Medicines have less of a role in treating BPD. In some cases, they can improve mood swings and treat depression or other disorders that may occur with this disorder.

Outlook (Prognosis)

Outlook of treatment depends on how severe the condition is and whether the person is willing to accept help. With long-term talk therapy, the person often gradually improves.

Possible Complications

Complications may include:

When to Contact a Medical Professional

See your health care provider if you or someone you know has symptoms of borderline personality disorder. It is especially important to seek help right away if you or someone you know is having thoughts of suicide.

Alternative Names

Personality disorder - borderline

References

American Psychiatric Association. Borderline personality disorder. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013:663-666.

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA, Hopwood CJ. Personality and personality disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 39.

Review Date 7/29/2016

Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.