Overview, Causes, & Risk Factors

Borderline personality disorder (BPD) is a serious psychiatric condition. A personality disorder is a general term for an abnormal, lifelong pattern of behavior and thoughts. People with a borderline personality are unstable in their self-image, moods, behavior, and relationships with others.

What is going on in the body?

No one knows what causes borderline personality disorder. The disorder may be associated with abnormalities in the structures and pathways in the brain that regulate emotion.

What are the causes and risks of the condition?

The exact cause of borderline personality disorder is unknown. Most experts believe that the disorder is caused by a combination of the following factors:

being a victim of violence, such as rape

genetic factors

a history of child abuse

a series of traumatic events as a young adult

vulnerability to stress

People with BPD are more likely to have other psychiatric disorders, including:

alcohol abuse

acute situational anxiety

generalized anxiety disorder

panic disorder

post-traumatic stress disorder

phobias

obsessive compulsive disorders

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bipolar disorder

depression

drug abuse

other types of personality disorders

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Symptoms & Signs

What are the signs and symptoms of the condition?

People with borderline personality disorder may have the following characteristics:

chronic feelings of emptiness and boredom. They may shift from one activity to another in order to fill the emptiness.

discomfort with being alone. They may even fake an illness to prevent someone from leaving.

impulsive behavior. They may drive recklessly, shoplift, and have episodes of binge eating.

intense and unstable relationships with others. They may shift back and forth from loving to hating someone or make and break friendships often.

intense anger and inability to control it. Someone with this disorder may frequently start fights or arguments.

a poor and shifting sense of who they are. For example, they may shift their goals or values constantly.

rapid and intense mood swings. For example, a person with BPD may change from total happiness to depression and thoughts of suicide.

tendency to harm themselves. This may include suicide attempts or intentional self-harm.

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Diagnosis & Tests

How is the condition diagnosed?

Diagnosis of borderline personality disorder begins with a medical history and physical exam. There is no one test that can make the diagnosis. A written survey of symptoms or a psychological test may be used to help make the diagnosis.

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Prevention & Expectations

What can be done to prevent the condition?

There are no known ways to prevent this condition. A stable and loving home life during childhood is thought to reduce the risk of personality disorders.

What are the long-term effects of the condition?

Long-term effects are mostly related to the person's behavior. This may include financial, legal, and social problems. Death may occur due to suicide or risk-taking behavior.

What are the risks to others?

Borderline personality disorder is not contagious and poses no risk to others.

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Treatment & Monitoring

What are the treatments for the condition?

Treatment options for borderline personality disorder have improved greatly in the past few years. Effective treatments include the following:

antidepressant medicines

antipsychotic medicines to treat distorted thinking

dialectical behavior therapy, which is a unique combination of behavioral and cognitive therapy designed for people with this disorder

group or individual psychotherapy

medicines that stabilize the person's mood

Unfortunately, many people with BPD are not compliant with their treatment plans.

What are the side effects of the treatments?

Medicines used to treat the disorder may cause drowsiness, dry mouth, and allergic reactions.

What happens after treatment for the condition?

Most people with borderline personality disorder have lifelong problems. As people get older, they often become a little more stable. Most people with this disorder need help and therapy for life, if they are willing to accept it.

How is the condition monitored?

Regular visits to a therapist are usually advised. Regular blood tests may be ordered to monitor medicine levels. Any new or worsening symptoms should be reported to the healthcare provider.

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