Topic Overview
What is borderline personality disorder?
Borderline personality disorder is a mental illness that causes intense
mood swings, impulsive behaviors, and severe problems with self-worth. It can lead to troubled relationships in every
area of a person's life.
Most of the time, signs
of the disorder first appear in childhood. But problems often don't start until
early adulthood. Treatment can be hard, and getting better can take years.
Problems with emotions and behaviors are hard to improve. But
with treatment, most people with severe
symptoms do get better over time.
What causes this disorder?
Experts don't
know exactly what causes borderline personality disorder. Problems with chemicals in the brain that help
control moods may play a role. It also seems to run in
families.
Often, people who get it faced some kind of childhood
trauma such as abuse, neglect, or the death of a parent. The risk is higher when people who had childhood trauma also have problems
coping with
anxiety or stress.
What are the symptoms?
Everyone has problems with
emotions or behaviors sometimes. But if you have borderline personality
disorder, the problems are severe, repeat over a long time, and disrupt your
life. The most common symptoms include:
- Intense emotions and mood swings.
- Harmful, impulsive behaviors. These may include things like substance
abuse,
binge eating, out-of-control spending, risky sexual behavior, and reckless
driving.
- Relationship problems. You may see others as either "good" or
"bad" and may shift from one view to the other suddenly, for minor reasons. This can make relationships very difficult.
- Low self-worth.
- A frantic fear of being left alone
(abandoned). This fear may lead to frantic attempts to hold on to those around
you. Or it may cause you to reject others before they can
reject you.
- Aggressive behavior.
Other symptoms may include:
- Feeling empty inside.
- Problems
with anger, such as violent temper tantrums.
- Hurting yourself, such
as cutting or burning yourself.
- Suicide attempts and suicidal
thoughts.
- Times when you feel paranoid or lose a sense of reality (psychosis).
It's easy to confuse this disorder with other mental
illnesses. And they may overlap. So if you think that
you or someone you know may have borderline personality disorder, see a doctor.
Don't try to diagnose yourself.
How is it treated?
Borderline personality disorder can be hard to treat. It's common for symptoms to return. And many people with the disorder have troubled relationships with their counselors and doctors.
But you can take steps to help control the disorder. Long-term treatment can reduce symptoms and harmful behaviors and help you better manage your emotions. Treatment may include:
- Counseling and therapy. It's important to find a counselor you can build a stable relationship with. This can be hard, because your condition may cause you to see your counselor as caring one minute and cruel the next, especially when he or she asks you to
try to change a behavior. Try to find a counselor who has special training in
dialectical behavioral therapy (DBT) to treat this disorder.
- Medicines, such as antidepressants, mood stabilizers, and antipsychotics. In combination with counseling or therapy, they may be helpful in treating symptoms of borderline personality disorder.
- Healthy habits, such as getting enough sleep, eating healthy foods, getting regular exercise, and avoiding alcohol and drugs. These habits can help reduce stress and anxiety. And they can help make your symptoms less severe and less frequent.
Many people find relief from harmful symptoms within the first year
of treatment.footnote 1 And about half of those treated find that they no longer have most of the behaviors after about 10
years of treatment.footnote 1
Unfortunately, many
people don't seek treatment for mental health problems. They may think that their symptoms aren't bad enough or that they can
work things out on their own. But getting treatment is key to improving your symptoms and the quality of your life.
People with this disorder often have other mental health problems such as
depression,
eating disorders, or
substance abuse. Treatment can help with these problems too.
How can family and friends help? What can they do to cope?
Accepting that a loved one has a personality disorder can be hard. You may feel helpless. But there are things you can do to help. Show love, and learn as much as you can about the illness. Understand that the behavior you may see-which may include anger directed at you-is caused by the illness, not by the person you love.
Know when to get help. This disorder can cause a person to become angry, violent, or suicidal. Take these situations seriously. Call for help if you think the person may be in danger or may harm someone else.
Finding your own support is important too. Ask your local or state health department about local support organizations, or contact the National Alliance on Mental Illness. For more information, go to www.nami.org.