Many people with BPD also have another mental health condition or behavioural problem, such as:. BPD can be a serious condition, and many people with the condition self-harm and attempt suicide. Our guide to care and support explains your options and where you can get support. Page last reviewed: 17 July Next review due: 17 July Home Mental health Mental health conditions Borderline personality disorder Back to Borderline personality disorder. Overview - Borderline personality disorder.
Symptoms of borderline personality disorder BPD The symptoms of BPD can be grouped into 4 main areas: emotional instability — the psychological term for this is affective dysregulation disturbed patterns of thinking or perception — cognitive distortions or perceptual distortions impulsive behaviour intense but unstable relationships with others The symptoms of a personality disorder may range from mild to severe and usually emerge in adolescence, persisting into adulthood. They may ask about: how you feel your recent behaviour what sort of impact your symptoms have had on your quality of life This is to rule out other more common mental health conditions, such as depression , and to make sure there's no immediate risk to your health and wellbeing.
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Share Page. Borderline Personality Disorder. Overview Borderline personality disorder is an illness marked by an ongoing pattern of varying moods, self-image, and behavior. Other signs or symptoms may include: Efforts to avoid real or imagined abandonment, such as rapidly initiating intimate physical or emotional relationships or cutting off communication with someone in anticipation of being abandoned A pattern of intense and unstable relationships with family, friends, and loved ones, often swinging from extreme closeness and love idealization to extreme dislike or anger devaluation Distorted and unstable self-image or sense of self Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating.
Family History. People who have a close family member, such as a parent or sibling with the disorder may be at higher risk of developing borderline personality disorder. Brain Factors. Studies show that people with borderline personality disorder can have structural and functional changes in the brain especially in the areas that control impulses and emotional regulation.
But is it not clear whether these changes are risk factors for the disorder, or caused by the disorder. Environmental, Cultural, and Social Factors. Many people with borderline personality disorder report experiencing traumatic life events, such as abuse, abandonment, or adversity during childhood. Others may have been exposed to unstable, invalidating relationships, and hostile conflicts.
Tests and Diagnosis A licensed mental health professional—such as a psychiatrist, psychologist, or clinical social worker—experienced in diagnosing and treating mental disorders can diagnose borderline personality disorder by: Completing a thorough interview, including a discussion about symptoms Performing a careful and thorough medical exam, which can help rule out other possible causes of symptoms Asking about family medical histories, including any history of mental illness Borderline personality disorder often occurs with other mental illnesses.
Psychotherapy Psychotherapy is the first-line treatment for people with borderline personality disorder. Two examples of psychotherapies used to treat borderline personality disorder include: Dialectical Behavior Therapy DBT : This type of therapy was developed for individuals with borderline personality disorder.
DBT uses concepts of mindfulness and acceptance or being aware of and attentive to the current situation and emotional state. DBT also teaches skills that can help: Control intense emotions Reduce self-destructive behaviors Improve relationships Cognitive Behavioral Therapy CBT : This type of therapy can help people with borderline personality disorder identify and change core beliefs and behaviors that underlie inaccurate perceptions of themselves and others, and problems interacting with others.
CBT may help reduce a range of mood and anxiety symptoms and reduce the number of suicidal or self-harming behaviors. Medications Because the benefits are unclear, medications are not typically used as the primary treatment for borderline personality disorder.
However, in some cases, a psychiatrist may recommend medications to treat specific symptoms such as: mood swings depression other co-occurring mental disorders Treatment with medications may require care from more than one medical professional. Other Elements of Care Some people with borderline personality disorder experience severe symptoms and need intensive, often inpatient, care. Therapy for Caregivers and Family Members Families and caregivers of people with borderline personality disorder may also benefit from therapy.
This type of therapy helps by: Allowing the relative or loved one develop skills to better understand and support a person with borderline personality disorder Focusing on the needs of family members to help them understand the obstacles and strategies for caring for someone with borderline personality disorder. Although more research is needed to determine the effectiveness of family therapy in borderline personality disorder, studies on other mental disorders suggest that including family members can help in a person's treatment.
Finding Help More information about finding a health care provider or treatment for mental disorders in general is available on our Help for Mental Illness webpage. Tips for Family and Caregivers To help a friend or relative with the disorder: Offer emotional support, understanding, patience, and encouragement—change can be difficult and frightening to people with borderline personality disorder, but it is possible for them to get better over time Learn about mental disorders, including borderline personality disorder, so you can understand what the person with the disorder is experiencing Encourage your loved one who is in treatment for borderline personality disorder to ask about family therapy Seek counseling for yourself from a therapist.
It should not be the same therapist that your loved one with borderline personality disorder is seeing. Free Brochures and Shareable Resources Borderline Personality Disorder : A brochure that offers basic information about borderline personality disorder, including signs and symptoms, treatment, and finding help.
Suicide in America: Frequently Asked Questions : Fact sheet can help you, or a friend or family member, learn about the signs and symptoms, risk factors and warning signs, and ongoing research about suicide and suicide prevention. Warning Signs of Suicide : An infographic presenting behaviors and feelings that may be warnings signs that someone is thinking about suicide.
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Need more information? Become a campaigner. This section has information on borderline personality disorder BPD , including symptoms, causes and treatments. You might find it helpful if you live with a diagnosis of BPD, or if you know someone who does. Borderline personality disorder is also called emotionally unstable personality disorder EUPD. In this section, we call it BPD as this is still the most common term for the illness. But we appreciate that both terms can be controversial.
Everyone has different ways of thinking, feeling, and behaving. These are often called our traits. They shape the way we view the world and the way we relate to others. By the time we are adults these will make us part of who we are. You can think of your traits as sitting along a scale. For example, everyone may feel emotional, get jealous, or want to be liked at times. But it is when these traits start to cause problems that you may be diagnosed as having a personality disorder.
BPD can affect how you cope with life, manage relationships, and feel emotionally. You may find that your beliefs and ways of dealing with day-to-day life are different from others. You can find it difficult to change them.
You may find your emotions confusing, tiring, and hard to control. This can be distressing for you and others. Because it is distressing, you may find that you develop other mental health problems like depression or anxiety.
You may also do other things such as drink heavily, use drugs, or selfharm to cope. Research shows that around 1 in people live with BPD. It seems to affect men and women equally, but women are more likely to have this diagnosis. This may be because men are less likely to ask for help. Some people feel that this describes the illness better. Some people who live with BPD think that the name is insulting or makes them feel labelled.
It is meant to describe the way the illness develops. And not a judgement of your character or you as a person. On a bad day, my distress levels go through the roof. I feel unloved, empty and helpless. At times I hate everyone and everything, which I deal with by cutting myself with a razor and by drinking alcohol.
Many people who live with BPD will also experience other mental health problems. Such as depression, anxiety, eating disorders, PTSD and alcohol or drug misuse. People who live with BPD can also be diagnosed with bipolar disorder. The symptoms of bipolar disorder can often be confused with those of BPD. Your GP will look at different things when deciding how best to help you.
So, it can help to keep a record of your symptoms. This can help you and your GP to understand what difficulties you are facing. It may help if you keep a record of:. Only a psychiatrist should make a formal diagnosis. A psychiatrist is part of the community mental health team CMHT.
There may be a waiting list to see your CMHT. When you have your first appointment with the CMHT they will ask you questions to understand how your mental health is affecting you. They will talk to you about:. Psychiatrists use the following guidelines to decide if you have a mental disorder. The guidelines tell your psychiatrist what to look for. They will diagnose you with BPD if you have at least five of the symptoms below.
NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at: www. The NHS does not have to follow these recommendations. But they should have a good reason for not following them. But the NHS should not refuse to give you specialist help because of your diagnosis.
They should have services to support people with BPD. For information about your options please see further down this page. There is no medication to treat BPD. But your doctor may offer you medication if you also have symptoms of another mental illness like anxiety or depression.
There are lots of different types of talking therapies and your doctor should talk to you about what is available, how it may help you and what type of therapy you would like. We have included details below of some of the therapies that your doctor may use.
But these are not available everywhere. And your doctor may recommend other types of talking therapy. The therapy you are offered should last at least 3 months.
If your doctor decides that talking therapies are not suitable, they should explain why. The goal of BPD is to help you accept that your emotions are real and acceptable.
And to challenge how you respond to those emotions by being open to ideas and opinions which are different to your own. DBT usually involves weekly individual and group sessions.
And you should be given an out-of-hours contact number to call if your symptoms get worse. DBT is based on teamwork. You'll be expected to work with your therapist and the other people in your group sessions.
In turn, the therapists work together as a team. Mentalisation-based therapy MBT Mentalisation means the ability to think about thinking. This means looking at your own thoughts and beliefs.
And working out if they are helpful and realistic. This type of therapy also helps you to recognise that other people have their own thoughts, emotions and beliefs. And that you may not always understand these. The therapy also helps you to think about how your actions might affect what other people think or feel. A course of MBT usually lasts around 18 months.
You may first be offered MBT in a hospital as an inpatient. The treatment usually consists of daily individual sessions with a therapist and group sessions with other people with BPD. Some hospitals and specialist centres like you to remain in hospital whilst you are having MBT.
But others recommend that you leave the hospital after a certain period of time but remain being treated as an outpatient. This means that you will visit the hospital regularly. Arts therapies There are different types of arts of creative therapies. These include:. These therapies can be offered individually but they are often done in groups.
Sessions are usually weekly. These therapies can be helpful to people who find it hard to talk about their thoughts and feelings. Therapeutic communities Therapeutic communities are not a treatment themselves. They are places you can go to have treatment. Most therapeutic communities are residential. They help people with long-term emotional problems, and a history of self-harming, by teaching them skills to help them have better relationships. These communities often set strict rules on behaviour.
For example, no drinking alcohol, no violence and no attempts at self-harming. You may stay for a few weeks or months, or you may visit for just a few hours a week.
You may have group therapy and self-help sessions. You would be expected to take part in other activities to improve your self-confidence and social skills. These activities may include household chores, games and preparing meals. Therapeutic communities vary a lot because they are often run by the people who use them. And they shape them based on what they want to achieve.
You may get support from a specialist service if your symptoms are getting worse. These services are not available in all NHS Trusts. And they can be difficult to access. You can speak to your CMHT and if they can refer you to a specialist service.
A mental health crisis is when you need urgent help. You may be feeling suicidal or wanting to self-harm. Your GP should:. If you are already under the CMHT, or a specialist service, then you should have a care plan. The care plan should include a crisis plan that you can follow. Your crisis plan is written by you and your mental health team. It should include:. Your doctor may think about offering you sedative medication. Sedatives can help you feel more relaxed.
But your doctor should not give you sedatives for more than a week. Some people find it helpful to contact emotional support lines during a mental health crisis. There is a list of contact numbers at the bottom of this page. It is common for people who live with BPD to self-harm. Some people find self-harming can help them to deal with painful feelings. But it can cause serious injury, scars, infections, or accidental death. A big focus of BPD treatment is to find other ways to deal with painful emotions.
People who live with BPD are more at risk of suicide or of attempting suicide. Most people who live with BPD who feel suicidal will feel more positive within a few hours. So it is important to use techniques to try and distract from the strong suicidal feelings. You are more likely to die by suicide if you are also using alcohol.
If you drink a lot of alcohol or use drugs, you may find it difficult to get treatment for BPD. But NICE guidelines state that you should be referred to a service that can help with your substance use.
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