Borderline personality disorder (BPD) is a condition characterized by difficulties in regulating emotion. It’s estimated that 1.6% of the adult U.S. population has BPD but it may be as high as 5.9%. 75% of people diagnosed with BPD are women. Men may be as frequently affected by BPD but are often misdiagnosed with PTSD or depression.
Signs and symptoms may include:
- Frantic efforts to avoid being abandoned by friends and family.
- Having emotions that are intense and last for long periods of time.
- Difficulty returning to a stable emotional baseline after experiencing emotional stimuli.
- Unstable personal relationships that alternate between idealization and devaluation.
- Distorted and unstable self-image
- Not knowing what your values, opinions, and goals are.
- Impulsive behaviors like excessive spending, unsafe sex, substance abuse or reckless driving.
- Suicidal and self-harming behavior.
- Periods of intense depressed mood, irritability or anxiety
- Chronic feelings of boredom or emptiness.
- Intense or uncontrollable anger—often followed by shame and guilt.
- Dissociative feelings
- Stress-related paranoid thoughts. Severe cases of stress can also lead to brief psychotic episodes.
BPD symptoms in adolescence are less fixed and may respond more quickly to intervention. This makes the adolescent years a critical period in which to initiate treatment.
Signs and symptoms may include:
- Instability in interpersonal relationships
- Impulsive behavior (beyond the normal teenage trajectory of impulsivity)
- Chronic emptiness and unstable sense of self
- Repetitive nonsuicidal self-injury (NSSI) and suicidal behavior
- Increased risk-taking and tendency to act impulsively in response to aversive emotional states, not taking into account the short and long-term consequences
- Sexual risk taking
- Substance use (often used for the purpose of affect-regulation in aversive emotional states)
- Impairments in functioning in social relationships, frequent fights and unstable relationships
- Poor academic performance
- A mixture of high levels of both internalizing (depressive symptoms, anxiety) and externalizing problems (conduct problems, attention-deficit/hyperactivity disorder symptoms)
- Frequent anger outbursts and disruptive behavior
- Very low self-esteem, insecure identity, lack of life goals
Watch a video of Marsha Linehan discussing BPD and why she developed DBT: https://www.nimh.nih.gov/news/media/2011/linehan.shtml
Sources: (2017) NAMI https://www.nami.org/Learn-More/Mental-Health-Conditions/Borderline-Personality-Disorder