BPD is a rare type of personality disorder where someone has difficulty processing or managing their emotions. It can range from self-image issues to varying moods and behavioral changes.

Borderline personality disorder (BPD) is a type of personality disorder in which a person has difficulty processing or managing their emotions. It often involves self-image issues, varying moods, and behavioral changes. In addition, it can cause a sense of instability and insecurity.

These symptoms can cause a person to engage in impulsive behaviors and develop strained relationships with family members, significant others, friends, and acquaintances.

About 1.4 percent of the population in the United States is living with BPD. Around 75 percent of diagnosed cases involve women, according to the National Alliance of Mental Illness (NAMI). But some experts believe BPD may be just as common in men. It’s often misdiagnosed as post-traumatic stress disorder (PTSD) or depression.

Living with BPD can look slightly different for everyone. However, there are certain signs and symptoms that can indicate borderline personality disorder may be present.

Some common signs and symptoms include:

  • self-harming behaviors, such as cutting
  • pattern of intense and unstable relationships with family, friends, significant others, and other loved ones
  • efforts to avoid abandonment, which can include leaving someone first or rushing into emotional or physical relationships with others
  • unstable and distorted self-image
  • impulsive behaviors, including spending sprees, unsafe sexual intercourse, binge eating or drinking, reckless driving, or others
  • feeling of emptiness that doesn’t go away
  • trouble trusting others and irrational fear of what other people are intending
  • anger issues, which can include irrational, intense anger or issues with controlling anger
  • feeling dissociated from your body
  • intense and quickly changing moods
  • suicidal thoughts or threats

You may experience all, some, or only a few of the signs and symptoms if you’re living with BPD. Certain events or people may trigger some of the symptoms.

Many of the symptoms of BPD can overlap with other mental health conditions, such as PTSD or depression. It’s important to talk with a mental health professional if you or someone you care about seems to be dealing with new or worsening mental health issues.

A diagnosis from a professional is often the first step toward proper treatment.

Several factors may influence the development of BPD, but researchers still don’t know the exact causes. Some think that genetic predisposition combined with environmental factors may be involved.

The most likely causes include:

  • genetics
  • environmental factors
  • changes in brain chemistry

It’s important to note that you may have exposure to one or more of the causes and never develop BPD.

Genetics

Research suggests that genetics, such as having a close family relative living with BPD, may increase your risk of developing the condition. But scientists haven’t found a specific gene or profile related to the development of BPD.

Environmental factors

Your environment may increase your risk of developing BPD.

According to a 2021 review, the effects of traumatic experiences in childhood are enhanced when “the dysfunctional familial environment that produces traumas interacts with the child’s innate temperamental traits or specific genetic polymorphisms.”

In other words, when combined with a prolonged stressful environment and other genetic risk factors, trauma from abuse, sexual assault, bullying, or other stressors in your childhood may cause the development of BPD.

Changes in brain function structure

Some research suggests that changes in how your brain functions and structure may increase your risk of developing BPD. The changes may influence impulsive behaviors and make it difficult to regulate emotions.

However, it’s not clear if the changes occur as a potential cause or risk factor, or if they occur as a result of living with BPD.

You may be at risk of developing BPD if:

  • you have a family member living with BPD
  • you experienced emotional, sexual, or physical abuse, bullying, attachment issues, social issues, or other traumatic events during your childhood

People living with BPD may not always receive a correct diagnosis.

For example, there’s a large discrepancy between the number of women who are living with BPD and the number of men who are living with it. An estimated 75 percent of diagnosed cases involve women, which leads some to believe that doctors may misdiagnose BPD in men.

A primary care doctor typically can’t diagnose BPD, but they may be able to refer you or a loved one to a licensed mental health professional. Some professionals who can diagnose the condition include:

  • psychiatrist
  • psychologist
  • clinical social worker

In order to diagnose BPD, a mental health professional will typically need to:

  • interview you about your symptoms and other topics pertinent to your mental and emotional health
  • ask about your family’s medical history and history of mental health issues

Diagnosing BPD can be challenging because it can often occur along with other mental health conditions, such as anxiety or depression.

That is, you may be dealing with symptoms of depression that may mask or overshadow symptoms of BPD, which can lead to a misdiagnosis of BPD.

Your mental health professional may recommend one or more treatments for BPD, including psychotherapy, medication, or hospitalization.

Psychotherapy

Psychotherapy is typically the main treatment for BPD. Your mental health professional may recommend one of the following types:

Cognitive behavioral therapy (CBT)

CBT helps you to identify and change unhealthy beliefs, behaviors, and inaccurate perceptions you may have about yourself or others. It teaches you better ways to react when you feel angry, insecure, anxious, or have suicidal thoughts.

Dialectical behavior therapy (DBT)

DBT teaches you how to recognize, be aware of, and accept your beliefs and behaviors. You can also learn more balanced responses to the behaviors of others.

Schema-focused therapy

Schema-focused therapy helps you to view yourself and the world in a more positive way.

Medication

Medication doesn’t cure BPD, but it can relieve symptoms. Your doctor may prescribe medication in addition to psychotherapy treatment to help with changes in mood or depression. For example, they may prescribe:

  • antidepressants to treat depression
  • antipsychotics to treat aggressive symptoms
  • antianxiety medications to treat anxiety

If you experience side effects from your medication, you should talk with your doctor. They may be able to recommend different medication or treatment options.

Hospitalization

If your symptoms are severe, your doctor may recommend that you temporarily stay in a hospital for treatment.

It’s important to remember not to feel shame or embarrassment regarding a hospital stay. Getting the treatment you or a loved one needs is an important part of self-care.

Therapy for family members

Family members may also benefit from therapy. In some cases, therapies may involve family members during one or more sessions. This may help them to both understand the condition better and help provide support.

BPD may raise your risk of developing other conditions, such as:

Your BPD symptoms can also increase your risk of:

  • work issues
  • relationship issues
  • being in an abusive relationship, as the abused or the abuser
  • sexually transmitted infections
  • self-injury
  • suicidal ideation
  • getting in a motor vehicle accident
  • getting in physical fights
  • becoming the victim of violent crimes

Suicide prevention

If you think someone is at immediate risk of self-harm or hurting another person:

  1. Call 911 or your local emergency number.
  2. Stay with the person until help arrives.
  3. Remove any guns, knives, medications, or other things that may cause harm.
  4. Listen, but don’t judge, argue, threaten, or yell.
  5. If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Living with BPD doesn’t mean you can’t live a full, happy life surrounded by loved ones. In fact, many treatments can help you and your family successfully manage the condition.

You also may find that, with proper treatment, your symptoms may become less severe. This doesn’t mean you may never experience symptoms again, but treatment can help you become better equipped to handle them.

One of the most important steps you can take is to seek and stick with your treatment. If you find that a particular type of treatment isn’t working for you, talk with your doctor about other potential options.