Borderline Personality Disorder
Borderline personality disorder (sometimes called BPD) is a particular pattern of extreme personality traits.
In borderline personality disorder, a person generally has difficulty maintaining steady relationships with other people. They may be dramatic, impulsive, and demanding.
People with borderline personality disorder also tend to be moody, experiencing a lot of high highs and low lows. Experiencing very intense, hard-to-control emotions is a hallmark of borderline personality disorder.
It’s normal to experience strong emotions, mood swings, and conflicts with other people at times. But if these conflicts and intense emotions are persistent and extreme enough to cause problems in your day-to-day life, you might have borderline personality disorder.
Unlike many other mental health conditions, personality disorders are usually present in some form throughout a person’s life.
Prevalence of borderline personality disorder
According to The National Institute of Mental Health, at least 1.6% of American adults have borderline personality disorder .
However, the actual percentage may be higher due to mistaken diagnoses of mental health conditions that appear similar to borderline personality disorder.
Borderline personality disorder is much more common for women than for men. About 75% of people diagnosed with borderline personality disorder in the U.S. are women.
Symptoms of borderline personality disorder
Borderline personality disorder can come with a wide array of symptoms, and not everyone will experience the same symptoms.
However, some of the most common symptoms include:
- Intense, often irrational emotions: You might tend to feel things very deeply in a way that is often out of proportion to a situation.
- Tumultuous personal relationships: Your relationships with other people might be unstable, and you might experience quick changes from very positive feelings to very negative ones.
- Fear of abandonment: You may feel constant fear that you will be rejected by your loved ones, to the point that you might actually push them away.
- Self-harm: You might engage in cutting or other self-harming behaviors.
- Thoughts of suicide or suicide attempts: Suicidal thoughts and behaviors are more common for people with borderline personality disorder.
- Impulsive behavior: You might take actions that are risky, dangerous, or erratic.
- Periods of severe anxiety or depression: Borderline personality disorder often comes with at least some symptoms of anxiety or depression.
- Issues with self-image: You may have unrealistic or unstable ideas about yourself, whether positive or negative.
Personality disorders can sometimes be confused with regular personality traits, but the difference is that a personality disorder deviates from cultural norms and causes a person significant trouble on a regular basis.
Types of borderline personality disorder
There is no clear consensus about whether or not different subtypes of borderline personality disorder exist. Some researchers and theorists have attempted to create these definitions, but for the most part they have not yet been clinically tested.
The important thing to note is that different people may experience borderline personality disorder in different ways. In particular, some people may have more outward symptoms, such as impulsive behavior and conflict with others. At the same time, other people may have more inward symptoms, such as paranoia and anxiety.
If you’re not sure whether your symptoms might be borderline personality disorder, it’s best to consult with a therapist or physician for further guidance.
Treatments for borderline personality disorder
There are a number of options that may be helpful if you think you might have borderline personality disorder:
- Therapy. Therapy can be a very helpful way to gain insight into your condition and work on evidence-based strategies to reduce your symptoms. (See tips on finding a therapist below.)
- Group therapy. Group therapy is also a commonly recommended course of treatment for borderline personality disorder, including dialectical behavior therapy (DBT) groups. DBT groups can be especially effective for individuals with BPD as they focus on helping participants build behavioral skills around issues they may be experiencing, such as instability in emotions and relationships.
- Medication: Medication is another option for managing symptoms of borderline personality disorder. Though most medications come with side effects, a psychiatric professional can help you manage these side effects and find the most effective treatment.
- Check-ups: Symptoms that seem like borderline personality disorder can sometimes be related to underlying medical conditions. It’s important to stay up-to-date with visits to your primary care physician to rule out related medical conditions.
- Mindfulness Practices: Some studies have found that meditation and other mindfulness practices can be a tool for easing symptoms of borderline personality disorder.
- Hotlines: If you’re having thoughts of suicide or need immediate support, you can always call the National Suicide Prevention Hotline at at 1-800-273-8255. The Substance Abuse and Mental Health Services Administration hotline at 1-800-622-4357 can also help you locate resources and treatment options.
What to look for in a therapist for borderline personality disorder
Look for a therapist who has a specialty in treating borderline personality disorders, ideally with DBT
Dialectical Behavioral Therapy (DBT) is often considered the best treatment for individuals with borderline personality disorder.
Several studies have found that DBT can be effective for individuals with BPD in improving coping skills, stabilizing mood, improving interpersonal skills, and reducing risk of suicide. 
Other therapy types that are utilized in the treatment of borderline personality disorder include:
Prioritize a personal fit
While personality fit is a nuanced factor, it is critical to your success in therapy. Multiple studies have revealed the importance of this factor, often referred to as “therapeutic alliance.”
On your initial phone call with the therapist, ask yourself:
- Could I see myself forming a connection with this therapist?
- Does their approach suit my personality?
- Do I feel like I will be heard and respected by this therapist?
Consider cost, location, and scheduling
Therapy will only work if it works for you. Before making an appointment, ask yourself honestly:
- Can I afford these session fees? The cost of therapy for for personality disorders depends on location, practitioner, and whether you’re using insurance.
- Can I commit to attending sessions regularly? Remember to account for travel time, and other demands in your schedule.
- Do the therapists’ available times work for me? Some therapists offer evening and weekend appointments if you have an otherwise limited schedule.