Borderline Personality Disorder

Overview

Borderline personality disorder (BPD) is a mental health condition that affects how you think and feel about yourself and other people. People with BPD often experience intense emotions, have trouble calming down, and may switch quickly from feeling fine to feeling very upset. It can be upsetting and confusing, but BPD is not your fault and it can be treated.

BPD is one of the more common mental health conditions. Around 1 in 100 people may have BPD, according to estimates.

BPD often begins in the teenage years or early adulthood. It can affect people of any gender. In some healthcare settings, more women are diagnosed, but men can also have BPD.

Symptoms

Common symptoms

• Strong mood swings that can last from a few hours to a few days
• Intense anger and difficulty controlling anger
• Fear of being abandoned or rejected
• Patterns of unstable or intense relationships
• Feelings of emptiness or boredom
• Acting impulsively, for example with spending, eating, or substance use
• Self-harm or thoughts of self-harm (not always linked to suicide)

Causes

Main causes

• The exact cause is unknown, but it likely involves a mix of genes, brain changes, and life events.
• Many people with BPD have experienced trauma, abuse, or neglect, but not everyone who does develops BPD.
• Difficulties in early relationships with caregivers can contribute.

Risk factors

• Having a close family member with BPD
• Experiencing physical, emotional, or sexual abuse
• Neglect or loss of a parent in childhood
• High stress or unstable living situations

When to see a doctor

See a doctor urgently if:

• You have thoughts of suicide or self-harm
• You feel you might act on dangerous impulses
• You are worried about your safety or someone else's safety

Book a routine appointment if:

• You often feel very emotional or empty
• Your relationships are being damaged by your moods
• You find it hard to manage work, school, or daily life

Diagnosis

There is no blood test or scan for BPD. A psychiatrist or other mental health professional will talk with you in detail about your feelings, thoughts, behaviors, and history. They will ask about your relationships, mood swings, and how you cope. They may also speak with a family member (with your permission) to understand more.

Tests that may be done

• A physical exam or blood tests may be done to rule out other health conditions
• There is no laboratory test to diagnose BPD

What to expect at your appointment

A diagnosis is usually made after several appointments. This is not something that can be decided in one short visit. You may be asked to fill out questionnaires. The process can feel tiring, but it is an important step toward getting the right treatment.

Treatment

Treatment for BPD is based on talking therapies. These help you understand your emotions, manage distressing feelings, and build healthier relationships. The main goal is to help you feel more in control of your life. Some people also use medication for other problems like depression or anxiety.

Self-care at home

• Stick to a regular daily routine
• Avoid alcohol and recreational drugs
• Build coping skills like deep breathing or grounding exercises
• Reach out to trusted friends or family when you feel overwhelmed
• Keep a mood diary to spot patterns

Medical treatments

Specialized talking therapies, such as dialectical behavior therapy (DBT), cognitive behavioral therapy (CBT), and mentalization-based therapy, are proven to help with BPD. These may be offered in individual or group sessions. Medication is not a cure for BPD, but a doctor may prescribe medicines to help with related problems like depression, anxiety, or sleep difficulties. Never stop or change medication without talking to your doctor.

Living with this condition

Living with BPD can feel like an emotional rollercoaster. Many people find it helpful to create structure in their day, plan for difficult moments, and have a list of people or activities that help them feel calmer. It's okay to take things one step at a time.

Lifestyle tips

• Get regular physical activity – even a short walk helps
• Aim for a steady sleep schedule
• Try journaling or creative hobbies to express feelings
• Minimize caffeine, especially in the evening
• Talk to your healthcare team about any substance use

Diet and exercise

Eating balanced meals can help keep your mood steady. Going long periods without food can make you feel worse. Gentle exercise like walking or swimming can reduce stress and improve sleep. There is no special diet for BPD, but taking care of your body supports your mind.

Mental health and emotional wellbeing

BPD can make people feel ashamed, lonely, and misunderstood. You might worry about being judged. Remember that BPD is a health condition, not a weakness. Treatment and support can help you feel more hopeful and rebuild confidence.

Prevention

BPD cannot always be prevented, but early support for emotional difficulties and a safe, caring environment can reduce risks. If you have noticed symptoms, seeking help early can make a difference. Even when symptoms are present, recovery is possible.

Complications

If left untreated

• Self-harm or suicide attempts
• Difficulties at work or in school
• Broken or strained relationships
• Substance misuse
• Other mental health issues, such as depression, anxiety, or eating disorders

Long-term outlook

With appropriate treatment and support, many people with BPD see significant improvement. Some people find that symptoms become less intense with age. Recovery is a journey, not a straight line, but many people build a life they value. You deserve help and hope.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.