Borderline Personality Disorder

Chaotic and intense: the keys to borderline personality disorder

Borderline personality disorder (BPD) is misunderstood and difficult to diagnose and is often confused with pathologies such as bipolar disorder or attention deficit hyperactivity disorder (ADHD), it has its own characteristics and symptoms that differentiate it.

What is borderline personality disorder?

Borderline personality disorder is a mental health condition characterized by an ongoing pattern of unstable moods, self-images, and behaviors. These symptoms often result in impulsive actions and problems in relationships with other people. A person with borderline personality disorder may have episodes of anger, depression, and anxiety that can last from a few hours to several days. Although recognizable symptoms usually appear during adolescence or early adulthood, the first symptoms of the disease may appear during childhood

What are the signs and symptoms?

People with borderline personality disorder may have mood swings and be uncertain about how they see themselves and their role in the world. As a result interests and values ​​can change quickly. People with borderline personality disorder also tend to see things very black and white, as if everything is good or everything is bad. Opinions of other people can also change quickly. A person who is considered a friend one day may be considered an enemy or traitor the next. These changes in feelings can lead to intense and unstable relationships.

Other signs or symptoms may include:

  • Efforts to avoid real or imagined abandonment, such as quickly entering into intimate relationships (physical or emotional) or cutting off communication with someone out of fear of being abandoned
  • A pattern of intense and unstable relationships with family, friends, and loved ones, often shifting from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)
  • Distorted and unstable self-image or sense of identity
  • Impulsive and often risky behaviors, such as crazy shopping, unprotected sex, substance abuse, reckless driving, and binge eating.
  • Self-destructive behaviors, such as cutting
  • Recurrent thoughts of suicidal behavior or threatening suicide
  • Intense and highly changeable moods, with episodes lasting from a few hours to several days
  • Chronic feelings of emptiness
  • Intense and inappropriate anger or problems controlling anger
  • Difficulty trusting, which is sometimes accompanied by an irrational fear of other people’s intentions
  • Feelings of dissociation, such as feeling distanced from oneself, looking at oneself from outside one’s body, or losing touch with reality

Not all people with borderline personality disorder have all of the symptoms. Some people have only a few symptoms, while others have many. Symptoms can appear from seemingly mundane events. For example, people with borderline personality disorder may become angry and distressed over minor separations from people they feel close to, whether due to business trips or change of plans. The severity and frequency of symptoms and how long they last vary depending on the person and the context.

What causes borderline personality disorder?

Scientists aren’t sure what causes borderline personality disorder, but research suggests that genetic, environmental, and social factors play a role.

Family history. People who have a close relative (such as a parent or sibling) with this disorder may be at increased risk of developing borderline personality disorder or features of the disorder (such as impulsiveness and aggressiveness). Biological factors. Studies show that people with borderline personality disorder may have structural and functional changes in the brain, especially in the areas that control impulses and emotional regulation. But it’s not clear whether these changes were risk factors for the disorder or caused by the disorder. Environmental, cultural and social factors. Many people with this disorder report that they have had traumatic events during childhood, such as abuse, neglect, or adversity. Other people may have been exposed to hostile conflict and unstable relationships in which they felt invalidated.

Although these factors may increase a person’s risk of having borderline personality disorder, they do not necessarily mean that they will have it. Likewise, there may be people without these risk factors who will develop borderline personality disorder at some point in their lives

How can I tell if I have borderline personality disorder?

A licensed mental health professional with experience diagnosing and treating mental disorders (such as a psychiatrist, psychologist) can diagnose borderline personality disorder based on a thorough interview and discussion of symptoms. A complete and thorough medical exam can also help rule out other possible causes of the symptoms. The mental health professional may also ask about the patient’s and family’s symptoms and medical history, including any history of mental illness. This information can help the mental health professional decide on the best treatment.

What other illnesses often occur with Borderline Personality Disorder?

Borderline personality disorder often occurs with other mental illnesses. These co-occurring disorders can make diagnosis and treatment of borderline personality disorder difficult, especially if the symptoms of other illnesses coincide with the symptoms of borderline personality disorder. For example, a person with borderline personality disorder may be more likely to also develop symptoms of major depression, bipolar disorder, anxiety disorders, substance abuse, or eating disorders.

How is borderline personality disorder treated?

Borderline personality disorder has historically been viewed as a difficult disorder to treat. However, with the latest evidence-based treatments, many people with this disorder have fewer or less severe symptoms and have better quality of life. It is important that patients with borderline personality disorder receive specialized evidence-based treatment by an appropriately trained mental health professional. Other types of treatment, or treatments offered by a provider who is not properly trained, may not benefit the patient. Many factors affect how long it takes for symptoms to improve once treatment begins, so it is important for people with this disorder, as well as their loved ones, to be patient and receive adequate support during treatment.

It is important to seek treatment and stick with it

Studies funded by the National Institute of Mental Health (NIMH) indicate that patients with borderline personality disorder who are not receiving appropriate treatment are more likely to have other chronic medical or mental illnesses and they are less likely to make healthy lifestyle choices. Borderline personality disorder is also associated with a significantly higher rate of suicidal and self-destructive behavior than in the general population.


Psychotherapy is the first treatment for people with borderline personality disorder. It can be offered individually with a therapist or in a group session. Therapist-led group sessions can help teach people with this disorder how to interact with others and how to express themselves effectively. It is important for people in therapy to get along with and trust their therapist. The very nature of borderline personality disorder can make it difficult for people with this disorder to form a trusting and easy bond with their therapist. Two examples of psychotherapies used to treat borderline personality disorder include dialectical behavior therapy and cognitive behavior therapy.

Dialectical behavior therapy, which was developed for people with borderline personality disorder, focuses on the concept of being mindful, or recognizing and being attentive to the current situation and emotional state. This type of therapy also teaches skills to control intense emotions, reduce self-destructive behaviors, and improve relationships.

Cognitive behavioral therapy can help people with borderline personality disorder identify and change core beliefs or behaviors underlying misperceptions of themselves and others, as well as problems interacting with others. This type of therapy can help decrease symptoms of mood swings and anxiety, as well as reduce the number of suicidal or self-destructive behaviors.


Medications are not generally used as the main treatment for borderline personality disorder because the benefits are unclear. However, in some cases, a psychiatrist may recommend medication to treat specific symptoms, such as mood swings, depression, or other mental disorders that can occur with borderline personality disorder. Medication treatment may require the attention of more than one medical professional.

Some medications can cause different side effects in different people. People with this disorder should talk to their doctor about what to expect.

Other aspects

Some people with borderline personality disorder have severe symptoms and require extensive care, often requiring hospitalization. Other people may need outpatient treatment but never need hospitalization or emergency care.

If you or someone you know may be suffering from Borderline Personality disorder, then don’t hesitate to contact with a healthcare professional in the ESHA Spain directory.


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