The causes of borderline personality disorder (BPD) are unknown. Genetic, family, and social factors are thought to play roles.
Risk factors for BPD include:
Abandonment in childhood or adolescence
Disrupted family life
Poor communication in the family
This personality disorder tends to occur more often in women and among hospitalized psychiatric patients.
People with BPD are often uncertain about their identity. As a result, their interests and values may change rapidly.
People with BPD also tend to see things in terms of extremes, such as either all good or all bad. Their views of other people may change quickly. A person who is looked up to one day may be looked down on the next day. These suddenly shifting feelings often lead to intense and unstable relationships.
Other symptoms of BPD include:
Fear of being abandoned
Feelings of emptiness and boredom
Frequent displays of inappropriate anger
Impulsiveness with money, substance abuse, sexual relationships, binge eating, or shoplifting
Intolerance of being alone
Repeated crises and acts of self-injury, such as wrist cutting or overdosing
Like other personality disorders, BPD is diagnosed based on a psychological evaluation and the history and severity of the symptoms.
Many types of individual talk therapy, such as dialectical behavioral therapy (DBT), can successfully treat BPD. In addition, group therapy can help change self-destructive behaviors.
In some cases, medications can help level mood swings and treat depression or other disorders that may occur with this condition.
The outlook depends on how severe the condition is and whether the person is willing to accept help. With long-term talk therapy, the person will often gradually improve.
1. The five of nine criteria needed to diagnose the disorder may be present in a large number of different combinations. This results in the fact that the disorder often presents quite differently from one person to another, thus making accurate diagnosis somewhat confusing to a clinician not skilled in the area.
2. BPD rarely stands alone. There is high co-occurrence with other disorders.
3. BPD affects between 1 - 2 percent of the population. The highest estimation, 2 percent, approximates the number of persons diagnosed with schizophrenia and bipolar disorder.
4. Estimates are 10 percent of outpatients and 20 percent of inpatients who present for treatment have BPD
5. More females are diagnosed with BPD than males by a ratio of about 3-to-1, though some clinicians suspect that males are underdiagnosed.
6. 75 percent of patients self-injure.
7. Approximately 10 percent of individuals with BPD complete suicide attempts.
8. A chronic disorder that is resistant to change, we now know that BPD has a good prognosis when treated properly. Such treatment usually consists of medications, psychotherapy and educational and support groups.
9. In many patients with BPD, medications have been shown to be very helpful in reducing the severity of symptoms and enabling effective psychotherapy to occur. Medications are also often essential in the proper treatment of disorders that commonly co-occur with BPD.
10. There are a growing number of psychotherapeutic approaches specifically developed for people with BPD. Dialectical behavioral therapy (DBT) is a relatively recent treatment, developed by Marsha Linehan, Ph.D. To date, DBT is the best-studied intervention for BPD. Find out more about DBT in NAMI's Borderline Personality Disorder Brochure.
11. These and other treatments have been shown to be effective in the treatment of BPD, and MANY PATIENTS DO GET BETTER!