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Borderline personality disorder

Borderline personality disorder (BPD) is a mental health condition in which a person has long-term patterns of unstable or turbulent emotions. These inner experiences often result in impulsive actions and chaotic relationships with other people.

Alternative Names

Personality disorder - borderline

Causes, incidence, and risk factors

Cause of borderline personality disorder is 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
  • Sexual, physical, or emotional abuse

This personality disorder tends to occur more often in women and among hospitalized psychiatric patients.

Symptoms

Persons with BPD are often uncertain about their identity. As a result, their interests and values can change rapidly. They also tend to view things in terms of extremes, such as either all good or all bad. Their views of other people can 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:

  • Intense fear of being abandoned
  • Cannot tolerate being alone
  • Frequent feelings of emptiness and boredom
  • Frequent displays of inappropriate anger
  • Impulsiveness, such as with substance abuse or sexual relationships
  • Repeated crises and acts of self-injury, such as wrist cutting or overdosing

Signs and tests

BPD is diagnosed based on a psychological evaluation that assesses the history and severity of the symptoms.

Treatment

Individual talk therapy may successfully treat BPD. In addition, group therapy can sometimes be helpful.

Medications have less of a role in the treatment of BPD. But in some cases, they can improve mood swings and treat depression or other disorders that may occur with this condition.

Expectations (prognosis)

Outlook of treatment depends on how severe the condition is and whether the person is willing to accept help. With long-term talk therapy, the person often gradually improves.

Complications

Calling your health care provider

See your health care provider if you or someone you know has symptoms of borderline personality disorder. It is especially important to seek help right away if you or someone you know is having thoughts of suicide.

References

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personality disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Elsevier Mosby; 2008:chap 39.

Updated: 11/10/2012

David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.


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