What it is
Borderline Personality Disorder is a pattern of intense emotions, unstable self-image, and difficulties in relationships and impulse control. People with BPD often feel emotions more quickly and strongly and may struggle to return to baseline. BPD is treatable—many improve substantially with the right therapy and support.
Common myths (not true): “BPD can’t be treated,” “people with BPD are manipulative.” The reality: behaviors usually reflect efforts to manage overwhelming emotions and fear of abandonment.
Common signs and symptoms
- Emotions: rapid mood shifts, intense anger, emptiness, shame
- Relationships: fear of abandonment, “push–pull” dynamics, idealization then disappointment
- Self-image: unstable sense of self, sudden shifts in goals/values
- Impulsivity: spending, substance use, binge eating, reckless driving
- Self-harm/suicidality: urges or behaviors in response to emotional pain
- Dissociation or feeling unreal, especially under stress
BPD often co-occurs with PTSD/trauma histories, depression, anxiety, ADHD, eating disorders, or substance use.
Why it happens
- Biological sensitivity to emotion plus slower return to calm
- Early invalidation/trauma, attachment disruptions, chronic stress
- Skills gaps in emotion regulation, distress tolerance, and interpersonal effectiveness
What helps
- Gold-standard therapy: Dialectical Behavior Therapy (DBT)
- Skills modules: mindfulness, emotion regulation, distress tolerance, interpersonal effectiveness
- Individual therapy, skills group, and between-session coaching (program-dependent)
- Other effective therapies
- Mentalization-Based Therapy (MBT), Schema Therapy, Transference-Focused Psychotherapy (TFP), Good Psychiatric Management (GPM)
- Medications
- No medication “for BPD,” but SSRIs/SNRIs can help depression/anxiety; mood stabilizers or atypical antipsychotics may target anger/impulsivity—use judiciously
- Safety plan
- Clear steps for self-harm urges; crisis lines; remove means; coping toolkit
- Lifestyle and supports
- Sleep, routines, exercise, substance reduction
- Boundaries and communication skills in close relationships; peer support groups
Recovery is common: many experience significant symptom reduction within 1–3 years of consistent therapy.
When to seek help now
- Self-harm or suicidal thoughts
- Escalating substance use, dangerous impulsivity
- Relationship or housing crises
How to talk to a clinician
- “I have intense emotions, fear of abandonment, and self-harm urges. I’d like DBT or MBT and help building a safety plan.”
Resources for readers in the USA
- Immediate help: 988 Suicide & Crisis Lifeline (call/text 988); Crisis Text Line (text HOME to 741741); The Trevor Project for LGBTQ+ youth: 1-866-488-7386 or text START to 678678
- Find care: Psychology Today (filter for DBT/MBT/Schema/TFP); FindTreatment.gov; NAMI HelpLine (nami.org/help)
- BPD-specific: National Education Alliance for BPD (NEABPD) family connections program: neabpd.org
- Low-cost/community: Open Path Collective; Community Health Centers (findahealthcenter.hrsa.gov); 211
- Insurance tips: Ask about in-network DBT programs (group + individual), session limits, prior authorization, copay/coinsurance, deductible, out-of-pocket max; note rep name/date/reference number
- Work/school supports: ADA accommodations; EAP; campus counseling
- Urgent options besides ER: Mobile Crisis via 988 (where available), behavioral urgent care
Disclaimer: Educational information, not a diagnosis. If in crisis, use the resources above.