How to Spot the Signs of Borderline Personality Disorder

By Kevin P. Caputo, M.D.

Borderline personality disorder (BPD) is a mental health disorder that affects the way someone feels about themselves and the people in their lives. A person suffering from the disorder is prone to extreme emotions, intense outbursts, unstable relationships, and a distorted self-image. While the people around them may see these behaviors and reactions as out of proportion and inappropriate for a given situation, they feel completely normal and justified to the person with borderline personality disorder.

Although BPD is not talked about as much as depression or anxiety, it’s fairly common. As many as 4 million Americans have been diagnosed with the disorder, and 75 percent of the people diagnosed are women. On top of this, the number of people with the disorder may actually be higher, since sufferers are frequently misdiagnosed with other mental health issues such as post-traumatic stress disorder (PTSD), bipolar disorder, or a major depressive disorder.

Proper diagnosis and treatment are critical since BPD can be very dangerous when left untreated. Roughly 70 percent of people diagnosed with the disorder will make at least one suicide attempt in their lifetime and 10 percent will complete the attempt, which is 50 times greater than the suicide rate among the general population.

What Are the Signs and Symptoms of BPD?

Many people will experience one of the following symptoms occasionally. However, a person with BPD will experience many of these symptoms regularly throughout their adult life:

  • A fear of abandonment coupled with extreme measures to avoid being alone or rejected
  • An unstable self-image and distorted sense of self
  • Unstable relationships with family and friends that fluctuate between idealization and intense dislike
  • Periods of stress-induced paranoia
  • Impulsive and risky behavior involving gambling, reckless driving, unsafe sex, binge eating and drug abuse, or self-sabotage of their own success
  • Wild mood swings that last a few hours or a few days
  • Suicidal threats or behavior, frequently in response to abandonment
  • Inappropriate and intense anger
  • Difficulty feeling empathy for other people

Who Is At-Risk for BPD?

The causes of BPD are not fully understood, but genetics, environmental and social issues, and potential brain abnormalities increase the risk for some people.

BPD runs in families, which means there may be a genetic predisposition that makes some people more likely to experience BPD than others. In fact, people with a close family member who has BPD are up to five times more likely than the general population to have BPD themselves.

Experiencing traumatic life events – such as abandonment or abuse as a child – may also make it more likely for someone to have BPD. However, it’s important to note that not everyone who experiences trauma will have BPD, and not everyone with BPD has experienced trauma.

Some research has shown that changes in the brain may make it more likely for someone to develop BPD, especially if those changes happen in areas of the brain responsible for impulse control and mood regulation.

Treating BPD Can Be Difficult

Treating BPD is complex but when done correctly and consistently, research shows that it helps to reduce the symptoms. The gold standard for treatment currently is talk therapy, focused on helping sufferers develop mindfulness of their emotions and an understanding of how other people may be thinking and feeling.  This type of therapy is evidence-based and typically is a long term solution to maladaptive behaviors that have taken place for years.

Medications are not used to treat BPD directly but can be used to help with other conditions that often occur with BPD, such as anxiety, depression, and the transient paranoia that accompanies the individual while under stress.

If you think you or a loved one may be suffering from BPD, talk to your doctor about your treatment options. If you’re experiencing suicidal feelings, call 911 right away.

About the Author

Kevin P. Caputo, M.D.

Dr. Caputo believes a trusting, open relationship is important to facilitate the healing process. He feels it is important for patients to be educated in order to create the best outcome.

To schedule an appointment with Dr. Caputo, please call 610-874-5257.

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