What is borderline personality disorder?
BPD is one of many personality disorders listed in the manuals used by doctors when they are giving someone a psychiatric diagnosis.
Below are the symptoms of borderline personality disorder according to government guidelines (National Institute for Health and Care Excellence [NICE] 2009). A doctor may diagnose you with borderline personality disorder if you have five or more of these symptoms and if the symptoms have a significant impact on your everyday life.
- you have emotions that are up and down (for example, feeling confident one day and feeling despair another), with feelings of emptiness and often anger
- you find it difficult to make and maintain relationships
- you have an unstable sense of identity, such as thinking differently about yourself depending on who you are with
- you take risks or do things without thinking about the consequences
- you harm yourself or think about harming yourself (for example, cutting yourself or overdosing)
- you fear being abandoned or rejected or being alone
- you sometimes believe in things that are not real or true (called delusions) or see or hear things that are not really there (called hallucinations).
If you have been diagnosed with borderline personality disorder you may be more likely to experience other mental health related problems, such as depression, anxiety, eating disorders or substance misuse (misusing drugs or alcohol).
The question of 'personality disorders' is controversial. What some experts term as 'personality' others regard as 'the self'; so any suggestion that a person's self is disordered, damaged or flawed can be distressing. What matters is that you get the help you feel you need. If after reading this booklet you feel you may have BPD, you may want to talk to someone who is medically qualified – be very wary of making a self-diagnosis.
How common is BPD?
BPD is thought to affect less than one per cent of the general population. It's been estimated that three-quarters of those given this diagnosis are women. It's a condition that is usually diagnosed in adults only.
What if I disagree with the diagnosis?
Some people feel they are only given this diagnosis because they do not fit easily into any other category. If you feel your GP or psychiatrist has misunderstood you, you are entitled to ask for a second opinion, although this doesn't necessarily mean that your request will be granted. If you are having problems getting the help you need, you may find an advocate (someone who can speak up for you and support you) useful. (For more information about advocates, contact the Mind Infoline or see The Mind guide to advocacy.)
What are the common feelings and experiences of people with BPD?
If you have BPD you may have had a series of unstable and intense relationships, or felt the need to cling too long to damaging relationships. This may be because you feel insecure, alone or lack self-worth.
You may have a poor self image, feel that you don't fit or belong, and find that your moods and feelings change rapidly. Therefore you may find social relationships difficult.
I have BPD and for me it feels like [I'm] a child being forced to live in an adult world. I feel too fragile and vulnerable for the world I live in.
Many people with BPD experience a deep sense of emptiness.
Feeling bereft and lifeless – with a void I can't fill no matter how much food I put down or activity, exercise, self harm and constant thinking I've gone through. I try to keep busy to combat the emptiness but it only masks it. The best antidote is to try to experience life and relationships more fully, then store the better memories.
You may feel tempted to harm yourself if your emotions become intensely painful and hard to cope with or express.
When it was really bad, I would be in so much emotional pain that suicide seemed like the only way I could find any release. My attempts at overdosing kept failing: I was secretly screaming for someone to just listen to me and show me a way out. But in the end, if they wouldn't or couldn't be bothered to help me I would rather have been dead than carry on as I was – I just didn't care about anything, apart from getting rid of the pain.
Research shows that people with BPD are more likely to have suicidal thoughts and make suicide attempts compared to people with other psychiatric diagnoses. If this applies to you, or someone close to you, you can find information about where to get help in the tab Getting help in an emergency.
What causes BPD?
The causes of BPD are unclear. Most researchers think that BPD develops through a combination of factors, including temperament, childhood and adolescent experiences. Difficult life events such as the early loss of a parent, childhood neglect, sexual or physical abuse are common in people diagnosed with BPD, though this is not always the case.
Stressful experiences, such as the break-up of a relationship or the loss of a job, can lead to already present symptoms of BPD getting worse.