Mental health diagnoses share common features. Most, if not all, arise from multiple developmental factors. They are commonly defined by their symptomatology and, most importantly, must cause significant distress or impairment to be considered a disorder. Personality disorders include these features but are distinct due to their pervasive, inflexible, and stable nature over an extended period. It is important to note that these disorders do not define an individual’s personality; rather, they are associated with one’s inner experience and interactions with oneself, others, and the world.
This blog will focus on Borderline Personality Disorder (BPD). Not to be confused with Bipolar Disorder—which shares similar initials and some overlapping symptoms but is fundamentally different—BPD will be examined through its symptoms and clinical approaches to treatment.
Like many other disorders, BPD has symptoms that affect both an individual’s internal experience and outward behavior. This section will focus on the former. While this is not a comprehensive list, it covers key characteristics of BPD. Individuals with BPD often experience an intense fear of abandonment, which drives many of their other symptoms. They also exhibit a rapidly shifting sense of self. In addition, people with BPD frequently experience drastic emotional fluctuations, persistent feelings of emptiness, and heightened sensitivity to emotional and physical pain. Some individuals may also suffer from stress-related paranoia. While these experiences are not exclusive to BPD, experts often describe them as being deeply tied to a sense of self that is largely defined by external validation and interactions with others.
From these internal experiences arise many observable symptoms of BPD. The disorder often results in unstable relationships, affecting not only the health of these relationships but also the way individuals with BPD perceive and treat their loved ones. Impulsivity is another common feature, leading to actions taken without forethought. Many individuals with BPD report frequent emotional outbursts and intense reactions that are disproportionate to the event which is occurring. Additionally, BPD may manifest in repeated self-destructive behaviors or threats. While these behaviors can be distressing for those around the individual, it is crucial to recognize that they stem from internal struggles rather than malicious intent. Contrary to harmful stereotypes, BPD is not defined by manipulative or malevolent behavior. Instead, it reflects a deep desire for connection and an overwhelming fear of rejection by loved ones.
As with most mental health disorders, BPD has multiple contributing factors, though its exact causes remain unclear. The two primary developmental factors are believed to be trauma and genetic predisposition. Marsha Linehan, the founder of Dialectical Behavior Therapy (DBT) and a clinician who personally lived with BPD, describes the disorder as developing when an emotionally vulnerable individual grows up in an invalidating environment. For many people with BPD, both conditions were present and played a role in shaping the disorder.
While symptoms, presentation, and contributing factors help with diagnosis, receiving a BPD diagnosis is not a life sentence. Instead, it offers insight and guidance for healing and personal growth. However, a formal diagnosis is not the only path to self-understanding and support. Mental health diagnoses exist on a spectrum, and within that spectrum, balance is essential. It is important to seek both understanding and identity beyond the disorder, combat stigma, and, above all, maintain hope.
This hope is not unfounded. There are evidence-based ways to address BPD and its symptoms. As with many mental health conditions, self-care and social support are vital for healing. Research suggests that even one stable, supportive relationship can significantly aid recovery. Talk therapy, particularly DBT, has been proven effective in treating BPD. Developed specifically for BPD, DBT emphasizes both self-acceptance and the pursuit of positive change. It teaches skills such as mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness—tools that are beneficial beyond BPD and applicable to various life challenges. DBT remains the leading therapeutic approach for BPD, though other treatments that address thoughts, emotions, and their interconnectedness have also shown promise.
Living with BPD can be challenging. The fear of abandonment, difficulty maintaining a stable sense of self, emotional pain, and relationship struggles can feel overwhelming. However, there is a way forward. This information is intended to offer encouragement, regardless of how these symptoms impact your life. You deserve support, and with time and effort, a fulfilling and meaningful life is within reach.
Jackson Van Meter
