Borderline personality disorder (BPD) is a mental health condition. People with BPD have extreme mood swings, unstable relationships and trouble controlling their emotions. They have a higher risk of suicide and self-destructive behavior. Talk therapy is the main treatment for BPD.
Borderline personality disorder (BPD) is a mental health condition marked by extreme mood fluctuations, instability in interpersonal relationships and impulsivity.
People with BPD have an intense fear of abandonment and have trouble regulating their emotions, especially anger. They also tend to show impulsive and dangerous behaviors, such as reckless driving and threatening self-harm. All of these behaviors make it difficult for them to maintain relationships.
Borderline personality disorder is one of a group of conditions called “Cluster B” personality disorders, which involve dramatic and erratic behaviors. Personality disorders are chronic (long-term) dysfunctional behavior patterns that are inflexible, prevalent and lead to social issues and distress.
Many people who live with borderline personality disorder don't know they have it and may not realize there’s a healthier way to behave and relate to others.
While bipolar disorder is also characterized by wide fluctuations in mood and behavior, it’s distinct from borderline personality disorder (BPD).
In BPD, mood and behavior change rapidly in response to significant stress, especially when interacting with other people, whereas in bipolar disorder, moods are more sustained and less reactive. People with bipolar disorder also have significant changes in energy and activity, unlike those with BPD.
Most personality disorders begin in the teen years when your personality further develops and matures. As a result, almost all people diagnosed with borderline personality disorder are above the age of 18.
Although anyone can develop BPD, it’s more common if you have a family history of BPD. People with other mental health conditions, such as anxiety, depression or eating disorders, are also at higher risk.
Nearly 75% of people diagnosed with BPD are people assigned female at birth (AFAB). Research suggests that people assigned male at birth (AMAB) may be equally affected by BPD, but they may be misdiagnosed with post-traumatic stress disorder (PTSD) or depression.
Borderline personality disorder is relatively rare. Approximately 1.4% of the adult U.S. population has BPD.
Signs and symptoms of borderline personality disorder usually appear in your late teenage years or early adulthood. A troubling event or stressful experience can trigger symptoms or make them worse.
Over time, symptoms usually decrease and may go away completely.
Symptoms can range from manageable to very severe and can include any combination of the following:
Not everyone with borderline personality disorder experiences all of these symptoms. The severity, frequency and duration of symptoms are unique to each person.
Healthcare providers believe BPD results from a combination of factors, including:
Personality continues to evolve throughout child and adolescent development. Because of this, healthcare providers don’t typically diagnose someone with borderline personality disorder until after the age of 18. Occasionally, a person younger than 18 may be diagnosed with BPD if symptoms are significant and last at least a year.
Personality disorders, including borderline personality disorder, can be difficult to diagnose, as most people with a personality disorder lack insight into their disruptive behavior and thought patterns.
When they do seek help, it’s often due to conditions such as anxiety or depression as a result of the problems created by their personality disorder, such as divorce or lost relationships, not the disorder itself.
A licensed mental health professional — such as a psychiatrist, psychologist or clinical social worker — can diagnose borderline personality disorder based on the diagnostic criteria for BPD in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.
They do so by performing a thorough interview and having conversations about symptoms. They ask questions that’ll shed light on:
Mental health professionals often work with the person’s family and friends to collect more insight into their behaviors and history.
BPD historically has been challenging to treat. But with newer, evidence-based treatment, many people with borderline personality disorder experience fewer and less severe symptoms, improved functioning and better quality of life.
But effective treatment takes time, patience and commitment. Treatment may include psychotherapy (talk therapy), medications or both.
Your healthcare provider may recommend a short-term hospital stay if you’re very distressed or at risk of harming yourself or others. During your stay, your healthcare provider will work with you to develop a treatment plan.
People with borderline personality disorder often have other mental health conditions, including:
If they have a co-existing condition, they’ll also need treatment for it.
Psychotherapy (talk therapy) is the treatment of choice for borderline personality disorder. The goal of treatment is to help you uncover the motivations and fears associated with your thoughts and behavior and to help you learn to relate to others more positively.
Types of therapy that can help treat BPD include:
Because the benefits of prescription medication for borderline personality disorder are unclear, healthcare providers typically don’t prescribe medications as the main treatment for BPD.
But in some cases, a psychiatrist may recommend medications to treat specific symptoms or co-occurring mental health conditions. Medications can treat anxiety and depression, regulate mood swings or help control impulsive behavior. Antipsychotic (neuroleptic) drugs help some people with BPD.
Unfortunately, there’s no way to prevent borderline personality disorder.
BPD is often inherited (passed through families), which means you have an increased risk of developing the condition if you have a family history of BPD. Ask your healthcare provider how to recognize signs of the disorder so you can get treatment as early as possible.
Most of the time, BPD symptoms gradually decrease with age. Some people’s symptoms disappear in their 40s. With the right treatment, many people with BPD learn to manage their symptoms and improve their quality of life.
Without treatment, people with borderline personality disorder have an increased risk of the following:
The risk of suicide in people with BPD is 40 times that of the general population. About 8% to 10% of people with BPD die by suicide.
Many people with untreated BPD also experience unstable or chaotic personal relationships and have trouble keeping a job. They have an increased risk of divorce, estrangement from family members and rocky friendships. Legal and financial problems are also common.
If you know someone who lives with borderline personality disorder, here are some ways you can help them:
People with BPD have a significantly higher rate of self-harming and suicidal behavior than the general population.
People with BPD who are thinking of harming themselves or attempting suicide need help right away.
If you or someone you know is in immediate distress or thinking about hurting themselves, call the Suicide and Crisis Lifeline toll-free at 988.
A note from Cleveland Clinic
It’s important to remember that borderline personality disorder (BPD) is a mental health condition. As with all mental health conditions, seeking help as soon as symptoms appear can help decrease the disruptions to life. Mental health professionals can offer treatment plans that can help people with BPD manage their thoughts and behaviors.
The family members and loved ones of people with borderline personality disorder often experience stress, depression, grief and isolation. It’s also important to take care of your mental health and seek help if you’re experiencing these symptoms.
Last reviewed by a Cleveland Clinic medical professional on 05/20/2022.
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