What is BPD?
Borderline personality disorder (BPD) is a type of personality disorder. You might be diagnosed with a personality disorder if you have difficulties with how you think and feel about yourself and other people. And if these difficulties make it hard to cope day to day. Experiences of BPD are different for different people. You may experience emotions that are very intense, overwhelming or changeable. You may also experience difficulties with relationships or your sense of identity. You may hear other names for BPD, such as: Emotionally unstable personality disorder (EUPD) Emotional intensity disorder (EID) Borderline pattern personality disorder (borderline pattern PD) It's your choice which term, if any, you use. People have very different views on BPD and there are ongoing debates about the diagnosis of personality disorders. Some people find a BPD diagnosis helpful or validating. Some find it unhelpful or stigmatising. There's no right or wrong way to understand or describe your experiences. The important thing to remember is that you deserve support and understanding.
When is BPD diagnosed?
You might be given a diagnosis of BPD if you experience at least five of the following things. And if they’ve lasted for a long time and have a big impact on different parts of your daily life:
- Feeling very worried about people abandoning you, and like you'd try very hard to stop that happening
- Having intense emotions that last from a few hours to a few days and can change quickly (such as feeling very happy and confident to suddenly feeling low and sad)
- Feeling insecure about who you are, with your sense of self changing significantly depending on who you're with
- Finding it really hard to make and keep stable relationships, and often viewing relationships as completely perfect or completely bad
- Feeling empty a lot of the time Acting impulsively and doing things that could harm you, such as binge eating, using drugs and alcohol, or driving dangerously
- Using self-harm to manage your feelings or feeling suicidal Feeling intense anger, which can be difficult to control
- Experiencing paranoia or dissociation in moments of extreme stress
What's it like to live with BPD?
How you might think or feel
- Lonely
- Overwhelmed by the strength of your emotions and how quickly they change
- Like there's something inherently wrong with you, and that it's your fault if bad things happen to you because you deserve them
- Like you're a bad person, or not a real person at all
- That you don't know what you want from life, or what you like or dislike
- Empty, numb or like you have no purpose
- Like your feelings are impossible to understand or describe Like you're a child in an adult world
How you might behave as a result
- Self-harming or attempting suicide
- Overspending or binge eating
- Using recreational drugs, alcohol or smoking to try to cope with your emotions
- Quitting just before achieving something, or avoiding activities where you think you might fail or be disappointed
- Often changing jobs, hobbies, goals or plans Keeping very busy so you're never alone
How you might think or feel
- That friends or partners will leave you forever if they're angry or upset with you
- That people are judging or thinking badly about you Like no one understands you, or you’re not like other people and will never be able to understand them
- That people are either completely perfect and kind, or bad and hurtful, and there's no middle ground (this is sometimes called 'splitting', or black-and-white thinking)
- Wanting to be close to others but also feeling scared of close relationships
- Like the world is a scary and dangerous place, and you want to run away and hide
How you might behave as a result
- Getting very angry or frustrated with people
- Struggling to trust people
- Having unrealistic expectations of people or contacting them very frequently
- Wanting to be close to people but worrying they'll leave or reject you, and so avoiding or pushing them away
- Spending a lot of time thinking and worrying about things that other people say or do
- Asking for lots of reassurance or testing people’s commitment or opinion of you
- Distancing yourself from people or ending relationships with friends or partners because you think they might leave you
- Anxiously looking out for signs that people might reject you
What causes BPD?
There's no clear reason why some people experience difficulties associated with BPD. Women are given this diagnosis more often than men – more research needs to be done to understand why this is. But it can affect people of all genders and backgrounds. Researchers think that BPD is caused by a combination of factors, including:
- Stressful or traumatic life events
- Genetic factor
- Often having felt afraid, upset, unsupported or invalidated Family difficulties or instability, such as living with a parent or carer who experienced an addiction
- Sexual, physical or emotional abuse or neglect
- Losing a parent
What treatments can help?
Talking therapiesTalking therapies are thought to be the most helpful treatment for BPD, although more research is needed into the types of treatments that are most effective. The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in health care – suggests that the following kinds of talking treatments may be helpful:
- Dialectical behaviour therapy (DBT) – uses individual and group therapy to help you learn skills to cope with difficult emotions. So far, NICE has recommended this treatment for women with BPD who often self-harm, and it's also thought to be helpful for other groups.
- Mentalisation-based therapy (MBT) – aims to help you recognise and understand your and other people's mental states, and to examine your thoughts about yourself and others
How can other people help?
If someone you care about is diagnosed with BPD you might sometimes find it hard to understand their feelings or behaviour, or to know how to help. But there are lots of positive things you can do to support them:
- Be patient
- Don't judge
- Be calm and consistent
- Remind them of their positive traits
- Set clear boundaries
- Plan ahead Learn their triggers
- Provide distractions
- Learn more about BPD
- Help them seek treatment and support
- Take care of yourself