Borderline personality disorder (BPD) is characterized by extreme emotional turmoil that leads to an unstable sense of self, volatile relationships and self-destructive behavior, including suicide attempts. People with BPD are often overwhelmed by intense anger and feelings of abandonment, emptiness, shame and self-loathing. BPD affects both adolescents and young adults.

Symptoms

  • Severely distorted or persistently unstable sense of self
  • Chronic feelings of worthlessness, anger, emptiness, or hopelessness
  • Frequent mood swings and difficulty controlling emotions, especially anger
  • Contradictory emotions over short spans of time, also known as a “black and white” thinking style
  • Brief, intense periods of anxiety or depression
  • Fear of being abandoned or periods of paranoid thinking, resulting in frantic efforts to avoid either real or imagined abandonment
  • Unstable relationships that veer quickly from intense idealization of or attachment to others to intense revulsion or criticism
  • Impulsive behavior such as risky driving, unsafe sex, or alcohol and substance abuse
  • Self-injury and suicidal behavior

Treatment

The gold-standard treatment for borderline personality disorder is a specialized form of cognitive behavioral therapy called dialectical behavioral therapy (DBT).  DBT teaches patients skills to regulate their overwhelming emotions and stop self-destructive behaviors. While in the past PBD was considered largely treatment resistant, long-term studies show that those treated with DBT have a good prognosis: In one study 74% of participants had no active symptoms after 6 years.

Medications cannot treat borderline personality disorder itself but are often used to reduce specific symptoms. Hospitalization may be required for more intense treatment of adolescents or young adults who are at risk of self-injury or suicidal behaviors.

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