By: Rachel Denney

• Individuals with BPD have a history of

unstable interpersonal relationships.
• They have difficulty interpreting
reality and view significant people in
their lives as either completely
flawless or extremely unfair and
uncaring (a phenomenon known as
"splitting"). These alternating feelings
of idealization and devaluation are
the hallmark feature of borderline
personality disorder.
• Because borderline patients set up
such excessive and unrealistic
expectations for others, they are
inevitably disappointed when their
expectations aren't realized.

• This disorder occurs in most by early

adulthood.
• Frantic efforts to avoid real or imagined
abandonment
• A pattern of unstable and intense
interpersonal relationships characterized by
alternating between extremes of idealization
and devaluation
• Identity disturbance, such as a significant and
persistent unstable self-image or sense of self
• Impulsivity in at least two areas that are
potentially self-damaging (e.g., spending, sex,
substance abuse, reckless driving, binge eating)
• Recurrent suicidal behavior, gestures, or
threats, or self-mutilating behavior
• Emotional instability due to significant
reactivity of mood (e.g., intense episodic
dysphoria, irritability, or anxiety usually lasting
a few hours and only rarely more than a few
days)
• Chronic feelings of emptiness
• Inappropriate, intense anger or difficulty
controlling anger (e.g., frequent displays of
temper, constant anger, recurrent physical
fights)
• Transient, stress-related paranoid thoughts or
severe dissociative symptoms
• The causes of borderline
personality disorder
(BPD) are unknown.
• Genetic, family, and social
factors are thought to
play roles.
Risk factors for BPD include:
• Abandonment in
childhood or adolescence
• Disrupted family life
• Poor communication in
the family
• Sexual abuse
• Borderline personality disorder
is more prevalent in females (75
percent of diagnoses made are
in females).
• It is thought that borderline
personality disorder affects
approximately 2 percent of the
general population.
• About 15 to 20 percent of
psychiatric inpatients and about
10 percent of mental health
outpatients have a borderline
personality disorder.
• This personality disorder is very
common among adolescent and
young adults with the highest
rates at the ages between 18
and 35.
•Treatment for this disorder is long
term in nature since the symptoms
have been present for an extended
time and interfere with many aspects
of the person's life. 

•Insight oriented therapy can be helpful

but research is showing an increased
support for a cognitive-behavioral
approach. 

•In other words, the individual's

thoughts and actions are monitored
both by the self and therapist and
specific behaviors are counted and a
plan is made to gradually reduce those
thoughts and behaviors that are seen
as negative. 

•A combined approach may be best,

but either way requires intensive time
and effort.
• Borderline personality disorder can
damage many areas of an individuals
life. Intimate relationships, jobs,
school, social activities and self-
image all can be negatively affected.
• Repeated job losses and broken
marriages are common.
• Self-injury, such as cutting or burning,
can result in scarring and frequent
hospitalizations.
• Suicide rates among people with BPD
are high.
In addition, they can have other mental
health disorders, including:
• Depression
• Substance abuse
• Anxiety disorders
• Eating disorders
• Bipolar disorder
Because of risky, impulsive behavior,
they are also more vulnerable to
unplanned pregnancies, sexually
transmitted diseases, motor vehicle
accidents and physical fights. They
may also be involved in abusive
relationships, either as the abuser or
the abused.
The outlook depends on how severe the condition is and
whether the person is willing to accept help. With long-
term talk therapy, the person will often gradually
improve.
• Because it is thought that
genetics plays a role in BPD,
there is not much to do to
prevent it.
• Therapy for children who
are abused or abandoned in
early life could help them
cope better.
• Having good
communication within the
family
• Getting the individual help
as soon as the signs and
symptoms are noticed
• The essential feature of Borderline Personality Disorder is a pervasive pattern of
instability of interpersonal relationships, self-image, and affects, and marked
impulsivity that begins by early adulthood and is present in a variety of contexts.
Individuals with Borderline Personality Disorder make frantic efforts to avoid real
or imagined abandonment (Criterion 1). The perception of impending separation
or rejection, or the loss of external structure, can lead to profound changes in self-
image, affect, cognition, and behavior. These individuals are very sensitive to
environmental circumstances. They experience intense abandonment fears and
inappropriate anger even when faced with a realistic time-limited separation or
when there are unavoidable changes in plans (e.g., sudden despair in reaction to a
clinician's announcing the end of the hour; panic or fury when someone important
to them is just a few minutes late or must cancel an appointment). They may
believe that this "abandonment" implies they are "bad." These abandonment
fears are related to an intolerance of being alone and a need to have other people
with them. Their frantic efforts to avoid abandonment may include impulsive
actions such as self-mutilating or suicidal behaviors, which are described
separately in Criterion 5.
• BPD is manifested by a pervasive
pattern of instability of interpersonal
relationships, self-image, and affects,
and marked impulsivity beginning by
early adulthood and present in a
variety of contexts, as indicated by
five (or more) of the following:
• Frantic efforts to avoid real or
imagined abandonment. Note: Do not
include suicidal or self-mutilating
behavior covered in (5).
• A pattern of unstable and intense
interpersonal relationships
characterized by alternating between
extremes of idealization and
devaluation. This is called "splitting."
• Identity disturbance: markedly and
persistently unstable self-image or sense
of self.
• Impulsivity in at least two areas that are
potentially self-damaging (e.g., spending,
sex, substance abuse, reckless driving,
binge eating). Note: Do not include
suicidal or self-mutilating behavior
covered in (5).
• Recurrent suicidal behavior, gestures, or
threats, or self-mutilating behavior.
• Affective instability due to a marked
reactivity of mood (e.g., intense episodic
dysphoria, irritability, or anxiety usually
lasting a few hours and only rarely more
than a few days).
• Chronic feelings of emptiness.
• Inappropriate, intense anger or difficulty
controlling anger (e.g., frequent displays
of temper, constant anger, recurrent
physical fights).
• Transient, stress-related paranoid ideation
or severe dissociative symptoms.
What is Borderline Personality Disorder (BPD)?
The main feature of borderline personality
disorder (BPD) is a long pattern of instability in
their relationships with others, and in their own
self-image and emotions. People with borderline
personality disorder are also usually very impulsive.
The instable pattern of interacting with others has
persisted for years and is usually closely related to
the person’s self-image and early social
interactions. The pattern is present in a variety of
settings (e.g., not just at work or home) and often
is accompanied by a similar liability (fluctuating
back and forth, sometimes in a quick manner) in a
person’s emotions and feelings. Relationships and
the person’s emotion may often be characterized
as being shallow. The disorder occurs in most by
early adulthood.
• What is the course of Borderline Personality
• How common is Borderline Personality Disorder?
It is not very common, and is estimated to be
found in 1 to 2% of the general U.S. population at
any give time. It is more common amongst people
seeking treatment for another mental disorder.
• Is Borderline Personality Disorder inherited?
Borderline Personality Disorder is about five times
more common among first-degree biological
relatives of those with the disorder than in the
general population. There is also an increased
familial risk for Substance-Related Disorders (e.g.,
drug abuse), Antisocial Personality Disorder, and
Mood Disorders, like depression or bipolar
disorder.
• How does Borderline Personality Disorder
cause problems?
Like any mental health issue, borderline
personality disorder causes problems in a
person’s social and life functioning by
interfering with the person’s ability to reliably
maintain these relationships or their everyday
living. People with this disorder often cause a
great amount of stress or conflict in
relationships with others, especially significant
others or those who are very close to the
person. This can often lead to divorce, physical,
sexual or emotional abuse, additional
emotional problems (such as an eating disorder
or depression), losing one’s job, estrangement
from one’s family, and more.
Disorder?
There is considerable variability in the course
of Borderline Personality Disorder. The most
common pattern is one of chronic instability in
early adulthood, with episodes of serious loss
of emotion and impulsive control, as well as
high levels of use of health and mental health
resources. The impairment from the disorder
and the risk of suicide are greatest in the
young-adult years and gradually wane with
advancing age. During their 30s and 40s, the
majority of individuals with this disorder attain
greater stability in their relationships and job
functioning.
• "Borderline Personality Disorder." AllPsych Online. AllPsych and Heffner Media
     Group, Inc., 15 May 2004. Web. 21 May 2011. <http://allpsych.com/
     disorders/personality/borderline.html>.
• "Borderline Personality Disorder." Encyclopedia of Mental Disorders. Advameg,
     Inc., 2011. Web. 21 May 2011. <http://www.minddisorders.com/A-Br/
     Borderline-personality-disorder.html>.
• "Borderline Personality Disorder." PubMed Health. National Center for
     Biotechnology Information, U.S. National Library of Medicine, 15 Nov. 2012.
     Web. 21 May 2011. <http://www.ncbi.nlm.nih.gov/pubmedhealth/
     PMH0001931/>.
• "Borderline Personality Disorder: Complications." Mayo Clinic. Mayo Foundation
     for Medical Education and Research, 19 May 2010. Web. 21 May 2011.
     <http://www.mayoclinic.com/health/borderline-personality-disorder/DS00442/
     DSECTION=complications>.
• "DSM-IV-TR (2004) Criteria for Diagnosis of Borderline Personality Disorder."
     Borderline Personality Disorder Resource Center. Borderline Personality
     Disorder Resource Center, 2004. Web. 21 May 2011.
     <http://bpdresourcecenter.org/DSM-IV.html>.
• Grohol, John M. "Borderline Personality Disorder." PsychCentral. Psych Central,
     1 June 2012. Web. 21 May 2011. <http://psychcentral.com/lib/2007/
     symptoms-of-borderline-personality-disorder/>.
• Winkler, Martin. "Borderline (Emotionally Unstable) Personality Prevalence -
     Statistics on the Frequency." Web4Health. Web4Health, 21 Aug. 2008. Web. 21
     May 2011. <http://web4health.info/en/answers/border-prevalence.htm>.