Is Borderline Personality Disorder a Serious Mental Illness?

Borderline personality disorder (BPD) is a serious mental illness characterized by intense mood swings and difficulty in relationships. A person who has BPD feels emotions with great intensity, and episodes of anger, anxiety or depression can go on for several days. When people with BPD have experiences that trigger emotional extremes, it can be difficult for them to return to a place of emotional stability.

Living with such stormy emotions leads to turbulent and unstable relationships. Self-esteem suffers, and if you have BPD you may self-harm as a reaction to your inability to control emotional intensity.

Signs and Symptoms of BPD

It’s not always easy to correctly diagnose a person who has BPD, and this condition can be confused with other mental illnesses with similar symptoms such as bipolar disorder, depression or PTSD. Signs and symptoms of borderline personality disorder include:

• Extreme fear of abandonment and frantic efforts to avoid it
• Impulsive and reckless behaviors, such as substance abuse, reckless driving and excessive spending
• Periods of intense emotions and highly changeable moods, such as anger, depression or irritability, which may last for several days
• Recurring suicidal thoughts or attempts
• Self-harming behavior
• Unstable patterns in relationships often swinging from idealizing a partner to intensely hating him or her
• Difficulty controlling anger
• Fearfulness, difficulty trusting others
• Chronic feelings of emptiness or being cut off from oneself

What Causes BPD?

Like other serious mental illnesses, borderline personality disorder doesn’t have one single cause, but it is thought to be caused by a combination of factors. These factors include:

• Biological Factors – There are strong indications that heredity is a factor in this illness, and those who have a close relative with BPD are as much as five times more likely to have it themselves. Additionally, research shows that temperament is biologically-based. The high sensitivity experienced by those with BPD is a biological factor.
• Brain function – There may be a neurological basis for an inability to regulate intense emotions or to make logical, well thought out decisions. It isn’t clear whether changes in the brain leading to impulsive behavior lead to the disorder or are caused by it.
• Environmental factors – Those who have lived in an unstable environment or who have experienced trauma are at increased risk of developing this condition.

Diagnosing Borderline Personality Disorder

A person with BPD may have no idea that they have a serious mental illness. They may simply be aware that their relationships never seem to be stable, that they have difficulty holding a job or keeping their emotions under control. They may tell their doctor only a small part of their symptoms, such as emphasizing depressive episodes or periods of anxiety.

To come up with a diagnosis, a doctor or mental health professional would perform a complete physical to rule out any medical reasons for instability or emotional outbursts.  The medical professional will conduct a thorough interview and may also interview family, friends and previous clinicians.

It can be difficult to diagnose borderline personality disorder, particularly since it often co-occurs with other conditions that may have overlapping symptoms. BPD often exists along with bipolar disorder, substance abuse, eating disorders or anxiety disorders.

Treating Borderline Personality Disorder

Although borderline personality disorder is a serious mental illness, effective BPD treatment is possible. Psychotherapy is the most important aspect of treatment and may include dialectical behavioral therapy (DBT), cognitive behavioral therapy and any other type of therapy that teaches ways to cope with emotional dysregulation. Medication is sometimes used to control symptoms such as anxiety or mood swings.

When a person with BPD is experiencing extreme self-harming behavior, including suicidal tendencies, short-term inpatient treatment may be recommended.  Many people who are diagnosed and treated for BPD eventually have their symptoms brought under control and can go on to lead stable and happy lives.