Borderline Personality Disorder Diagnosis and Treatment
Learn more about borderline personality disorder and its causes, symptoms, and treatments here.
The information presented on this page is an overview of the average evaluation of borderline personality disorder and is offered here as a resource. At J. Flowers Health Institute, our evaluations and treatment plans are customized and tailored to each individual’s needs. We specialize in providing a comprehensive team approach to your care. Our evaluations may include a behavioral assessment, neuropsychological testing, and a medical evaluation to help diagnose the root of your symptoms to provide the holistic care you deserve.
If you would like to learn more about J. Flowers Health Institute, please do not hesitate to reach out.
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Introduction to Borderline Personality Disorder (BPD)
Living with borderline personality disorder may lead to significant challenges in regulating emotions. Someone with BPD may be impulsive and experience difficulty in their relationships. Some may view themselves in a negative light or feel poorly about their personality, image, or behaviors.
They may also worry about how others feel about them. This leads to an intense fear of abandonment and being alone.
Characteristics of BPD
Many of the key characteristics of borderline personality often lead to an individual’s friends and loved ones pulling away.
These characteristics generally include:
- Frequent mood changes
- Anger
- Aggression
- Antisocial behavior
- Impulsive behavior
- Self-destructive behavior
- Chronic feelings of emptiness
What is BPD? A Closer Look
Understanding Borderline Personality Disorder
When it comes to mental health, feeling good about yourself and your relationships is important. Unfortunately, that’s sometimes easier said than done. For people who have borderline personality disorder, this can be incredibly difficult.
If you think you or a loved one may suffer from borderline personality disorder, find out more about the diagnosis and treatment below.
What is Borderline Personality Disorder?
Borderline personality disorder isn’t to be confused with bipolar disorder, though the abbreviation is the same.
Borderline personality disorder impacts the way that you think about yourself and others. This leads to problems with everyday life for those suffering from mental health conditions.1
The causes for the emotional swings associated with borderline personality disorder are often minor, such as a loved one leaving for a work-related trip. Still, minor risks like these can lead to overwhelming emotions and intense fear.
How Common is BPD?
At this point, it’s estimated that nearly 1.4% of people in the United States have borderline personality disorder. But, due to frequent misdiagnosis or underdiagnosis, the actual number of Americans living with BPD is likely higher.2
Of these diagnosed individuals, roughly 75% are women. However, it’s now believed that men may be suffering from BPD more often than was thought. The belief is that they’ve been misdiagnosed with PTSD or a depressive disorder instead of BPD.
What Does it Feel Like to Have BPD?
Important Note About Co-Occurring Conditions
It’s important to note that people with borderline personality disorder often have other mental health concerns.
Data from The National Comorbidity Survey Replication suggests that more than 85% of survey participants with BPD had symptoms or a diagnosis of another mental health condition as well.3
Because the symptoms of mental health conditions may overlap, recognizing and diagnosing BPD can be challenging. Examples of common co-occurring mental health conditions include:4
- Major depressive disorder
- Post-traumatic stress disorder (PTSD)
- Anxiety disorders
- Bipolar disorder
- Eating disorders
- Substance use disorders
Causes and Risk Factors of BPD
There isn’t a pinpointed cause for borderline personality disorder at this point. However, some of the common risk factors that may point to BPD include:5
Genetics
If others in your family have been diagnosed with borderline personality disorder, it’s more likely that you may develop the condition as well.
You may be at a higher risk if the relative with BPD is a first-degree relative such as your:
- Mother
- Father
- Sister
- Brother
Environmental Factors
People who’ve experienced abuse or trauma are also more likely to develop BPD. This includes:
- Sexual abuse
- Emotional abuse
- Physical abuse
- Parental neglect or mistreatment
Brain Abnormalities
Studies show that people suffering from BPD often have brain abnormalities that affect how the parts of the brain that regulate emotions communicate. BPD has been linked to the amygdala and limbic systems of the brain.
The hippocampus and amygdala size in those who have BPD has been shown to be as much as 16% smaller.6 It remains unclear, however, whether these changes lead to the development of borderline personality disorder or whether BPD caused changes in the brain.
Traumatic or Stressful Life Events
Adults who experience significant stress or trauma during childhood are at a greater risk for developing BPD.
For example, children raised in unstable environments, such as living with a parent with a substance use disorder, or a child who experienced parental loss, may be more likely to develop BPD.
Some researchers suggest BPD symptoms may evolve from coping strategies developed during youth.7
Signs and Symptoms of BPD
One must present with multiple symptoms to meet the diagnostic criteria for borderline personality disorder. Below are some of the most common symptoms seen in people suffering from BPD:
Unstable Relationships
This is due to the inability to regulate feelings towards others. For example, idealizing a person one moment, then accusing them of not caring the next.
Impulsive, Self-Destructive Behaviors
These behaviors can include:
- Gambling
- Reckless driving
- Unsafe sex
- Spending sprees
- Binge eating
- Drug abuse
- Sabotaging success
- Ending positive relationships
- Self-injury
- Suicidal thoughts/threats
Chronic Feelings of Emptiness, Loneliness, and Depression
This also includes intense fears of abandonment, and the person often goes to extreme measures to prevent this from happening.
Shifting Feelings
This includes constantly changing feelings regarding self-image that can cause changes in goals and values.
Stress-Related Paranoia
This stress-related paranoia can lead to losing contact with reality for extended periods.
Mood Swings
These mood swings may last anywhere from a few hours to a few days. They may include emotions like:
- Happiness
- Depression
- Irritability
- Anxiety
- Shame
How Do Mental Health Professionals Diagnose BPD?
Since there’s so much that remains unknown about borderline personality disorder, getting diagnosed can be difficult.
For the most part, diagnosis takes multiple steps, including some or all of the following:
Interview
The first step is a detailed interview with a mental health professional. In this interview, relationships and symptoms will be discussed in-depth.
Psychological Evaluation
A psychological evaluation helps rule out any other disorders presenting as BPD.
Medical History and Exam
This step involves going over your medical history. It also includes an exam to rule out any physical issues causing BPD-like symptoms to occur.
Discussing Signs and Symptoms
This discussion of your signs and symptoms happens with a mental health provider. The goal is to ensure that it’s BPD that a person is suffering from.
Evaluation of Family History
An evaluation of your family medical history is also part of an assessment for borderline personality disorder.
“Living MRI” Comprehensive Evaluation
J. Flowers Health Institute provides our “Living MRI” which offers specific tests and exams with our medical professionals that will be personalized to your needs.
Depending on your symptoms and needs, some of the tests to help us determine your borderline personality diagnosis include:
- Medical evaluation
- Psychological and psychiatric evaluation
- Substance use disorder testing
- Lifestyle assessment
- Trauma assessments
Diagnosing Borderline Personality Disorder in Youth
In most cases, symptoms of borderline personality disorder occur in early adulthood, but it can also occur in youth and teens.
However, borderline personality disorder is difficult to diagnose accurately in children. This is because BPD symptoms may evolve into one of several behavioral disorders as the child grows and develops.
Mental health providers may wait until adolescence to attribute emotional and behavioral symptoms to borderline personality disorder. In specific situations, people under the age of 18 may be diagnosed with borderline personality disorder if their symptoms are severe and persist for longer than one year.
Borderline Personality Disorder Treatments
The treatments for BPD can vary depending on the individual and the severity of their condition.
The primary treatment model used in BPD treatment is psychotherapy. In some instances, medications may help to limit the impact of certain symptoms. A mental health provider may also recommend short-term hospitalization before therapeutic treatment if a person’s health or safety is at risk.
The goal of BPD treatment is to help someone with borderline personality disorder develop crucial skills and tools that will help them manage their symptoms. Therapy can also address the symptoms of any co-occurring mental health condition.
Psychotherapy
Psychotherapy is also referred to as talk therapy. It’s a primary therapeutic model for BPD treatment.
Psychotherapy sessions have several goals, including:
- Teaching patients how to manage and cope with uncomfortable emotions
- Learning how to observe and sit with feelings rather than act on them
- Working on improving and healing relationships by learning to be aware of the feelings of others (as well as the person’s own emotions)
- Learning more about borderline personality disorder
- Focusing on improving function and reducing impulsivity
There are several different forms of psychotherapy available to people suffering from BPD. A list of some possible treatments will be detailed below.
Dialectical Behavior Therapy (DBT)
DBT attempts to identify and change negative thinking patterns and pushes for positive behavioral changes.
What is DBT?
Schema-Focused Therapy
This includes the identification of unhelpful patterns and help in understanding and resolving them.
Mentalization-Based Therapy (MBT)
MBT is an analysis of mental states and their underlying causes.
Systems Training for Emotional Predictability and Problem-Solving (STEPPS)
STEPPS is a 20-week program that combines skills training and cognitive-behavioral therapy.
Transference-Focused Psychotherapy (TFP)
TFP includes twice-weekly therapy sessions that help stress the importance of social interactions in changing maladaptive behavior.
Good Psychiatric Management
This is a once-weekly form of therapy that focuses on social adaptation. The goal of this treatment model is to help participants make sense of emotional challenges by considering personal feelings.
In some instances, this type of therapy may integrate:8
- Family education
- Individual sessions
- Group therapy
- Medications
Importance of Therapeutic Relationships
Difficulties with trust are a hallmark symptom of borderline personality disorder. As a result, developing a healthy and productive relationship with a therapy provider can be challenging for someone in the early stages of BPD treatment.
Because of this, individual therapy sessions are often the most beneficial for helping someone with borderline personality disorder learn how to interact and express themselves in a healthy way around others.
BPD Medications
There are no specific medications for borderline personality disorder at this point. But, in some instances, the use of antidepressants, mood stabilizers, and anti-anxiety medications in combination with therapy has proven helpful for patients.
Certain medications may also help reduce symptoms of co-occurring diagnoses, such as:
- Anxiety
- Impulsive behavior
- Depression
- Aggression
Important Note About Medications
Medications may lead to side effects for some people. It’s crucial to talk to your provider about each medication to ensure a clear understanding of the potential positive and negative outcomes of its use.
It’s also important to discuss any pre-existing health conditions or other medications you use, as some medications should not be combined.
Hospitalization
Should the symptoms of BPD become a danger for the person suffering from the disorder, inpatient hospitalization may be needed.
This is to help the person avoid self-harm or possibly harming others while getting them started on the psychotherapy they need to begin recovery.
As a result, some people may need a more intensive stabilization period before beginning therapy.
Coping With Borderline Personality Disorder
Living with BPD can be difficult. If you or a loved one lives with symptoms of borderline personality disorder, check out the following tips to help with the symptoms of this disorder.
Calm the Emotional Storm
Meditating or practicing mindfulness can help you keep your emotions centered, reducing BPD symptoms.
Learn to Control Impulsivity and Tolerate Distress
Engaging in less harmful behaviors can lead to better relationships, reducing the amount of stress you experience.
Improve Your Interpersonal Skills
Practicing social behaviors can help you strengthen your existing relationships and make new ones as well. This can help reduce feelings of abandonment or other negative emotions that often occur for those with BPD.
Don’t Make Assumptions
Assumptions about your relationships with others are often intrusive thoughts that can damage them.
Keep Up a Healthy Lifestyle
Staying healthy and staying fit can keep you happier, reducing the causes and symptoms of BPD.
Getting Treatment for BPD at J. Flowers Health Institute
Recovery and healing take time. The path to learning how to manage behaviors, emotions, and thoughts in a safe and healthy way looks different for everyone.
While therapy is proven to help most people improve significantly, symptoms of BPD may always linger. Some people find they experience periods where symptoms are better and times when they are worse.
Remaining engaged and active in your treatment program can help improve your ability to function and improve your self-esteem and the quality of your relationships.
Contact J. Flowers Health Today
If you or a loved one live with borderline personality disorder and would like to learn more about how J. Flowers Health Institute can help, contact us today.
A member of our experienced, compassionate treatment team will work with you to teach you about treatment for BPD and how we can help you take the first steps toward freedom from the challenges of borderline personality disorder.
We can help you diagnose and treat your BPD so that you can get back to living a happy and fulfilling life.
Resources
- https://www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/symptoms-causes/syc-20370237
- https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Borderline-Personality-Disorder
- https://www.sciencedirect.com/science/article/abs/pii/S0006322306011929
- https://www.nimh.nih.gov/health/topics/borderline-personality-disorder#:~:text=How%20is%20borderline%20personality%20disorder,experiences%2C%20and%20family%20medical%20history
- https://my.clevelandclinic.org/health/diseases/9762-borderline-personality-disorder-bpd
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1863557/
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/borderline-personality-disorder
- https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bpd.pdf
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