What is borderline personality disorder?

Borderline personality disorder (BPD) is a mental health condition that affects how a person thinks, feels, and relates to others. It can cause intense emotions, impulsive behavior, and difficulty maintaining stable relationships. With the right care, many people learn to manage symptoms and build healthier patterns.

Possible causes and risk factors:

BPD does not have a single known cause. It is often linked to a mix of factors, including:

• Family history of mental health conditions
• Childhood trauma, abuse, or neglect
• Stressful or unstable early environments
• Differences in how the brain processes emotions

Symptoms

BPD symptoms often begin in the teen or early adult years and may vary from person to person. They typically involve emotional, behavioral, and relationship challenges.

Common symptoms include:

• Rapid changes in mood or emotional reactions
• Strong fear of being abandoned or left alone
• Unstable relationships that shift between closeness and conflict
• Difficulty controlling anger
• Ongoing feelings of emptiness
• Sudden changes in self-image or identity
• Risky or impulsive behaviors, such as substance use or unsafe decisions
• Feeling disconnected from reality or having suspicious thoughts
• Self-harm or thoughts of suicide

How is it diagnosed?

A diagnosis of BPD is made by a trained mental health professional, such as a psychiatrist, psychologist, or licensed therapist. They will talk with you about your symptoms, experiences, and personal history.

Your provider may also:

• Review your medical and mental health background
• Ask about family history
• Evaluate for other conditions with similar symptoms
• Perform a physical exam if needed to rule out other causes

How is it treated?

Treatment for BPD focuses on helping you better understand and manage your emotions, thoughts, and behaviors. Many people improve with the right support and care plan.

Common treatment options include:

Therapy (first-line treatment):

• Dialectical behavior therapy (DBT): Teaches skills to manage emotions and reduce harmful behaviors
• Cognitive behavioral therapy (CBT): Helps identify and change negative thinking patterns
• Other structured therapies: Focus on self-image, coping skills, and relationships

Medications:

• May be used to treat related symptoms such as anxiety, depression, or mood swings
• Not typically the primary treatment for BPD itself

Additional care:

• Group therapy or family involvement may improve outcomes
• Hospital care may be needed during severe symptoms or safety concerns

With ongoing treatment, many people develop healthier coping skills and experience fewer symptoms over time.