Everything to Know About Living With Borderline Personality Disorder

Borderline personality disorder (BPD) is a condition that affects how you think, feel, and interact with other people. It’s the most commonly recognized personality disorder.

You may wonder what it feels like to live with BPD, but everyone is different so it’s hard to predict. We do know that BPD can cause intense emotional pain and feelings of emptiness, desperation, anger, and loneliness. These symptoms can affect every part of your life, including your personal relationships.

Despite the challenges, many people with BPD learn how to cope with the symptoms so they can have fulfilling lives.

Female psychiatrist talking with female patient

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What Does BPD Mean?

Borderline personality disorder is a psychological condition that’s characterized by unstable moods and emotions, relationships, and behavior. It’s one of 10 personality disorders recognized by the American Psychiatric Association (APA).

In the fifth edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), BPD is diagnosed on the basis of several of the characteristics of emotional instability being present.

In addition, the patient’s own self-image, aims, and internal preferences are often unclear or disturbed. There are usually chronic feelings of emptiness. A tendency to become involved in intense and unstable relationships may cause repeated emotional crises and may be associated with excessive efforts to avoid abandonment and a series of suicidal threats or acts of self-harm.

Symptoms

A hallmark of borderline personality disorder is emotional and relational instability. Symptoms of BPD include at least five of the following:

  • Fear of abandonment
  • Unstable and intense relationships with rapid changes from idealization to devaluation, known as “splitting” (seeing people or things as “all good” or “all bad”)
  • Rapid changes in self-identity and self-image
  • Impulsive and risky behavior, such as gambling, reckless driving, unsafe sex, spending sprees, binge eating, or drug abuse
  • Recurrent suicidal behavior, threats of suicide, or self-injurious behavior
  • Emotional instability
  • Chronic feelings of emptiness
  • Inappropriate anger, uncontrollable aggression
  • Periods of stress-related paranoia and loss of contact with reality, lasting from a few minutes to a few hours

Not everyone with BPD experiences every symptom. Some individuals experience only a few symptoms, while others have many. 

Things People With BPD Say

Megan C., 24, has lived with BPD for five years, she explains what it’s like to live with the condition:

“When I’m splitting, and I lash out I’ll say ‘I hate you,’ or go the other way and say ‘I can’t live without you.’ I tell my parents most days that I’m leaving home. I’ve quit jobs after a week when someone has triggered me. If someone I like doesn’t reply to my messages I’ll assume they hate me and never want to speak to me again. I tried therapy but it didn’t work quickly enough so I stopped going.”

Common Stigmas

Common stereotypes include that BPD patients are dangerous, dramatic, manipulative, and attention seeking. These stereotypes can cause therapists to not take your symptoms or fears seriously. They can also interfere with treatment, causing mental health professionals to emotionally distance themselves from clients or be unwilling to help and therapeutically engage.

Tips for Living With BPD

Living with BPD poses some challenges, and symptoms can affect every part of your life. Despite the challenges, there are many ways to cope.

At Work

The effects of BPD can vary in different workplace settings, affecting your job performance and your ability to “fit in” with your coworkers. Some ways to cope with the struggles of the day-to-day demands include:

  • Avoiding stressful situations: Taking a step back from potential confrontation can help you see a situation more clearly. It also gives you the opportunity to use positive communication skills more effectively, which is especially important in work relationships.
  • Try relaxation exercises: Relaxation techniques like deep breathing and meditation can help you maintain some stability if you ever find yourself in a stressful situation.

Relationships

People with BPD may have difficult relationships, both platonic and romantic. Romantic relationships present a unique set of challenges for people with BPD and for their partners.

Symptoms of BPD can cause constant changes in emotions. But it’s important to know that you can have a healthy relationship despite your personality disorder. Treatment, along with a strong support network, can help you find stability in your emotional state and in your relationships.

Self-Image

Strong self-esteem helps you remain confident and connect with other people. But if you have BPD, you may be faced with a negative internal monologue which can make you feel incompetent or worthless.

Your healthcare provider may recommend cognitive behavioral therapy or dialectical behavior therapy to help manage your symptoms. A regular focus will be on addressing your self-esteem. You will work together to identify your strengths and accomplishments so that you understand your worthiness and value.

Physical Health 

BPD may also have a major impact on your physical health. BPD is associated with a variety of conditions, including chronic pain disorders such as:

BPD by Age 

According to research, BPD tends to begin in adolescence, and symptoms can “burn out” as the sufferers age, although some can retain symptoms in later life.

BPD has historically been seen as a lifelong, highly debilitating disorder. However, research during the past two decades has challenged this assumption. There appears to be a link between age and decreased symptoms in BPD, but research has yet to identify the exact cause. 

BPD may present differently depending on your age.

Adolescence

Many experts have argued that BPD should not be diagnosed in anyone younger than 18 since technically, their personality is not yet fully formed. In the DSM-5, though, there is a provision that allows for the diagnosis of borderline personality before the age of 18.

Symptoms such as instability in interpersonal relationships, impulsive behavior, chronic emptiness, and unstable sense of self may look different in teens. It may also sometimes be difficult to distinguish between symptoms of BPD and “normal” teenage behavior.

Adulthood

By the age of the late 20s or 30s, most people have a sense of self and identity. People with BPD, however, may never feel that they know who they are.

The most common course of BPD is one of chronic instability in early adulthood, with episodes of serious affective and impulsive reactions leading to repeated use of emergency services during crisis prior to a BPD diagnosis.

Older Adults 

It is important to understand that while BPD is often thought of as a young adulthood disorder, there is a group of people who meet the criteria at an older age (40 to 60 years of age).

In one study, older people with BPD were more likely to exhibit feelings of chronic emptiness and have higher degrees of social impairment. They were less likely to have impulsivity, engage in self-harm, or have rapid shifts in mood. 

BPD Remission

The prognosis is good for patients with BPD. A longitudinal study of 290 inpatients diagnosed with borderline personality disorder and reassessed at two-year intervals over 16 years yielded the following rates of remission:

  • 35% remission after two years
  • 91% remission after 10 years
  • 99% remission after 16 years

Treatment Options 

Historically, medical experts believed that BPD was unlikely to respond to treatment, but research has shown that BPD is very treatable. Despite the obstacles that BPD can cause, many people with BPD lead normal, fulfilling lives when they stick with their treatment plan.

Psychotherapy

Psychotherapy is the first-line treatment for people with BPD. It is important that people in therapy establish a sense of trust with their therapist. The nature of BPD can make it difficult for people with this disorder to maintain a comfortable and trusting bond with their therapist.

Examples of psychotherapies that are targeted to BPD include:

  • Dialectical behavior therapy (DBT) teaches coping skills and strategies for dealing with urges related to self-harm and suicide, regulating emotions, and improving relationships.
  • Mentalization-based therapy (MBT) is a psychotherapy that helps people better identify what others may be thinking and feeling.
  • Transference-focused therapy (TFP) helps people better understand and deal with their emotions and interactions by examining them through the relationship between the patient and therapist.

Medication

No medications are currently approved by the Food and Drug Administration for the treatment of BPD, but to treat certain symptoms, a mental health professional may recommend medications such as:

  • Antidepressants: These can help improve a depressed mood, anger, or impulsivity.
  • Antipsychotics: These may be beneficial for people who often lose touch with reality.
  • Mood stabilizers: These prevent mood swings and reduce irritability and aggression.

Support Groups

There are support groups in most communities and online for people with mental health issues. There you can find support from people who are also experiencing BPD. For example, the National Alliance for Mental Illness (NAMI) runs support groups. See the NAMI website for details on where to find a group near you.

Frequently Asked Questions 

What is the meaning of BPD?

BPD is a personality disorder in which people experience an ongoing pattern of instability in moods, self-image, relationships, and behavior. These symptoms often result in impulsive actions and can cause problems in relationships.

What triggers people with BPD?

The most common BPD triggers are related to interpersonal distress, especially relationships. People with BPD often experience intense fear, anger, impulsive behavior, self-harm, and even suicidal tendencies when events in a relationship make them feel rejected, criticized, or abandoned (what’s known as abandonment or rejection sensitivity).

Can you have healthy relationships with BPD?

Yes. It’s important to know that you can have a healthy relationship despite your personality disorder. Treatment, along with a strong support network, can help you find stability in your emotional state and in your relationships.

How do you tell people you have BPD?

Disclosing your mental health diagnosis is a very personal decision, and each time you are faced with it, the circumstances are unique.

Speak to your therapist about ways to introduce BPD into the conversation, and be prepared for a lot of questions. Have resources available that you can share with loved ones so they can understand your condition more clearly.

Seek Help

If you or a loved one is struggling with borderline personality disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

A Word From Verywell

BPD can be an intimidating, but ultimately treatable condition. Remission is highly possible with a good support system and the right therapist. Knowing your triggers and being mindful of stressful situations at work, in relationships, and at home can help manage the condition.

Remember that treatment may take time and may involve a combination of therapies. Speak to your doctor to find the right treatment for you.

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Article Sources
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  1. American Psychiatric Association. What are personality disorders?

  2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Fifth Edition. American Psychiatric Association; 2013.

  3. Brüne M. Borderline personality disorder: why ‘fast and furious’? Evol Med Public Health. 2016;2016(1):52-66. doi:10.1093/emph/eow002

  4. Creurer SR. The professional stigmatization of borderline personality disorderProfessional Psychology Dissertations. 2015;5.

  5. Sansone RA, Sansone LA. Chronic pain syndromes and borderline personality. Innov Clin Neurosci. 2012;9(1):10-14. PMID:22347686; PMCID:PMC3280073

  6. Biskin RS. The lifetime course of borderline personality disorderCan J Psychiatry. 2015;60(7):303-308. doi:10.1177/070674371506000702

  7. Guilé JM, Boissel L, Alaux-Cantin S, de La Rivière SG. Borderline personality disorder in adolescents: prevalence, diagnosis, and treatment strategiesAdolesc Health Med Ther. 2018;9:199-210. doi:10.2147/AHMT.S156565

  8. Bozzatello P, Bellino S, Bosia M, Rocca P. Early detection and outcome in borderline personality disorderFront Psychiatry. 2019;10:710. doi:10.3389/fpsyt.2019.00710

  9. Morgan TA, Chelminski I, Young D, Dalrymple K, Zimmerman M. Differences between older and younger adults with borderline personality disorder on clinical presentation and impairmentJ Psychiatr Res. 2013;47(10):1507-1513. doi:10.1016/j.jpsychires.2013.06.009

  10. Gunderson JG, Stout RL, McGlashan TH, et al. Ten-year course of borderline personality disorder: psychopathology and function from the Collaborative Longitudinal Personality Disorders StudyArch Gen Psychiatry. 2011;68(8):827-837. doi:10.1001/archgenpsychiatry.2011.37

  11. Choi-Kain LW, Finch EF, Masland SR, Jenkins JA, Unruh BT. What works in the treatment of borderline personality disorderCurr Behav Neurosci Rep. 2017;4(1):21–30. doi:10.1007/s40473-017-0103-z

  12. National Institute of Mental Health. Borderline personality disorder. Updated December 2017.

  13. Stoffers JM, Völlm BA, Rücker G, Timmer A, Huband N, Lieb K. Psychological therapies for people with borderline personality disorderCochrane Database Syst Rev. 2012;2012(8):CD005652. doi:10.1002/14651858.CD005652.pub2

  14. Ripoll LH. Psychopharmacologic treatment of borderline personality disorderDialogues Clin Neurosci. 2013;15(2):213–224.

  15. Staebler K, Helbing E, Rosenbach C, Renneberg B. Rejection sensitivity and borderline personality disorderClin Psychol Psychother. 2011;18(4):275-283. doi:10.1002/cpp.705