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What is borderline personality disorder?
Borderline personality disorder (BPD) is a mental health condition that affects a person’s mood and how they interact with others. People with BPD experience strong emotions, which can change quickly. They also find it difficult to maintain friendships and relationships with other people and might do risky things without thinking it through first.
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BPD is also known as:
- Emotionally unstable personality disorder (EUPD)
- Emotional intensity disorder (EID)
On this page we use the terms borderline personality disorder and BPD because they are the terms most people are aware of and the ones they search for when they’re trying to find information. If you have BPD, it’s up to you what term or terms you use, and people should do their best to respect your choice.
What is a personality disorder?
A personality disorder is a type of mental health condition. People with personality disorders think, feel, and behave differently, and it’s common for them to find it difficult to relate to and interact with other people. These differences affect a lot of different areas of someone’s life.
BPD is the most commonly recognised personality disorder.
Having a personality disorder does not mean that a person is bad. It’s a way of describing some of the things they struggle with.
Some people don’t like the term ‘personality disorder’, and others think that there’s too much overlap between the symptoms of personality disorders and other conditions like autism, ADHD, or PTSD. Some people also think that diagnosing someone with a personality disorder can mean that the impact of things that have happened to them in the past (such as trauma) gets overlooked.
With the right support, people with personality disorders can live good lives, and it is possible to recover.
Symptoms and signs of borderline personality disorder
To be diagnosed with borderline personality disorder (BPD), your symptoms need to last for a long time and affect different parts of your life.
What might people with BPD feel?
People with BPD often:
- have intense, ‘big’ emotions that last anywhere between a few hours and a few days
- find that their emotions can change quickly – they can go from feeling really happy to really sad, for example
- feel intense anger, which they might struggle to control
- feel empty or numb
- feel lonely
- feel insecure about who they are – they might feel like who they are changes a lot depending on who they’re with
- feel worried that people will abandon or leave them
How might BPD affect how people think?
It’s common for people with BPD to have distressing thoughts, like thinking they’re a terrible person or feeling like they do not exist. Sometimes people with BPD think that it’s their fault if bad things happen to them, or that they deserve bad things to happen to them.
It can be really difficult to have thoughts like these, even if you’re not sure if they’re true.
People with BPD can also have unusual experiences like hearing voices that are not there or having distressing beliefs that other people don’t share (like thinking someone they know is secretly spying on them). These can be brief or last for a long time and can be symptoms of psychosis.
What sorts of things might people with BPD do?
People with BPD can be more likely to act impulsively – this means doing or saying things without thinking through the consequences.
Impulsive behaviour can include things like:
- binge eating
- using drugs
- smoking or vaping
- drinking a lot of alcohol
- driving dangerously
- having unsafe sex
- spending more money than you can afford to spend
People might also be more likely to quit or give up on things, even when they’re really close to achieving a goal. This might mean that they seem to change jobs or hobbies often. They might also avoid trying things at all because they’re afraid of failing.
They may also use self-harm as a way of coping and experience suicidal thoughts and feelings.
How might BPD affect people's relationships?
People with BPD can struggle to make relationships, including friendships as well as romantic relationships. They can also find it difficult to get on with people in general, for example, people in their class or their colleagues at work.
It can also be difficult for people with BPD to maintain relationships and keep them stable. Part of this is often because people with BPD often see relationships as either brilliant or awful – they might struggle to see that relationships can be positive overall, even when they’re not perfect.
People with BPD can also worry about being abandoned by their friends, family, and partners. They might try really hard to stop people from leaving them, but this can lead to them doing things like constantly messaging someone or even saying they will harm themselves if someone leaves them, which can make the relationship unhealthy.
Sometimes, people with BPD might also feel like other people are too close and act in a way that pushes them away. As a result, their friendships and relationships can fall into a pattern of becoming really close and then damaged, over and over again.
However, these difficulties do not mean that people with BPD cannot have really good friendships and relationships with the right people supporting and understanding them.
How does borderline personality disorder impact someone’s life?
Borderline personality disorder (BPD) has a big impact on a lot of different areas of people’s lives.
Living with BPD can be difficult, so it’s important that you get the right support. It can affect people’s ability to get an education or go to work, their relationships with their friends and family members, and their physical health.
You might feel guilt or regret about things you’ve done impulsively or the way you’ve treated other people. You might also have to deal with the outcomes of things you’ve said or done, for example, if you’ve injured yourself doing something risky or said something hurtful to a friend you care about.
Sometimes, people with BPD experience judgement or stigma from other people who don’t understand the condition (or personality disorders in general), which can be really frustrating and can make life harder.
People with BPD might also experience other mental health conditions, such as anxiety, depression, or eating problems.
But this doesn’t mean that things are hopeless. With the right support, people with BPD can go on to lead really good lives.
How do you know if you have borderline personality disorder?
It’s rare for people aged under 18 to be diagnosed with any personality disorder.
Sometimes people might be given a diagnosis of an ‘emerging’ personality disorder if they’re showing some of the symptoms so that they can get the right help as soon as possible, without having to wait for a ‘full’ diagnosis.
You can be diagnosed with borderline personality disorder (BPD) by a psychiatrist (a medically qualified doctor who is a specialist in mental health) or a psychologist (a specialist mental health professional).
How do I get a referral?
To see a psychiatrist or psychologist, you usually need to be referred by a GP or someone at your school. This means that the GP or person at school sends your details on to the service where the psychiatrist or psychologist works, so they can contact you and offer you an appointment.
In some places, you might be able to self-refer – this means that you can ask for an appointment with the service, for example, by filling in an online form or making a phone call without anyone else (like a GP or teacher) helping you.
How will I be diagnosed?
Psychiatrists and psychologists diagnose people using diagnostic criteria – specific guidelines about the signs and symptoms that mean someone has BPD, rather than any other mental health condition.
A psychiatrist or psychologist might do a few different things to find out more about you and your experiences. The exact process is different for everyone, depending on their situation.
You might be asked to fill out some questionnaires, and they might talk to you and see what your behaviour is like. They might also ask your parents or carers how things are at home (and at school or college) at the moment.
BPD can’t be diagnosed by any sort of blood test or scan, but sometimes people with symptoms of BPD might have blood tests so doctors can check that their symptoms aren’t caused by a physical health condition.
What causes borderline personality disorder?
We do not know exactly what causes borderline personality disorder (BPD). The research that’s been done suggests there might not be one cause, so we think a combination of different things can play a part in someone developing BPD.
Family history
Research suggests that people with a close family member with BPD are more likely (but not certain) to develop it too. We don’t know how much of this is due to biology (like genes inherited from your parents) and how much is due to your family being around you as you grow up and learn how to cope with the world. If genes are involved, it’s likely that it’s much more complex than one single gene causing BPD.
Brain development
Brain scans have shown that in many people with BPD, three parts of their brain were smaller than expected or had unusual activity. These parts of the brain are responsible for keeping your mood stable, and their development is affected by someone’s early childhood.
Childhood experiences
Going through difficult experiences when you’re a child or young person, and the distress that they cause, might be part of the reason someone develops BPD. These experiences can include being a victim of abuse, being exposed to long-term fear or distress, or being neglected.
Treatment and looking after yourself if you have borderline personality disorder
Your treatment for borderline personality disorder (BPD) is likely to include talking therapies. People with BPD are often offered dialectical behavioural therapy (DBT), but can be offered other types of talking therapy like cognitive behavioural therapy (CBT) too.
In the UK, guidelines don’t recommend using medication to treat the ongoing symptoms of BPD because there is not enough evidence that any specific medicine is effective. However, lots of people with BPD are prescribed medication for other mental health conditions they also have, or to help with specific symptoms of BPD. They might also be prescribed medication for a short amount of time if they’re in crisis.
Sometimes, people with BPD are told that they are ‘difficult’ to help or that BPD cannot be treated. This is not fair and not true. Everyone struggling with their mental health should be treated with compassion and supported to access the help they need to feel better.
There are lots of things you can try to do to help yourself manage if you have BPD.
Make a coping plan for emotions
Lots of people with BPD find it helpful to make a plan for healthy ways to cope with feelings like anger or loneliness. Choosing some coping methods when you feel calm can make it easier to use them when you’re experiencing intense emotions. Find information about other emotions and how to cope.
Make a crisis plan
If you experience urges to self-harm, suicidal thoughts or feelings, or urges to behave impulsively it can be helpful to make a crisis plan to help yourself stay safe. This might include signs that you’re starting to struggle, as well as things you (and the people around you) can do in response.
Make a self-soothe box
Self-soothe boxes are filled with items that can help you cope when things feel overwhelming. What you put in a self-soothe box is up to you, but people often choose items that help them engage with their senses.
Keep a mood journal
Some people find it helpful to track their mood and what’s happening in their life, to see if they can spot any things that trigger difficult thoughts and feelings, or any things that help. You could use a notebook or a wellbeing app on your phone.
Take care of your overall wellbeing
If you have BPD, taking care of yourself can involve lots of ‘normal’ self-care too, like making sure you get enough sleep and finding movement or exercise that makes you feel good. You might have to adapt things to work for you, and that’s OK.
Be careful with (and avoid) alcohol and drugs
It’s important for everyone to understand the consequences of consuming alcohol and drugs, but people with BPD might find that alcohol and drugs make their symptoms worse or cause them to become really distressed or impulsive.
How to get more help if you think you have borderline personality disorder
Emergency?
If anyone is in immediate danger, call 999 now.
If you need urgent help for mental or physical health, call NHS 111 or get help from NHS 111 online.
If you think you may have BPD (or have a diagnosis but are struggling to manage), the first step is to speak to an adult you trust. This might be a parent or carer, teacher, youth worker, or GP. Find out more about getting help from an NHS GP in England.
Together, you can make a plan so that you get the support you need to cope.
If you’re not sure where to start or want to practise talking about BPD before you have a conversation with an adult in your life, you might find it helpful to contact NATTER.
Text NATTER for help
Anyone can text ‘NATTER’ to 85258 to seek
help, wherever they are in the UK. It’s a free, anonymous service and available 24/7.
More about NATTER
How to help someone else with borderline personality disorder
If someone you care about has borderline personality disorder (BPD), it can be difficult to know how to support them. You might be able to offer support in different ways, depending on your own life and your relationship with the person with BPD.
Learn about BPD
If you learn more about BPD, people with BPD don’t have to spend as much time raising awareness. It also means you can better understand what’s going on for them, which can be really helpful if they do something you find difficult.
Listen to what they tell you
Everyone has their own experience of BPD, so it’s really important to listen to people if they want to tell you what it’s like for them. It’s OK to ask how you can help, too – especially if you can plan ahead and ask when the person is feeling well.
Stay calm
It’s really helpful if you can stay calm and predictable when someone with BPD is experiencing really intense emotions. This might mean you need to take a break (like going for a walk) if you start to feel overwhelmed, and that’s OK.
Set boundaries
Healthy friendships and relationships usually involve boundaries, and if someone has BPD this is no different. It can be helpful to be clear what you expect (and do not expect) from each other, especially if someone with BPD is worried about being abandoned.
Do normal ‘friend stuff’
When someone’s struggling with their mental health, spending time together talking about shared interests (or doing a hobby you both enjoy) can help them feel more like themselves again. This might mean continuing to invite someone to do stuff, even if they’re not always able to say yes.
Help them be kind to themselves
If someone with BPD is struggling with something, you can show them that you understand it’s hard, while encouraging them to use any strategies they have to take care of themselves.
Remind them of their strengths
People with BPD spend a lot of time being reminded of the difficulties they have in navigating the world, so help your friends remember what they’re great at and why you love spending time with them too.
Supporting other people
Find more information about supporting others, including how to ask someone if they’re OK, how to listen, and understanding boundaries and responsibility.
There’s also support if you’re a young carer, and tips for looking after yourself while supporting someone else.
