Borderline Personality Disorder Treatment for Lasting Growth

The diagnostic criteria below for BPD involves nine features. In order to be diagnosed with the disorder, a person must display any five, which reflects the variability in how the disorder presents itself:[7]

1. Fear of abandonment — Intense efforts to avoid real or imagined abandonment, including frantic behavior, rage, or self-destructive acts in response to perceived rejection or separation
2. Unstable relationships — A pattern of intense, unstable interpersonal relationships characterized by alternating between idealization and devaluation (splitting)
3. Identity disturbance — A markedly unstable self-image or sense of self, identity confusion, or rapid changes in values and goals
4. Impulsivity — Impulsive behaviors in at least two potentially damaging areas such as spending money recklessly, using drugs excessively, engaging in excessive gambling, repeated promiscuous sexual activity, compulsive eating, or reckless driving
5. Self-harming behaviors — Recurrent suicidal behavior, gestures, or threats including verbal statements indicating intent to harm oneself, actions taken that could lead to death, or making plans to take one’s own life
6. Emotional dysregulation —  Extreme mood swings and intense emotional reactivity, with episodes of intense depression, irritability, or anxiety that can last hours to days
7. Inappropriate intense anger — Difficulty controlling anger, frequent displays of temper, or repeated incidents of violence
8. Chronic feelings of emptiness — A persistent, painful sense of internal emptiness or numbness
9. Stress-related paranoia or dissociation — Transient, stress-related paranoid ideation or severe dissociative symptoms

BPD symptoms often cause immense suffering not only for individuals with the diagnosis but for the people who love them, which is why family program involvement is a meaningful component of comprehensive BPD treatment.

BPD develops through a combination of genetic and biological susceptibility and adverse environmental experiences. Below are some risk factors:

• Genetics and temperament  — People with high levels of emotional sensitivity, who tend to feel things deeply and are slow to recover from emotional experiences, are particularly susceptible to developing BPD.[8]
• Childhood trauma and adverse experiences — Childhood abuse and neglect, sexual abuse, and significant disruptions in early relationships increase the likelihood that someone will develop BPD.[9]
• Neurobiological factors — Neuroimaging research documents differences in amygdala reactivity, prefrontal cortical regulation, and the connectivity between emotional and regulatory brain systems in people diagnosed with BPD; these differences underlie the emotional dysregulation and impulsivity that are the disorder’s core features.[10]

Most people with BPD do not see significant improvement in their symptoms without receiving specialized clinical treatment. 

It is very important to seek professional help when:

• Self-harm or suicidal behavior has occurred or is being considered
• Severe emotional dysregulation is negatively affecting your job, social life, or ability to function daily
• Unstable relationships and fear of abandonment are creating a cycle of crises and collapse
• Alcohol or drugs seem like the only way to cope with emotional pain
• Co-occurring depression, anxiety disorders, eating disorders, or bipolar disorder is present
• Previous treatment for mental illness was not specific to BPD or did not address a co-occurring condition
• A family member or loved one is in a state of crisis due to BPD symptoms

Although BPD can be treated using general mental health treatment, research shows that those with BPD will achieve better results with specialized BPD-focused care.