Borderline personality disorder: symptoms, causes, diagnosis and treatment
Contents
- What is borderline personality disorder?
- Causes and risk factors of borderline personality disorder
- Genetic and biological factors
- Environmental factors
- Psychological factors
- Interaction between factors
- Common symptoms of borderline personality disorder
- General symptoms
- Specific manifestations in women
- Specific manifestations in men
- Specific manifestations in adolescents
- Differences between borderline and bipolar disorder
- Diagnosis of borderline personality disorder
- Treatment options for borderline personality disorder
- Psychotherapy
- Drug treatment
- Neurofeedback therapy
- Family therapy and educational support
- Holistic and complementary interventions
- Complications without treatment
What is borderline personality disorder?
Borderline Personality Disorder (BPD ) is a severe psychiatric condition characterized by emotional instability, unstable personal relationships and increased impulsivity. Affected individuals have difficulty managing their emotions and maintaining a stable self-image, which leads to significant problems in daily and professional life.
Causes and risk factors of borderline personality disorder
Genetic and biological factors
There is a significant genetic component associated with BPD. First-degree relatives of people with borderline personality disorder are at higher risk of developing the condition. Abnormalities in brain structures responsible for regulating emotions, such as the amygdala and prefrontal cortex, are also associated with the disorder.
Environmental factors
Trauma from childhood, including physical, emotional or sexual abuse and family instability, are major risk factors for developing borderline personality disorder.
Psychological factors
Increased impulsivity, emotional sensitivity and difficulties in regulating emotions predispose people to BPD. Attachment problems in childhood can contribute to interpersonal and relational difficulties.
Interaction between factors
BPD is caused by a complex combination of genetic, biological and environmental factors, and the risk of developing the disorder is significantly increased when factors overlap.
Common symptoms of borderline personality disorder
General symptoms
- Intense fear of abandonment
- Unstable and intense relationships (idealization and devaluation)
- Fluctuating self-image
- Impulsivity in risky activities
- Self-harm or suicidal behavior
- Emotional instability and increased irritability
- Chronic feelings of inner emptiness
- Difficulty controlling anger
- Transient paranoid or dissociative symptoms
Specific manifestations in women
Women with BPD frequently show rapid emotional changes, easily going from euphoria to depression or deep anxiety in a short time. They are prone to self-harm behaviors such as cutting and suicide attempts in response to intense emotional stress. Fear of abandonment is often heightened, leading to impulsive behavior and highly volatile relationships.
Specific manifestations in men
Men diagnosed with BPD are often impulsive, frequently engaging in risky behaviors such as substance abuse, gambling, overspending, or unsafe sexual activity. Episodes of intense anger and aggression may be frequent and disproportionate to the actual circumstances. Identity instability is often reflected in frequent changes in career goals, values and interests.
Specific manifestations in adolescents
Adolescents with borderline personality disorder experience major difficulties in relationships with peers and family, with frequent and intense conflicts. They experience significant emotional instability with rapid mood swings. Self-harm behaviors are common, including cutting and suicide attempts, often in response to perceived abandonment, rejection or feelings of insecurity. Diagnosis in adolescents requires caution, as the manifestations may be mistaken for typical emotional disorders of this age.
Differences between borderline and bipolar disorder
Bipolar disorder involves distinct episodes of mania and depression, each lasting long periods of time, while borderline is marked by rapid mood swings during the same day, often triggered by stressful social interactions.
Diagnosis of borderline personality disorder
The diagnosis of BPD is made by detailed clinical assessment and follows DSM-5 criteria. Clear distinction from other similar conditions, especially bipolar disorder, is essential.
Treatment options for borderline personality disorder
Psychotherapy
- Dialectical Behavior Therapy (DBT)
- Cognitive Behavioral Therapy (CBT)
- Mentalization Based Therapy (MBT)
- Schema-Focused Therapy (SFT)
Drug treatment
Medications used include antidepressants, mood stabilizers and atypical antipsychotics.
Neurofeedback therapy
Neurofeedback can help reduce symptoms by improving emotional regulation and behavioral control.
Family therapy and educational support
Involving the family in treatment and educating family members helps to improve relationships and stabilize the patient.
Holistic and complementary interventions
Mindfulness, regular physical activity and balanced nutrition can support the treatment of TPB.
Complications without treatment
Left untreated, borderline disorder can lead to severe complications such as self-harm, suicidal behavior, substance abuse, occupational difficulties and social isolation.
Borderline Personality Disorder is a severe but treatable condition, and early and correct treatment significantly improves patients' quality of life. Early diagnosis and personalized treatment are crucial for effective symptom management.
Latest medical review:
03.06.2025, Dr. Nicoleta Cartas - Primary Psychiatrist and Georgiana Ginghină - Clinical Psychologist and Cognitive - Behavioral Psychotherapist, Psychology
References:
- "Borderline Disorder. Regina Maria, 2022.
- Pop, Diana. "Borderline - causes, symptoms, diagnosis and treatment". Brainmap Neuroscience Institute, 2024.
- Sararu, Maria (Psych.)"Borderline personality disorder: manifestations and treatment". Medicover, 2023.