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Borderline personality disorder

Definition:

Borderline personality disorder (BPD) is a mental condition in which a person has long-term patterns of unstable or turbulent emotions. These inner experiences often result in impulsive actions and chaotic relationships with other people.



Alternative Names:

Personality disorder - borderline



Causes:

Cause of borderline personality disorder (BPD) is unknown. Genetic, family, and social factors are thought to play roles.

Risk factors for BPD include:

  • Abandonment in childhood or adolescence
  • Disrupted family life
  • Poor communication in the family
  • Sexual, physical, or emotional abuse

BPD tends to occur more often in women and among hospitalized psychiatric people.



Symptoms:

People with BPD are often uncertain about who they are. As a result, their interests and values can change rapidly. They also tend to view things in terms of extremes, such as either all good or all bad. Their views of other people can change quickly. A person who is looked up to one day may be looked down on the next day. These suddenly shifting feelings often lead to intense and unstable relationships.

Other symptoms of BPD include:

  • Intense fear of being abandoned
  • Cannot tolerate being alone
  • Frequent feelings of emptiness and boredom
  • Frequent displays of inappropriate anger
  • Impulsiveness, such as with substance abuse or sexual relationships
  • Repeated crises and acts of self-injury, such as wrist cutting or overdosing


Exams and Tests:

BPD is diagnosed based on a psychological evaluation. The health care provider will consider how long and how severe the person's symptoms are.



Treatment:

Individual talk therapy may successfully treat BPD. In addition, group therapy can sometimes be helpful.

Medicines have less of a role in the treatment of BPD. In some cases, they can improve mood swings and treat depression or other disorders that may occur with BPD.



Outlook (Prognosis):

Outlook of treatment depends on how severe the condition is and whether the person is willing to accept help. With long-term talk therapy, the person often gradually improves.



Possible Complications:

Complications may include:



When to Contact a Medical Professional:

See your health care provider if you or someone you know has symptoms of borderline personality disorder. It is especially important to seek help right away if you or someone you know is having thoughts of suicide.



References:

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013.

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personality disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Elsevier Mosby; 2008:chap 39.

Leichsenring F, Leibing E, Kruse J, New AS, Leweke F. Borderline personality disorder. Lancet. 2011;377(9759):74-84. PMID 21195251 www.ncbi.nlm.nih.gov/pubmed/21195251 .




Review Date: 10/31/2014
Reviewed By: Fred K. Berger, MD, Addiction and Forensic Psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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Morristown Medical Center

100 Madison Avenue
Morristown, NJ 07960
973-971-5000

Overlook Medical Center

99 Beauvoir Avenue
Summit, NJ 07901
908-522-2000

Newton Medical Center

175 High Street
Newton, NJ 07860
973-383-2121

Chilton Medical Center

97 West Parkway
Pompton Plains, NJ 07444
973-831-5000

Hackettstown Medical Center

651 Willow Grove Street
Hackettstown, NJ 07840
908-852-5100

Goryeb Children's Hospital

100 Madison Avenue
Morristown, NJ 07960
973-971-5000

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