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What is borderline personality disorder?

Borderline personality disorder (BPD) is a mental illness and personality disorder characterized by significant emotional instability, intense relationships with others and a strong fear of abandonment. It is also known as emotionally unstable personality disorder (EUPD). People with BPD may experience rapid and extreme mood swings, and their self-image may also be unstable.

BPD often involves self-harm, suicidal thoughts and possibly substance abuse. Help is available. Psychiatrists and outpatient mental health departments are usually the most helpful treatment options. In case of suicidal thoughts, call 911, call or text the National Suicide Hotline at 988, or go to your nearest emergency department.

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What is a personality disorder?

Personality disorders are psychological conditions that affect an individual’s thoughts, feelings and behaviours in a way that often differs significantly from society’s norms and expectations.

Why do people get BPD?

The causes of borderline personality disorder are not entirely clear, but may be a combination of genetic, biological and environmental factors, including early trauma. Some theories suggest that growing up in an environment with frequent invalidation can contribute to the development of BPD.

In adolescence, there may be symptoms similar to borderline personality disorder, as this period involves an exploration of identity. However, these symptoms usually resolve themselves. With borderline personality disorder, the symptoms are more persistent but they also tend to improve with age.


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How common is BPD?

According to the Canadian Mental Health Association, approximately 2% of the population has BPD.

Symptoms of borderline personality disorder

There are several symptoms of borderline personality disorder. It is important to note that the severity and prevalence of symptoms can vary greatly between individuals. In addition, BPD can co-occur with other mental health conditions, such as ADHD, autism, depression, eating disorders and PTSD, which can affect how symptoms present themselves. Licensed psychologists or psychiatrists can diagnose BPD. Here are some of the main symptoms and characteristics of borderline personality disorder:

  1. Fear of abandonment: An intense fear of real or imagined abandonment. This can lead to impulsive attempts to avoid abandonment.
  2. Unstable relationships: Relationships can be intense and stormy, with periods of idealization followed by devaluation. These swings are often due to black-and-white thinking, with the person with BPD either idealizing others as “perfect” or dismissing them as “terrible”.
  3. Unstable self-image: A deeply disturbed or changing perception of oneself. People with BPD may have problems with their identity and self-esteem.
  4. Impulsivity: This can include risky behaviors such as substance abuse, reckless driving, or excessive spending.
  5. Self-harm and suicidal ideation: Includes behaviours such as self-harm and suicidal thoughts or attempts.
  6. Emotional instability: Rapid and intense mood swings that can be difficult to control.
  7. Feelings of emptiness: A chronic sense of emptiness or meaninglessness.
  8. Intense anger: Difficulty managing anger, which can lead to outbursts or constant irritation.
  9. Stress-related paranoia or dissociation: During periods of extreme stress, people with BPD may experience paranoia or dissociation from reality.

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Assessment of personality disorders

Psychiatrists typically diagnose personality disorders. This involves taking an initial medical history to review the background, identifying symptoms and completing assessment forms. The diagnostic process usually includes interviews both with the individual and their family. You will often see both a doctor and a psychologist, and the assessment may include a blood test to rule out an underlying medical cause.

Treatment for borderline personality disorder

Treatment for BPD usually involves a combination of psychotherapy, medication (to manage co-occurring conditions such as depression or anxiety) and self-help strategies. Dialectical behavioural therapy (DBT) is a form of therapy specifically for treating BPD. Studies show that it is particularly effective. MBT, which is short for mentalization-based therapy, is also helpful.

An important part of the treatment is mindfulness to manage emotions. However, other strategies and tools are also helpful to increase self-understanding and improve the ability to manage emotions.

Advice for loved ones

Try not to judge: A personality disorder is a medical diagnosis and not a character flaw. It does not always excuse a person’s behaviour, but it can explain it. Try to have an empathetic attitude.

Be careful with boundaries: It is important to set clear boundaries to protect yourself and your own psychological well-being.

Seek professional help: It is not your job to diagnose or treat someone.

Be aware of your own needs: Take care of yourself and seek support, either from friends, family or a professional therapist or psychologist.

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Approaching the topic of personality disorders can feel overwhelming, but we are here to make the difficult easier. When you feel it’s time to talk to a psychologist or therapist, you can easily book a session with us. No matter when you take the step, our experienced team is always ready to help you or your loved ones.


12 frequently asked questions about borderline personality disorder

What is a personality disorder?

A personality disorder is an enduring pattern of behaviour, worldview and inner experience that is markedly different from what is expected of those around you. This is because personality disorders can affect one’s ability to relate to others and function effectively in everyday life.

Is BPD a type of personality disorder?

Yes, borderline personality disorder is one of several types. It is a mental illness characterized by significant emotional instability, intense interpersonal relationships and a strong fear of abandonment.

How is BPD diagnosed?

Diagnosis of BPD is usually carried out by a psychiatrist or psychologist and involves a detailed diagnostic interview and family interview.

What treatment options are available for BPD?

Treatment usually involves a combination of psychotherapy and medication. Recommended psychotherapy includes dialectical behavioural therapy (DBT).

Does DBT help with trauma?

If you have experienced trauma and have symptoms of post-traumatic stress disorder (PTSD), it is important to get a thorough assessment and treatment for your PTSD symptoms. It is possible to get help with trauma as part of the treatment.

Is there any way to prevent personality disorders?

Personality disorders are largely caused by environmental influences during childhood, so there are things you can do to prevent unhealthy coping mechanisms from developing if you have children.

What is the difference between DBT and cognitive behavioural therapy (CBT)?

DBT is a later development of CBT but they are based on the same foundation of learning theory and thoughts, feelings and behaviours. DBT also includes more mindfulness-based elements that have been inspired by Zen Buddhism.

Are women more likely to attend DBT than men?

It is equally common for men and women to be diagnosed with BPD, with about 2% of the population having it. However, it is much more common for women to seek care and receive DBT, with about 75% of DBT clients being women.

Is it called EUPD instead of BPD?

Emotionally unstable personality disorder is also known as BPD, but EUPD is starting to be used more in healthcare as BPD can be a stigmatized term. EUPD is used in the ICD diagnostic manual while borderline personality disorder is described in the DSM-5 diagnostic manual.

What can I do as a family member?

The most important step is to encourage the person to seek professional help. You can also offer emotional support, but remember that you are not a substitute for qualified care.

Can you force someone to go to therapy?

No, you can’t force someone to undergo therapeutic treatment. A person needs to understand that they need to work on themselves. However, if your loved one is unable to care for themselves or poses an immediate risk to themselves or others, they may need to be admitted to the hospital involuntarily temporarily. This decision is made by a doctor. If you are concerned for a loved one with BPD, call 911.

Where can I get help?

If you think you may be in need of treatment, you can seek care through your family doctor or walk-in clinic and get a referral to psychiatry. If you thoughts of suicide or self-harm, call 911, call or text the National Suicide Hotline at 988, or go to your nearest emergency department.


Written by Sophia Coulter

Sophia is a registered nurse with experience in inpatient, emergency and community mental health care. She has a passion for providing emergency support for those experiencing mental health crises.