Learning About Borderline Personality Disorder

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What is borderline personality disorder?

Borderline personality disorder is a mental health condition. It causes intense mood swings, impulsive behaviors, and severe problems with self-worth. It can lead to troubled relationships in every area of your life.

Experts don't know exactly what causes the disorder. It may be linked to a problem with the parts of the brain that control reactions to emotions. The disorder also seems to run in families. Often, people who get it faced some kind of childhood trauma such as abuse, neglect, or the death of a parent. Most of the time, signs of the disorder first appear in childhood. But problems often don't start until the early adult years.

It's important to know that the disorder can be treated. Treatment can be hard, and getting better can take years. But with treatment, most people with borderline personality disorder do get better over time.

What are the symptoms?

Everyone has problems with emotions or behaviors sometimes. But if you have borderline personality disorder, the problems are severe. They repeat over a long time and disrupt your life. The most common symptoms include:

  • Intense emotions and mood swings.
  • Harmful, impulsive behaviors. These may include substance use, binge eating, out-of-control spending, risky sexual behavior, and reckless driving.
  • Hurting yourself. This may include cutting or burning yourself or attempting suicide.
  • Trouble with relationships. You may see others as either "good" or "bad." And your view may suddenly shift from one to the other, for minor reasons.
  • Feeling worthless or empty inside.
  • A frantic fear of being left alone (abandoned). This fear may lead to desperate attempts to hold on to those around you. Or it may cause you to reject others before they can reject you.
  • Problems with anger. These may include violent temper tantrums and aggressive behavior.

How is it treated?

It may seem that there is no one on your side. You might have been told that there is no hope. But just because you've heard this, that doesn't mean it's true. Getting medical treatment and taking care of yourself can really help.

Medical treatment

When you start treatment, you will find health professionals who will help you. You will also meet others who have gone through what you are going through.

Long-term treatment can reduce symptoms and harmful behaviors. It can also help you manage your emotions better. Treatment may include:

  • Counseling and therapy. It's important to find a counselor you can build a stable relationship with. This can be hard. Your condition may cause you to see your counselor as caring one minute and cruel the next. This can happen especially when your counselor asks you to try to change a behavior. Try to find a counselor who has special training in dialectical behavioral therapy. It's a type of therapy that is often used to treat people with this disorder.
  • Medicines. Examples are antidepressants, mood stabilizers, and antipsychotics. They may be helpful when you use them along with therapy.

Self-care

There are things you can do to help yourself. Here are some tips:

  • Keep a regular daily schedule.
  • Do not drink alcohol or use drugs. If your doctor prescribed medicines for you, take them exactly as directed.
  • Get a healthy amount of sleep. Try to be active during daylight hours, and go to sleep and wake up at the same time each day.
  • Eat healthy foods like fruits and vegetables; whole-grain breads and cereals; and lean meats, fish, and poultry.
  • Practice mindfulness or other meditation. To be mindful means to pay attention to and accept the things that are happening right now, in the present moment.
  • Keep to your treatment plan, even when it's hard.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

  • Call the Suicide and Crisis Lifeline at 988.
  • Call 1-800-273-TALK (1-800-273-8255).
  • Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to 988lifeline.org for more information or to chat online.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You feel you cannot stop from hurting yourself or someone else.

Call your doctor now or seek immediate medical care if:

  • You feel much more depressed.
  • You hear voices.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have a new crisis you can't handle.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

Go to http://www.healthwise.net/patientEd

Enter G653 in the search box to learn more about "Learning About Borderline Personality Disorder".

The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.