What is borderline personality disorder?
“Borderline personality disorder is a mental illness marked by an ongoing pattern of varying moods, self-image, and behavior. These symptoms often result in impulsive actions and problems in relationships. People with borderline personality disorder may experience intense episodes of anger, depression, and anxiety that can last from a few hours to days.”
The numbers
- The past-year prevalence of any personality disorder among US adults is 9.1%; for borderline personality disorder specifically it is 1.4%.
- Sex and race were not found to be associated with the prevalence of personality disorders.
Watch: What is borderline personality disorder? — Kati Morton on BPD, self-harm and eating disorders, and how they relate.
In their words
What is black-and-white thinking?
“When I am speaking to a group about my history, I always list the typical symptoms of borderline personality disorder, since most people are unfamiliar with the diagnosis. One of the questions I am most frequently asked is: what is black-and-white thinking?”
Read the article (The Mighty)
How it feels from the inside
“BPD makes me lash out, allowing some of the cruelest things to tumble from my mouth. And believe me, there are only so many times loved ones will forgive a lack of control.”
The symptoms, as memes
Read the article (The Mighty)
How does treatment help?
Treatment for BPD usually means a talking therapy rather than medication, and it tends to run for a year or more. Two are designed for it specifically.
Dialectical behavior therapy
DBT was built for BPD. It starts from two ideas: that some people are more emotionally vulnerable than others, so a small amount of stress produces a large amount of distress; and that growing up somewhere your emotions were dismissed — told you had no right to feel sad, or that you were being silly — teaches you that having those feelings makes you a bad person. Together those can become a loop: intense feeling, then guilt about the feeling, then more intense feeling.
DBT tries to break the loop with two ideas of its own. Validation means accepting that your emotions are real and reasonable. Dialectics means holding that most things are not either-or, and that two contradictory things can both be true. A therapist might accept that sadness is what leads you to self-harm, and that this does not make you a terrible person — while also challenging the idea that self-harm is the only way to cope with it.
It usually involves weekly individual and group sessions. It has the strongest evidence of any treatment for BPD, particularly for people with a history of self-harm.
Mentalisation-based therapy
MBT is built on the idea of mentalising — thinking about thinking. That means being able to step back from a thought and ask whether it is useful, realistic and true, rather than acting on it immediately. It also means recognizing that other people have their own thoughts and reasons, and that your read on what someone else is feeling may simply be wrong.
The goal is to build that stepping-back ability. A course usually lasts around eighteen months.
Books that portray BPD
Girl, Interrupted, by Susanna Kaysen
In 1967, after a session with a psychiatrist she had never met, eighteen-year-old Susanna Kaysen was put in a taxi and sent to McLean Hospital. Her account of the two years that followed.
The Bell Jar, by Sylvia Plath
Esther Greenwood is brilliant, talented and successful, and slowly going under.
Get Me Out of Here, by Rachel Reiland
A memoir of recovery from BPD.
Celebrities who advocate
Pete Davidson
On living with BPD, and on being in dialectical behavior therapy for it. Read the article (The Mighty)
Nessa Barrett
“I wish that I had a person that was releasing music or openly advocating for mental health, to help me realize that there's a lot of people that go through the same thing.”
A note from the team
We are not experts and do not seek to diagnose or act in place of professional psychiatric treatment. We are an organization seeking to raise awareness. If you have concerns about any of this material, please email us.
Sources
- National Institute of Mental Health — Borderline personality disorder (the definition)
- National Institute of Mental Health — Personality disorders statistics (the numbers)
- NHS — Borderline personality disorder: treatment (the descriptions of DBT and MBT, condensed; the UK-specific parts of this page are deliberately not reproduced)