Borderline personality disorder

Borderline personality disorder (BPD) is one of a group of psychiatric conditions known as ‘personality disorders’. BPD is marked by distressing emotional states, difficulty relating to other people and self-harming behaviour.

Symptoms of borderline personality disorder (BPD)

People with BPD have difficulty relating to other people and the world around them. Symptoms may include:

• Idealising or devaluing other people
• Difficulty compromising
• An absence of control in areas that could be self-damaging. For example, spending of money, unsafe sex or substance abuse
• Intense outbursts of anger, anxiety and depression.

Extreme behaviour and BPD

People with BPD may exhibit extreme behaviour, such as repeated self-mutilation or taking overdoses of medication. There may be a variety of reasons for such behaviour. The person with BPD may feel that they are dependent on others for their identity or may be afraid of being abandoned. The extreme behaviours are frantic efforts to avoid real or imagined abandonment. Such behaviour is often dismissed as ‘attention-seeking’ or manipulation. However, the behaviour is a symptom of the disorder and requires professional help, as well as education and support for family and other carers.

Causes of BPD

The causes of BPD are unclear, but may involve:

• Psychological factors
• Biological factors
• Social factors.

Traumatic experiences in early life are common in people with BPD.

Numbers of people with BPD

About two in every 100 people (about 300,000 Australians) will develop BPD. Women are three times more likely than men to develop BPD.

Treatment can reduce BPD symptoms

Treatment can help people manage, reduce or even eliminate symptoms of BPD. The behaviour associated with this condition means that people with BPD often alienate those who know them, so they have difficulty finding effective support and treatment.

Current effective treatments for BPD

Currently, the most effective treatments for BPD are:

• Psychotherapy – the doctor or psychologist talks to the person about their symptoms. They also discuss alternative ways to cope with symptoms
• Psychosocial rehabilitation – to help people learn social skills
• Medication – this may help reduce associated symptoms such as anxiety or depression.

Treatment of associated conditions

BPD often occurs with:

• Mood disorders (for example, bipolar disorder and depression)
• Eating disorders
• Alcohol or drug abuse.

It is essential that each of these disorders is recognised and treated separately.

• People with BPD often have trouble relating to other people.
• BPD may cause a person to display extreme behaviours, such as self-mutilation.
• BPD often occurs with mood disorders, eating disorders and alcohol or drug abuse. Each condition (including BPD) must be recognised and treated separately.