Borderline Personality Disorder

What is Borderline Personality Disorder or BPD?

Borderline personality disorder is a disorder characterized by an ongoing pattern of varying moods, self-image, and behavior. These changes in mood often result in impulsive actions. These impulsive actions can cause relational problems and a pattern of unstable relationships. People with BPD may experience intense episodes of anger, depression, low self-esteem, and anxiety. These episodes can last from a few hours to a few days.

What does BPD look like?

People with BPD tend to view things in extremes, such as all good or all bad. Their opinions of others can shift quickly. They can see a person as a close, dear friend one day and an enemy the next. Because of these extreme shifts, those with BPD often have unstable, “roller coaster” types of relationships. This includes their relationships with people who are not their significant other such as friends, coaches, and family.

Other signs or symptoms may include:

  • Efforts to avoid real or imagined abandonment, such as quickly initiating intimate relationships or cutting off communication with someone in anticipation of being abandoned
  • Impulsive and often dangerous behaviors, such as gambling, reckless driving, unsafe sex, spending sprees, binge eating or drug abuse, or sabotaging success by suddenly quitting a good job or ending a positive relationship
  • A pattern of unstable intense relationships, such as idealizing someone one moment and then suddenly believing the person doesn’t care enough or is cruel
  • Rapid changes in self-identity and self-image that include shifting goals and values
  • Feelings of emptiness
  • Periods of stress-related paranoia and loss of contact with reality, lasting from a few minutes to a few hours
  • Suicidal threats, behavior, or self-harm, often in response to fear of separation or rejection

How does the DSM define BPD?

*Please note that this is intended for educational purposes only. For a diagnosis of SUD, you must have a complete history & evaluation completed by a behavioral health specialist.*

The Criteria for a BPD Diagnosis according to the DSM-5:

BPD is a pervasive pattern of instability in interpersonal relationships, self-image, and emotion, as well as marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  • Chronic feelings of emptiness
  • Emotional instability in reaction to day-to-day events (e.g., intense episodic sadness, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
  • Frantic efforts to avoid real or imagined abandonment
  • Identity disturbance with markedly or persistently unstable self-image or sense of self
  • Impulsive behavior in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
  • Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
  • Pattern of unstable and intense interpersonal relationships characterized by extremes between idealization and devaluation (also known as “splitting”)
  • Recurrent suicidal behavior, gestures, or threats, or self-harming behavior
  • Transient, stress-related paranoid ideation or severe dissociative symptoms

How is BPD treated?

In most cases, Borderline Personality Disorder is best treated with a combination of behavior therapy, family therapy and at times — medication. Certain modalities like trauma informed therapies (ART, EMDR, Somatic therapies, mindfulness) in conjunction with other therapies that target impulses & thought patterns like CBT (cognitive behavioral therapy) and DBT (dialectical behavioral therapy) are often integrated into a treatment plan. What works best can depend on the person and their family system. Good treatment plans will include close monitoring, follow-ups, family & relational work, and making changes, if needed, along the way.

When should I call your office? 

If you or your loved ones have concerns about BPD, you can work with a specialist. At Soma Therapy, we can help! Call 316-201-6047 or fill out our contact form to get help & learn more about BPD resources today. We also often provide referrals if we cannot connect you with the right resources within Soma Therapy. 

Resources and Sources: