Borderline Personality Disorder (BPD) is quite well-known to the general public, especially due to media coverage. However, it is often presented with exaggerated and inaccurate symptoms, which contributes to stigma and misunderstanding. BPD frequently remains undiagnosed, and people who could receive help and improve their quality of life continue to struggle alone and are sometimes even criticized.

 

What is Borderline Personality Disorder?

Borderline Personality Disorder is a serious mental health condition characterized by instability that affects interpersonal relationships, self-esteem, and emotional regulation, accompanied by intense impulsivity. People with this disorder have difficulty managing their emotions and behavior.

Impulsive behavior may manifest in at least two potentially dangerous areas such as uncontrollable spending, sex, substance abuse, gambling, and more. Individuals with BPD are prone to suicide attempts and self-harm. Emotional instability is expressed by sudden mood swings accompanied by a chronic feeling of emptiness. People with BPD sometimes feel intense and disproportionate anger or have difficulty controlling it. In response to stress, paranoid thoughts (suspiciousness) or severe dissociative symptoms may appear. In addition, they experience an intense fear of abandonment and constantly make efforts to avoid real or imagined situations of being left alone.

The causes of BPD are not fully understood, but it is believed to result from a combination of genetic, biological, and psychosocial factors. Traumatic childhood experiences such as abuse or neglect can significantly contribute to the development of this disorder.
It is estimated that 1–2% of the world’s population lives with BPD. It is diagnosed more frequently in women than in men.

 

Impact on Life

People with BPD are very sensitive to environmental circumstances. The intense fear of abandonment and unwarranted anger can arise even in situations involving realistic and ordinary separations from a loved one. They may believe that the loved one’s “departure” means that they are “bad.”

These experiences lead to intense and unstable relationships where every disagreement may seem catastrophic. They may idealize a partner or friend, only to suddenly change their opinion and devalue people if they feel disappointed or betrayed. Emotional instability and sudden mood changes are core features of their inner experience. These changes may occur without any obvious reason, making their lives unpredictable and stressful. The feeling of emptiness and a lack of clear self-identity lead to a constant search for external sources to confirm their importance and worth.

Self-harm and suicide attempts are often calls for help and expressions of deep internal pain.

Unstable and conflictual relationships, difficulties with self-esteem, and frequent emotional fluctuations also lead to social and occupational problems.

 

Treatment

Effective help for a person with BPD includes psychotherapy, sometimes medication, and support from loved ones.

In some cases, short-term intensive treatment in a hospital setting may be required, but treatment is mainly provided on an outpatient basis.

Medication may include antidepressants, mood stabilizers, and antipsychotics to manage symptoms. However, the primary treatment method is psychotherapy.

Dialectical Behavior Therapy (DBT) was specifically developed to help people with Borderline Personality Disorder. It uses concepts of mindfulness or awareness of the present moment and emotional state. It also teaches skills that help people manage intense emotions, reduce self-harming behaviors, and improve relationships.

Another effective method can be Cognitive Behavioral Therapy (CBT), which helps identify and change core beliefs and behaviors arising from inaccurate perceptions and interpersonal difficulties. CBT can help reduce mood swings and anxiety symptoms and may decrease self-harm and suicide attempts.

As a result of therapy, symptoms in most people with BPD significantly decrease and often disappear. However, these improvements do not necessarily translate into stable relationships or the ability to maintain employment. The goal of treatment is to help the person better manage daily challenges. Improvement in symptoms after starting treatment may take time.

It is important for people with Borderline Personality Disorder and their loved ones to be patient, adhere to the treatment plan, and seek support throughout the therapeutic process.