Borderline Personality Disorder

Borderline personality disorder (BPD) is a serious mental illness marked by unstable moods, behavior and relationships. The term was first used by psychiatrists to describe this disorder which was on the “border” of psychosis. A more accurate term does not exist yet.

The American Psychiatric Association describes people with BPD as having a distorted and unstable self-image or sense of self. Without the emotional grounding that a belief system or sense of identity provides, their values, opinions and feelings can change suddenly. They may feel compelled to do things they would rather not do or may be unaware of actions they have taken. 
People with severe BPD will have extreme changes in personality (psychotic episodes) lasting a few hours and only rarely more than a few days.  Most people who have borderline personality disorder suffer from:

  • Difficulty controlling emotions and thoughts
  • Impulsive or self-destructive behavior (excessive spending, risky sex, drug or alcohol abuse, reckless driving or binge eating)
  • Chaotic relationships with others which alternate between extremes of idealization and devaluation

Additional Signs and Symptoms

  • Frantic efforts to avoid real or imagined abandonment
  • Chronic feelings of emptiness or worthlessness
  • Inappropriate, intense anger or difficulty controlling anger (frequent displays of temper, constant anger, recurrent physical fights)
  • Transient, stress-related paranoid thoughts
  • Feeling disconnected from one’s body, thoughts or surroundings (dissociative symptoms)
  • Inability to gain any satisfaction from work or hobbies

People with BPD often have an additional disorder (co-occurring disorder or dual diagnosis), such as:  depression, anxiety disorders, substance abuse, eating disorders and self-harm. They are at greater risk for suicidal behavior or committing suicide.


There is no single cause for borderline personality disorder, although researchers believe that developing it comes from a combination of multiple factors, including an individual’s genes, personal temperament, social interactions, and coping skills. A dysfunctional family life, including, physical, sexual and emotional abuse, and abandonment during childhood or adolescence may contribute to the development of BPD. It usually starts in the teen years, although some signs of it may appear in childhood.


After medical exam is performed to rule out other possible causes of symptoms, the individual is referred to a mental health professional experienced in diagnosing and treating mental disorders, such as a psychiatrist, psychologist, clinical social worker, or psychiatric nurse (APRN or ARNP).  They can conduct a thorough interview and perform a psychological evaluation to assess the severity of the symptoms.


Psychotherapy usually is the most effective treatment for borderline personality disorder. Medication may be prescribed to treat depression and mood swings. Types of psychotherapy used to treat borderline personality disorder include the following:

  • Cognitive behavioral therapy (CBT). CBT can help people with borderline personality disorder identify and change core beliefs and/or behaviors that underlie inaccurate perceptions of themselves and others and problems interacting with others. CBT may help reduce a range of mood and anxiety symptoms and reduce the number of suicidal or self-harming behaviors.
  • Dialectical behavior therapy (DBT). This type of therapy focuses on the concept of mindfulness, or being aware of and attentive to the current situation. DBT teaches skills to control intense emotions, reduces self-destructive behaviors, and improves relationships. This therapy differs from CBT in that it seeks a balance between changing and accepting beliefs and behaviors.
  • Schema-focused therapy. This type of therapy combines elements of CBT with other forms of psychotherapy that focus on reframing schemas, or the ways people view themselves. This approach is based on the idea that borderline personality disorder stems from a dysfunctional self-image—possibly brought on by negative childhood experiences—that affects how people react to their environment, interact with others, and cope with problems or stress. Source:  National Institutes of Mental Health Information Resource Center

CHI Health Psychiatric Associates, with offices in Omaha and surrounding areas, has highly-trained mental health providers who can address the psychological needs of those who suffer from for personality disorders,

If you think you or a loved one may be suffering from for borderline personality disorder, call (402) 717-HOPE.