Borderline Personality Disorder: What It Looks Like

Marked by intense outbursts of anger, impulsiveness, periods of depression and anxiety, and deep-seated fear of abandonment, borderline personality disorder (BPD) can distort how its sufferers perceive themselves and the people around them. People with BPD tend to see life and other people through a filter of binary, black/white or good/bad thinking that can damage their relationships and cause them to suddenly distance themselves from loved ones.

It feels like going through life with third-degree burns; everything is hot and painful to touch.

According to the National Institute of Mental Health, symptoms of borderline personality disorder include:

• Volatile, unstable relationships with friends and family
• Hypersensitivity to abandonment (real or imagined) and going to great lengths to avoid it, including breaking off relationships suddenly or preemptively
• Impulsive behaviors (spending sprees, sexual hookups, substance abuse, and the like)
• An altered sense of self/self-worth
• Self-harming, or suicidal thoughts or threats
• Chronic mood swings and spells of intense, out-of-proportion anger
• Deep trust issues, suspicion of others’ motives, and persistent feelings of emptiness
• Distorted views of others and self

In sum, the churning feelings that BPD patients deal with can lead to “intense and unstable relationships,” the NIMH says. This can be challenging both for the person with BPD and those around them.

Researchers aren’t certain of the causes of BPD, but it’s believed that genetics may play a role in the development of the disorder, as may a history of traumatic events. Researchers have identified some structural differences in the brains of patients with borderline personality disorder, but they do not yet understand if these structural changes are a cause of the disorder – or a result of it.

What Is It Like to Have Borderline Personality Disorder?

Healthline questioned patients about what it’s like living with borderline personality disorder. The responses indicate that sufferers experience their feelings very strongly. One person interviewed said, “Everything is felt more intensely: good, bad, or otherwise.” Another described a “pervasive fear” of abandonment. Said another, “It feels like going through life with third-degree burns; everything is hot and painful to touch.”

Another respondent discussed the stigma surrounding people with BPD: “Many people believe that those living with it can be manipulative or dangerous due to their symptoms. While this can be the case in a very small minority of people, most people with BPD are just struggling with their sense of self and their relationships … and need a little bit of extra love.”

Treating Borderline Personality Disorder

BPD can be challenging to treat, in part because its symptoms can be confused with, or co-occur with, those of other disorders, like bipolar disorder or depression. Borderline personality disorder is sometimes confused for multiple personality disorder because of the patient’s rapid mood changes – but they’re not the same thing.

According to the NIMH, treatment with a therapist who specializes in BPD will be most effective. Treatment may utilize Cognitive Behavioral Therapy (CBT), which helps patients develop their problem-solving and emotion-processing skills, or Dialectical Behavior Therapy (DBT), which was developed to treat BPD.

BPD can be challenging to treat, in part because its symptoms can be confused with, or co-occur with, those of other disorders, like bipolar disorder or depression.

DBT helps patients:

• develop increased mindfulness (being able to accept and be present in what’s happening right now)
• learn to tolerate stress (to increase their ability to deal with negative emotions)
• manage their emotional responses to events around them
• work on their interpersonal communication skills to improve their relationships

Psychotherapy is favored over medication, although mood stabilizers or anti-depressants may also be used to help manage symptoms in some cases.

Treatment may also include family members or loved ones who are impacted by the patient’s emotional volatility. Counseling involving loved ones may help them to understand how the disorder works and learn ways of interacting that benefit their patient. This may also help the person with BPD feel understood and supported.