Borderline Personality
A Challenging but Treatable Disorder

Borderline personality disorder (BPD) is a serious mental illness that centers on the inability to manage emotions effectively.  The disorder occurs in the context of relationships:  sometimes all relationships are affected, sometimes only one or several.

The symptoms include:  fear of abandonment, impulsivity, anger, bodily self-harm, suicide, feelings of emptiness, chaotic relationships. While some persons with BPD are high functioning in certain settings, their private lives may be in turmoil. Others are unable to work and require financial support.

Diagnostic Criteria

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

1)   Frantic efforts to avoid real or imagined abandonment.

2)   A pattern of unstable and intense interpersonal relationships characterized by alternating between  extremes of idealization and devaluation.

3)  Identity disturbance:  markedly and persistently unstable self-image or sense of self.

4)   Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).

5)   Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

6)   Affective [mood] instability.

7)   Chronic feelings of emptiness.

8)   Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

9)   Transient, stress-related paranoid ideation or severe dissociative symptoms.

*Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association

Officially recognized in 1980 by the psychiatric community, BPD is more than two decades behind in research, treatment options, and family psycho-education compared to other major psychiatric disorders. BPD has historically met with widespread misunderstanding and blatant stigma.  However, evidenced-based treatments have emerged over the past two decades bringing hope to those diagnosed with the disorder and their loved ones.


Suicide and Self-Injury

10% of adults with BPD commit suicide

55-85% of adults with BPD self-injure their bodies

33% of youth who commit suicide have features of BPD

Heritability of this illness is estimated to be up to 68%.

Treatment Challenges

evidence-based therapies for BPD exist but need wider dissemination

about 85% of people with BPD also meet the diagnostic criteria of another mental disorder

a 30-year woman with BPD typically has the medical profile of a woman in her 60s

38% of adults with BPD are prescribed three or more medications

Economic Impacts

up to 40% of high users of mental health services have BPD

over 50% of people with BPD are severely impaired in employability

BPD is implicated in 17% of the prison population

38% of those with BPD have substance abuse/dependence disorders


Growing Support and Awareness

  • NAMI raises BPD to one of its priority populations in March 2006
  • Congressional Luncheon Briefing on Borderline Personality Disorder, May 8, 2007
  • U.S. House of Representatives unanimously passes House Resolution 1005 on April 1, 2008, designating May as Borderline Personality Disorder Awareness Month
  • Congressional Luncheon Briefing on Borderline Personality Disorder, May 19, 2010
  • Well-known individuals are finally coming forth to help build awareness and bring hope

For additional information on BPD, please see our articles on What is BPD and A BPD Brief.

Source: Research presentations at NEABPD Conferences 2002-2013 https://www.borderlinepersonalitydisorder.org