Borderline personality disorder (BPD)

Borderline personality disorder (BPD) is a mental health disorder that can be treated. It affects people's thoughts, emotions and behaviours making it difficult for them to cope in many areas of life. People with borderline personality disorder may feel unsure about themselves and their relationships. They often have trouble controlling their feelings and urges.

Research estimates 1 in 100 adults live with borderline personality disorder. It's more common for women to be diagnosed, but men experience it at a similar rate. Usually symptoms appear in the teenage years or early adulthood.

There are many different borderline personality disorder symptoms including:

• feeling empty or having low self-esteem
• overwhelming emotions and feelings
• anger, irritability or unstable moods
• anxiety about relationships and attempts to avoid abandonment
• difficulties with self-image or sense of self
• self-harm, suicidal thoughts or suicide attempts
• impulsive and risk-taking behaviour — such as unsafe sex, alcohol or drug use, gambling, over eating, reckless driving or spending money without thinking about it

People with BPD often have unstable relationships, where they feel very close to someone else and then suddenly dislike them very much.

Not all people with borderline personality disorder have the same symptoms.

The causes of borderline personality disorder are not completely understood. It is probably caused by a combination of genes and life experiences.

It is common for people with borderline personality disorder to have a history of childhood abuse, neglect or trauma. These experiences can lead to strong emotions and difficulty putting trust in other people, and can result in symptoms of BPD. However, you can develop BPD without these experiences. You can also have these experiences without getting BPD.

You should see a doctor if you:

• feel you need support
• have signs of emotional distress (being very sad, angry or anxious)
• are harming yourself
• think or talk about suicide

It's common for people with borderline personality disorder to have thoughts of self-harm and suicide.

If you or someone you know has symptoms of borderline personality disorder, the first step is to see your doctor.

Your doctor can refer you to a mental health professional, such as a psychologist or psychiatrist. You should be assessed by a mental health professional who has experience treating people with borderline personality disorder. They can diagnose BPD based on your symptoms and experiences.

Once a diagnosis is made for borderline personality disorder, you will need ongoing treatment with a mental health professional.

The most effective treatment is a mix of support and psychological therapy. Medicine can sometimes help relieve some of the symptoms, but it is not a main treatment.

In severe cases, a person with borderline personality disorder may need to go to hospital. This is not a standard treatment. It is usually only used as a short-term solution for those who are at risk of harming themselves or suicide.

Psychological therapy

Psychological therapy is the main type of treatment for borderline personality disorder.

Examples of evidence-based therapies that can help include:

• dialectical behavioural therapy (DBT)
• psychodynamic therapy
• schema therapy — a type of cognitive behaviour therapy

These are long term therapies that focus on:

• helping people understand and cope with emotions
• tolerating distress
• choosing different behaviours when triggered
• healthy relationships
• taking responsibility for themselves

Medicine

Medicine is not recommended as the main treatment for borderline personality disorder, though it can sometimes be useful for a short period of time to help control some symptoms.

Speak with your doctor if you have borderline personality disorder and have any concerns.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Family and friends of people with borderline personality disorder may also need support to help them cope with caring for their loved one. SANE Australia (Opens in new tab) has guides and resources for families, friends and others caring for someone with a mental illness.

If you need someone to talk to or want to find out more online, here are some organisations that might be able to help:

• Lifeline (Opens in new tab) 13 11 14 — for anyone in crisis
• ReachOut.com (Opens in new tab) — youth mental health service for information and online forum
• SANE Australia (Opens in new tab) — provide fact sheets on borderline personality disorder (Opens in new tab)
• Australian BPD Foundation (Opens in new tab)
• Medicare Mental Health (Opens in new tab) — for advice and to get connected to local mental health services, call 1800 595 212. Check the operating times.

Do you prefer to read in languages other than English?

• Transcultural Mental Health Centre (Opens in new tab) has many resources about wellbeing and mental health in different languages.

Looking for information for Aboriginal and/or Torres Strait Islander people?

• Yarn Safe (Opens in new tab) has mental health and wellbeing information for Aboriginal and/or Torres Strait Islander people.
• Wellmob (Opens in new tab) has more mental health information and resources Aboriginal and/or Torres Strait Islander people.