Borderline Personality Disorder: Causes, Symptoms & Treatment

Borderline Personality Disorder (BPD) is an inability to control intense feelings. An individual with BPD cannot moderate their emotions, leading to greater impulsivity, a decline in self-esteem, and strained relationships or social interactions.

According to the National Institute of Mental Health (NIMH), around 1.4% of adults in the US suffer from Borderline Personality Disorder. This is based on the National Comorbidity Study Replication data for 2001 to 2023.

Out of the 52% of the adult population in the US suffering from an anxiety disorder, 60.5% also simultaneously developed or showed signs of Borderline Personality Disorder. Of the 67% of people affected by any personality disorder, 84.5% were equally affected by BPD.

As per the Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County, 75% of the adults diagnosed with BPD are women. While men are also affected in similar numbers, BPD, in their case, is often misdiagnosed as PTSD.

Let’s look at the major causes of BPD to understand the core issue and its primary causative factors.

Causes of Borderline Personality Disorder

Borderline Personality Disorder is associated with a wide variety of symptoms. So, it is fairly difficult to make an accurate diagnosis. It might be tough for psychiatrists to evaluate BPD fully in its nascent stage.

This is because the symptoms can overlap with other mental illnesses, such as bipolar disorder, depression, and more.

Here are the primary causes of Borderline Personality Disorder:

1. Genetics plays a significant role. The risk of getting affected by BPD may be increased by the genes you inherit from your parents. 
2. An individual with BPD might have been a victim of violence, bullying, sexual abuse, and mistreatment by parents as a kid.
3. BPD patients might have had exposure to extreme distress early on in life. This could have a significant impact on your mood control abilities by hindering the development of the brain.
4. Chemical imbalances in the brain can also be another cause of BPD. Many researchers believe that abnormalities in brain neurotransmitters like serotonin and dopamine have a role in BPD.
5. Based on the Brain Magnetic Resonance imaging studies conducted on people affected by BPD, developmental issues in the brain can also be held responsible for BPD.

The MRI scans of the brain indicated that most people with BPD had an unusually abnormal brain size and also experienced irregularities in the three most important areas of the brain – the orbitofrontal cortex, the amygdala, and the hippocampus.

The orbitofrontal cortex manages critical thinking and planning, the amygdala controls negative emotions, and the hippocampus regulates behavior and enables exercising self-control.

So, when the functioning of the above crucial regions of the brain is compromised, you are more likely to experience BPD symptoms.

Symptoms of Borderline Personality Disorder

If you are dealing with Borderline Personality Disorder, you will constantly feel a burden of a mixed bag of uncontrollable emotions. But how do you exactly figure out if you have BPD?

Here are some ways to find out:

• Are your relationships with the people around you highly unstable, especially the relationship with your partner or spouse?
• You experience intense bouts of anger, stress, anxiety, sadness, etc
• In extreme situations, you think of giving up on life and contemplate suicide
• You tend to snap at people around you due to a sudden burst of anger
• You feel incredibly insecure and conscious of your self-image
• You impulsively engage in dangerous habits like excessive drinking, substance abuse, unsafe sex, etc
• You are constantly worried about close friends and family abandoning you for your random behavior
• You do not feel encouraged to pursue your goals
• You feel lonely at all times
• You experience a regular shift in mood swings 
• You get easily triggered and are extremely sensitive
• You have extreme trust issues

Treatments for Borderline Personality Disorder

Despite the severity of this mental condition, BPD is treatable. A proper diagnosis with an appropriate line of treatment can improve prognosis.

It is advisable to ditch the stigma around BPD and willingly undertake extensive treatment. Because according to mental health experts, those seeking help for BPD have better recovery outcomes than those who are left untreated.

It is reported that patients with BPD receiving organized therapy feel much better in about a year since the start of the treatment.

However, it is important to understand that there is no medication available to treat BPD upfront. There might be some drugs to alleviate symptoms, support your ongoing treatments, and help with better outcomes eventually.

Can Medications be Used for Treating Borderline Personality Disorder?

Supplements containing fish oil/Omega-3 fatty acids might help with mellowing down depression and aggression, especially in women suffering from BPD.

Some research even suggests administering mood stabilizers and anti-psychotic drugs to help control some of the major symptoms of BPD.

Medications that alter the oxytocinergic, glutamatergic, and opioid neurotransmitter systems have shown initial promise in treating Borderline Personality Disorder. Primary care doctors can also prescribe selective serotonin reuptake inhibitors to combat anxiety or depression that comes along with BPD.

Medication management supports primary treatment approaches and can improve prognosis to a considerable extent.

Different Treatment Methods for Borderline Personality Disorder

DBT, or Dialectical Behavioral Therapy, has been shown to be one of the most effective BPD treatment approaches. This approach works the best in most cases because it is highly regimented and calls for a serious commitment with full attendance from both the patients and the medical practitioners.

DBT involves a skill-based approach and even incorporates meditation. The method is particularly effective as you may be able to enhance your grip over your emotions that are otherwise hard to control. This way, you are in a better position to cope with difficult situations.

If you are recently diagnosed with BPD, the best initial line of treatment is psychotherapy or talk-based therapy offered by platforms such as BetterHelp, Talkspace, etc. This type of treatment falls in the category of CBT or Cognitive Behavioral Therapy.

CBT is effective initially as it can identify problematic thought patterns that can cloud your ability to think and find better solutions to challenging situations.

Talk therapy based on the concept of mentalization can teach you to distinguish your own thoughts from others. This can help promote and support the process of individual thinking.

Another method that can help you with BPD treatment is Schema-focused therapy or SFT. This involves re-framing your individual perception of yourself on the premise that BPD stems from a flawed self-image.

Your relationship with your medical professional or therapist can make a huge difference to the treatment outcomes of BPD. This is especially important for transference-focused psychotherapy.

Transference-focused therapy lays more emphasis on two-way communication and developing trust between you and your clinician. This approach can help your therapist understand your state of mind better to manage your emotions and interpersonal conflicts more effectively.

You can also opt for group therapy in addition to primary care or treatment for BPD.

Is Admission in Hospitals Required for Borderline Personality Disorder Treatment?

The severity of your BPD will determine the degree of special and isolated care that would be needed. Predominantly, counseling combined with psychiatric medication assistance is used for in-patient care.

Admittance to a special facility, mental health program, or hospital for BPD is a rarity. But there are dedicated psychiatric clinics or short-term hospital accommodations available for those who show suicidal tendencies or have a history of rampant violence and self-harm.

Conclusion

The best way to go about Borderline Personality Disorder treatment is to treat the individual at a holistic level instead of just targeting the specific symptoms of BPD.

The BPD statistics reported by the Recovery Village state that the treatment approaches practiced for Borderline Personality Disorder had a success rate of roughly 50% during a 10-year observation period.

The National Library of Medicine states that about 91% of adults recovered successfully with consistent therapy and experienced respite from BPD for longer than expected durations.

However, it should be noted that medical care for this mental condition can be time-consuming and would only show a significant positive impact if pursued patiently.