What Is Borderline Personality Disorder?
Borderline personality disorder is a mental health condition where the core problem is difficulty managing emotions. People with BPD feel emotions at high intensity and for longer than most people. When something upsetting happens, it takes much longer to calm back down.
The name itself is outdated. In the 1930s, psychiatrist Adolph Stern used the word "borderline" because he thought these patients fell between neurosis and psychosis. What doctors now understand is that BPD is fundamentally about emotional dysregulation.
BPD has historically been diagnosed far more often in women, who make up about 75% of clinical diagnoses. However, men with BPD tend to show outward symptoms like explosive anger or substance abuse, which leads to misdiagnosis.
Recognizing the Symptoms
The DSM-5 lists nine symptoms of BPD. A person needs to show at least five of them consistently for a diagnosis:
Emotional & Identity Symptoms
- Fear of abandonment: Deep fear of being left alone or rejected
- Unclear or shifting sense of identity and values
- Chronic emptiness: Persistent feeling of being hollow or numb
- Emotional instability: Rapid mood swings triggered by events
Behavioral & Relational Symptoms
- Unstable relationships: Alternating between extreme closeness and conflict
- Impulsive, self-damaging behavior (e.g., reckless spending, substance use)
- Self-harm or suicidal behavior
- Intense, inappropriate anger or difficulty controlling temper
- Stress-related paranoid thinking or dissociation
What Causes Borderline Personality Disorder?
There is no single cause. BPD develops from a combination of genetics, brain differences, and life experiences:
Genetics
- Having a close relative with BPD raises the risk
- Family and genetic factors may increase risk, but they do not determine whether someone will develop BPD.
Brain Differences
- Overactive amygdala (emotional center)
- Underactive prefrontal cortex (impulse control)
- Mismatched emotional regulation networks
Childhood Environment
- History of trauma, abuse, or neglect
- Invalidating childhood environment where emotions were dismissed or punished
Treating Borderline Personality Disorder at SavantCare
BPD is highly treatable. Long-term studies show that with sustained treatment, the majority of people eventually achieve remission:
Dialectical Behavior Therapy (DBT)
The gold standard treatment. Teaches mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
Mentalization-Based Therapy (MBT)
Helps improve the ability to understand what you and others are thinking and feeling during stressful moments.
Schema-Focused Therapy
Targets deeply held negative beliefs formed in childhood to help meet emotional needs in healthier ways.
Your Care Team
Our board-certified psychiatrists specialize in treating psychotic disorders with compassion and expertise.
Dr. Bernice Ponce de Leon
DO, Board-Certified Child & Adolescent Psychiatrist | Licensed in CA, NV
View profileWhen Should You Seek Help?
If someone you care about has BPD, your support matters but it needs to come with firm boundaries. Consider these approaches:
Reach out if you or a loved one experience:
- Validate their feelings without necessarily agreeing with their behavior
- Set clear, consistent limits and hold them every time
- Use the SET method during crises: Support, Empathy, Truth
- Encourage professional treatment and seek your own support
Ready to take the next step?
Our team is here to help — no pressure, no judgment.
Frequently Asked Questions
Cured is not quite the right word, but many people experience significant improvement. Specialized therapies can help individuals manage symptoms, improve relationships, and build a stable, fulfilling life.
No. Both involve mood instability but the pattern is different. BPD mood shifts are rapid (hours) and triggered by relationships. Bipolar episodes are longer (weeks) and include distinct manic or depressive phases.
Triggers usually involve other people. Feeling rejected, being criticized, a sudden change in plans, or sensing that someone is pulling away can set off a strong reaction.
Genetics play a role, as having a close relative with BPD raises the risk. However, environment and childhood experiences also significantly contribute to its development.
Yes, it is very common. Many people with BPD experience major depression at some point. A coordinated treatment plan can help address both mood symptoms and BPD-related patterns.
This informal phrase is sometimes used for people whose symptoms are less visible to others, but it is not a formal diagnosis.
This is a debated, non-diagnostic framing. While some advocates include BPD because of differences in emotional processing, it is not required for clinical care and is not traditionally classified as a neurodivergent condition like autism or ADHD.