Main Symptoms
Borderline personality disorder* is a mental disorder that results in four groups of
behavioral symptoms:
- excessive, unstable and poorly regulated emotional responses, especially anger;
- impulsive behaviors that are harmful to you or to others, such as spending sprees, excessive use of alcohol or drugs, self-injurious acts, and sexual indiscretions;
- suspiciousness, misperceptions, an unstable self-image, a poor sense of your identity, and difficulty in reasoning under stress; and
- tumultuous relationships that vary from extreme fear of abandonment to episodes of excessive anger directed towards a person very close to you, and the desire to get away from that person.
*The term
borderline disorder is primarily used on this website because many patients and family members find the inclusion of the word “personality” in the name of the disorder to be offensive. In addition, there is ongoing debate about this issue amongst the leading professionals in the field.
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Age of Onset
The
symptoms of borderline personality disorder usually first occur in the teenage years and early twenties. However, onset may occur in some adults after the age of thirty, and
behavioral precursors are evident in some children.
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The Effects
Borderline disorder often results in devastating effects on those who suffer from it, as well as on their families and friends. The
behaviors associated with borderline personality disorder may be extremely disruptive to your life in many ways, and to your family as well, resulting in frequent arguments, fights, running away, absences from and poor performance at school and work, frequent job changes and divorces. The children of those with
borderline personality disorder are especially affected.
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Prevalence
The results of the largest, and recently published (Grant et al, 2008), National Institute of Mental Helath study suggests that the lifetime prevalence rate of borderline disorder is about 6%, and occurs equally in men and women. These results are in stark contrast to those of former, much smaller studies, which reported prevalences of 1 to 2 %, and rates three times more common in women than in men. To place these numbers in perspective, if the 6% prevalence rate is correct, then approximately 1 in every 17 persons suffers from the disorder. Most people personally know more than one person with borderline disorder.
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Complications
People with borderline disorder are much more likely to
seek medical help for
physical and emotional symptoms than other people in the general population. For example, about 6% of patients seen in primary care settings suffer from borderline disorder, a rate three to six times more frequent than the general prevalence of the disorder. Ten percent of all psychiatric outpatients, and 20% of psychiatric inpatients involve people with borderline disorder.
Borderline disorder is also associated with a much higher rate of
other psychiatric disorders, such as
depression,
anxiety disorders,
substance abuse, and
ADHD than the prevalence of these disorders in those without it. In addition, about 9% of people with borderline disorder commit suicide.
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Risk Factors
There are biological and environmental factors that increase the
risk of someone developing borderline disorder. The most common
biological risk factor appears to be genetic. The importance of biological factors in borderline disorder is indicated, in part, by the findings of numerous neuroimaging (brain scan) studies. These have shown significant abnormalities in specific pathways in the brains of people with borderline disorder compared to people in the general population. Poor parenting, and repeated physical, emotional and sexual abuse are very common
environmental risk factors for borderline disorder. It now seems apparent that in most cases,
biological and environmental factors interact to result in the disorder.
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Treatments
Effective treatments are now available for people who suffer from borderline disorder. The main treatments utilized are
medications in combination with the most appropriate
individual and group psychotherapies. It is now increasingly well recognized that structured
family involvement in the treatment process substantially improves the results and shortens the length of treatment.
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Prognosis
With
effective treatment, most people with borderline disorder experience a significant reduction in
symptoms and improvement in their lives. As of now, there are no complete
cures of the disorder. The periods of improvement are often referred to as partial remissions, because all of the symptoms may not improve entirely, and symptoms that have been relieved may return to some degree under stress. This recurrence and significant worsening of symptoms, referred to as a relapse, usually requires additional
medications, therapy and other supportive measures.
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Resources
It is often difficult for people with borderline disorder, and the people who love them, to find sufficient, valid
information about the disorder and help in its treatment. For example, it is difficult to
locate psychiatrists and other mental health professionals who are experienced in treating the disorder. Sources of additional information about borderline disorder, and guidelines for locating effective care, are provided on this website.
Click here for borderline disorder resources.
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Myths About Borderline Disorder
In spite of a considerable amount of sound research evidence to the contrary, there are a number of popular
myths about borderline disorder. Unfortunately, these myths increase the stigma associated with the disorder and discourage people with it from seeking effective care.
These myths are presented and discussed on this website.
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What is Borderline Personality Disorder > 
