Borderline Personality Disorder
Borderline personality disorder (BPD) involves a pervasive pattern of instability in emotions, self-image, relationships and impulse control; it is treatable and should not be used as a judgement.
Possible features
- Intense sensitivity to real or perceived abandonment.
- Relationships that shift rapidly between idealisation and disappointment.
- An unstable sense of identity, values or direction.
- Impulsive behaviour that can carry significant risk.
- Rapidly changing, intense emotions, chronic emptiness or strong anger.
- Self-harm, suicidal behaviour or short periods of stress-related paranoia or dissociation.
Individual features can occur in many people. Diagnosis requires a broad, persistent pattern and careful assessment; it cannot be made from social-media descriptions.
Assessment without stigma
A clinician reviews current safety, the course of difficulties, trauma history, relationships, functioning, substance use and possible overlapping conditions. Bipolar disorder, PTSD, ADHD, depression and other personality patterns can share some features but require different formulations. Assessment should be collaborative and should not reduce the person to a label.
Treatment and safety
Structured psychotherapy is the main treatment. Several evidence-based approaches can improve emotion regulation, relationships, self-understanding and safety. Treatment usually includes clear goals, crisis planning and continuity. Medication may be used by a doctor for specific co-occurring symptoms or conditions, but is not the primary treatment for BPD itself.