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Borderline personality disorder

Definition

Borderline personality disorder is a condition in which a person makes impulsive actions, and has an unstable mood and chaotic relationships.

Alternative Names

Personality disorder - borderline

Causes, incidence, and risk factors

Personality disorders are long-term (chronic) patterns of behavior that negatively affect relationships and work. The cause of borderline personality disorder (BPD) is unknown. People with BPD are impulsive in areas that have a potential for self-harm, such as drug use, drinking, and other risk-taking behaviors.

Risk factors for BPD include:

  • Abandonment in childhood or adolescence
  • Disrupted family life
  • Poor communication in the family
  • Sexual abuse

This personality disorder tends to occur more often in women and among hospitalized psychiatric patients.

Symptoms

Relationships with others are intense and unstable. They swing wildly from love to hate and back again. People with BPD will frantically try to avoid real or imagined abandonment.

BPD patients may also be uncertain about their identity or self-image. They tend to see things in terms of extremes, either all good or all bad. They also typically view themselves as victims of circumstance and take little responsibility for themselves or their problems.

Other symptoms include:

  • Feelings of emptiness and boredom
  • Frequent displays of inappropriate anger
  • Impulsiveness with money, substance abuse, sexual relationships, binge eating, or shoplifting
  • Intolerance of being alone
  • Recurrent acts of crisis such as wrist cutting, overdosing, or self-injury (such as cutting)

Signs and tests

Personality disorders are diagnosed based on psychological evaluation and the history and severity of the symptoms.

Treatment

Group therapy can help change self-destructive behaviors. Having peers reinforce appropriate behaviors may be more successful than one-on-one counseling, because people with this condition often have difficulty with authority figures, which can prevent them from learning.

Medications can help level mood swings and treat depression or other disorders that may occur with this condition.

Expectations (prognosis)

Borderline personality disorder has a poor outlook because people often do not comply with treatment.

Complications

Calling your health care provider

Call your health care provider if you or your child is has symptoms of borderline personality disorder.

References

Moore DP, Jefferson JW. Borderline personality disorder. In: Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004: chap 138.

Montandon M, Feldman MD. Borderline personality disorder. In: Ferri FF, ed. Ferri's Clinical Advisor 2008: Instant Diagnosis and Treatment. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008.


Review Date: 10/17/2008
Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Timothy A. Rogge, MD, private practice in Psychiatry, Kirkland, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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