What is it?
People with Borderline Personality Disorder (BPD) have trouble controlling their emotions and behaviour.
A child or youth with BPD may:
- experience depression, anxiety or anger
- act on impulse or seem aggressive.
- try to harm themselves, or take actions that can be hurtful to others (drive dangerously, binge-eat, self-harm, abuse drugs or alcohol)
- avoid social situations or getting involved
- worry about being embarrassed, criticized, rejected, or abandoned
- feel misunderstood and not have a good sense of who they are
Day-to-day life can be very challenging for someone with borderline personality disorder. Because they have trouble controlling their emotions, it can be hard to have healthy relationships with family, friends and co-workers . The symptoms can make it difficult to do a job or take part in social events and deal with the pressures of everyday life. It can be hard to know how someone with BPD will react to small problems and daily situations.
BPD is difficult to diagnose because it often occurs in people who have depressive or bipolar disorders. It also looks similar to other personality disorders. That is why it’s important to have a trained person evaluate the youth or young adult (a psychiatrist, psychologist, or pediatric neurologist).
How do I know?
Borderline Personality Disorder (BPD) usually begins by early adulthood. Someone with BPD will have problems with relationships, self-image and impulsive behaviour. To be diagnosed with BPD, a youth must show five (or more) of the following:
- Frantic efforts to avoid real or imagined abandonment
- A pattern of unstable, intense relationships and extreme swings of positive and negative feelings toward people
- An unstable self-image or sense of self that seems to change with different situations or people
- Impulsive behaviour that could be self-damaging in two or more areas (spending money, sex, substance abuse, reckless driving, binge eating)
- Self-harming or suicidal behaviour, threats, or signals
- Strong moods of feeling hopeless, uncomfortable, unhappy, irritable or anxious that last a few hours and only rarely more than a few days
- Feelings of emptiness
- Extreme and/or inappropriate anger or difficulty controlling anger (often loses temper, physical fights)
- Paranoid ideas or seriously disturbed thinking that comes and goes when under stress
Who does it affect?
BPD is found in about 2 – 6% of the population. It may be less common in older people. A person is about five times more likely to have BPD if their parents, siblings, or children have it. It is much more likely in females than males. (about 75%).
What can be done?
Many patients with Borderline Personality Disorder (BPD) receive psychiatric services through things like inpatient treatment, outpatient treatment, or partial hospitalization. The following therapies are also used to treat BPD.
- Psychotherapy: May include cognitive behavioural therapy and other interpersonal therapies.
- Dialectical behaviour therapy (DBT): The most well established and accepted psychological treatment for BPD. It focuses on learning mindfulness skills and how to manage feelings, cope with distress and improve relationships.
- Group psychotherapy: Taking part in a group led by a professional may help people with BPD learn how to better interact with others and express themselves.
- Family therapy: Some forms of therapy (such as DBT) may include family members to help them develop the skills to understand and support a relative with borderline personality disorder
- Mentalization-Based Treatment (MBT): This therapy focuses on thinking about and reflecting on your beliefs, thoughts, feelings, and intentions and learning to recognize these feelings in others. MBT works to create and strengthen this ability to ‘mentalize,’ which is often weak in people with BPD
Medications are usually not effective for BPD. However, sometimes they can be used to help treat specific symptoms of BPD, including anxiety, depression, and aggression. Medications can also be used along with psychotherapy to help treat BPD.
Where to from here?
- Talk to your doctor. They can determine whether you may need a referral to more specialized services (e.g. a psychiatrist), and can assist you in this referral process.
- Get a mental health assessment and support through your local Child and Youth Mental Health team (through a walk-in intake clinic in your community).
- Contact a private psychologist for an assessment. You can start by visiting the BC Psychological Association website or call 1-800-730-0522
For additional information about options for support and treatment in BC, visit the Find Help section of our site.