Borderline personality disorder - Introduction

Personality disorders are mental health conditions that can cause a range of distressing symptoms and patterns of abnormal behaviour, such as:

• overwhelming feelings of distress, anxiety, worthlessness or anger
• difficulty managing such feelings without self-harming, for example by abusing drugs and alcohol or taking overdoses
• difficulty maintaining stable and close relationships
• sometimes, periods of loss of contact with reality
• in rare cases, threats of harm to others

Personality disorders typically start in adolescence and persist into adulthood. The cause is often a combination of genetic reasons and a harmful childhood experience. Personality disorders range from mild to severe.

For more information, go to the A-Z overview of Personality disorders.

What is borderline personality disorder (BPD)?

It used to be thought that people with borderline personality disorder (BPD) were at the border between:

• neurosis, where a person is mentally distressed but can still tell the difference between their imagination and reality
• psychosis, where a person is unable to tell the difference between their imagination and reality, and may experience delusions (an unshakable belief in something that is implausible, bizarre or obviously untrue) and hallucinations (seeing or hearing things that other people do not)

Now it is known that this is not an accurate description. BPD is best understood as a disorder of mood and interpersonal function (how a person interacts with others).

BPD is one of the most commonly seen personality disorders by GPs.

Although BPD is said to be more common in women, this is probably because fewer men seek treatment.

How does BPD develop?

The causes of BPD are unclear. However, as with many mental health conditions, BPD appears to be the result of a combination of genetic and environmental factors.

Traumatic events that occur during childhood are a major risk factor for developing BPD. An estimated 8 out of 10 people with BPD experience parental neglect or physical, sexual or emotional abuse during their childhood. For more information, see Borderline personality disorder - causes.

Outlook

BPD is a serious condition because many people with the condition will self-harm and attempt suicide. It is estimated that 60-70% of people with BPD will attempt suicide at some point in their life, and 10% will succeed.

However, the outlook for people with BPD is reasonably good as long as they are patient and willing to commit to long-term treatment.

Treatment for BPD usually involves a range of individual and group psychological therapies. Effective treatment usually lasts at least a year (see Borderline personality disorder treatment for more information).

A study carried out in 2010 found that half of all people with BPD will completely recover and around 80% of people will remain mostly free of symptoms for at least four years.