Introduction

Borderline Personality Disorder is a serious condition which is estimated to affect between 1-3% of the general population. Yet, despite being so prevalent, BPD is not commonly known about or understood.

People who live in a relationship with a person who suffers from borderline personality disorder often know that something is terribly wrong with the behavior of their family member or loved-one but often do not know what to do about it, or that there is even a name for it.

Alternate Names for BPD

There are a number of different names used around the world for Borderline Personality Disorder:

Borderline Personality Disorder (BPD)

Emotional Regulation Disorder (ERD)

Emotional Dysregulation Disorder

Emotional Intensity Disorder (EID)

Emotionally Unstable Personality Disorder (EUPD)

Emotion-Impulse Regulation Disorder (EIRD)

Impulsive Personality Disorder (IPD)

The most commonly used name today is Borderline Personality Disorder - or BPD - as defined in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM-IV-TR).

The term "Borderline" is a historic term coined to describe people who were diagnosed to be on the borderline between a neurotic and psychotic disorder. It is commonly felt that the "Borderline" label is misleading and stigmatizes the disorder.

Borderline Personality Disorder (BPD) - The DSM Criteria

Borderline Personality Disorder (BPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as an Axis II, Cluster B (dramatic, emotional, or erratic) Disorder:

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

Frantic efforts to avoid real or imagined abandonment. [Not including suicidal or self-mutilating behavior covered in Criterion 5] A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. Identity disturbance: markedly and persistently unstable self-image or sense of self. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, promiscuous sex, eating disorders, substance abuse, reckless driving, binge eating). [Again, not including suicidal or self-mutilating behavior covered in Criterion 5] Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days) Chronic feelings of emptiness. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). Transient, stress-related paranoid ideation or severe dissociative symptoms.

Characteristics & Traits

The following list is a collection of some of the more commonly observed behaviors and traits of those who suffer from BPD. Click on the links on each one for more information about a particular trait or behavior and some ideas for coping with each.

Note that these traits are given as a guideline only and are not intended for diagnosis. People who suffer from BPD are all unique and so each person will display a different subset of traits. Also, note that everyone displays "borderline" behaviors from time to time. Therefore, if a person exhibits one or more of these traits, that does not necessarily qualify them for a diagnosis of BPD. See the DSM Criteria on this page for diagnostic criteria.

Abusive Cycle - This is the name for the ongoing rotation between destructive and constructive behavior which is typical of many dysfunctional relationships and families.

Alienation - The act of cutting off or interfering with an individual's relationships with others.

"Always" and "Never" Statements - "Always" and "Never" Statements are declarations containing the words "always" or "never". They are commonly used but rarely true.

Anger - People who suffer from personality disorders often feel a sense of unresolved anger and a heightened or exaggerated perception that they have been wronged, invalidated, neglected or abused.

Baiting - A provocative act used to solicit an angry, aggressive or emotional response from another

Blaming - The practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Bullying - Any systematic action of hurting a person from a position of relative physical, social, economic or emotional strength.

Catastrophizing - The habit of automatically assuming a "worst case scenario" and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

Chaos Manufacture - Unnecessarily creating or maintaining an environment of risk, destruction, confusion or mess.

Cheating - Sharing a romantic or intimate relationship with somebody when you are already committed to a monogamous relationship with someone else.

Chronic Broken Promises - Repeatedly making and then breaking commitments and promises is a common trait among people who suffer from personality disorders.

Circular Conversations - Arguments which go on almost endlessly, repeating the same patterns with no resolution.

Confirmation Bias - The tendency to pay more attention to things which reinforce your beliefs than to things which contradict them.

"Control-Me" Syndrome - This describes a tendency which some people have to foster relationships with people who have a controlling narcissistic, antisocial or "acting-out" nature.

Denial - Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

Dependency - An inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.

Depression - People who suffer from personality disorders are often also diagnosed with symptoms of depression.

Dissociation- A psychological term used to describe a mental departure from reality.

Domestic Theft - Consuming or taking control of a resource or asset belonging to (or shared with) a family member, partner or spouse without first obtaining their approval.

Emotional Abuse - Any pattern of behavior directed at one individual by another which promotes in them a destructive sense of Fear, Obligation or Guilt (FOG).

Emotional Blackmail - A system of threats and punishments used in an attempt to control someone’s behaviors.

Engulfment - An unhealthy and overwhelming level of attention and dependency on another person, which comes from imagining or believing one exists only within the context of that relationship.

False Accusations - Patterns of unwarranted or exaggerated criticism directed towards someone else.

Favoritism and Scapegoating - Systematically giving a dysfunctional amount of preferential positive or negative treatment to one individual among a family group of peers.

Fear of Abandonment - An irrational belief that one is imminent danger of being personally rejected, discarded or replaced.

Feelings of Emptiness - An acute, chronic sense that daily life has little worth or significance, leading to an impulsive appetite for strong physical sensations and dramatic relationship experiences.

Gaslighting - The practice of brainwashing or convincing a mentally healthy individual that they are going insane or that their understanding of reality is mistaken or false. The term “Gaslighting” is based on the 1944 MGM movie “Gaslight”.

Harassment - Any sustained or chronic pattern of unwelcome behavior by one individual towards another.

Holiday Triggers - Mood Swings in Personality-Disordered individuals are often triggered or amplified by emotional events such as family holidays, significant anniversaries and events which trigger emotional memories.

Hoovers & Hoovering - A Hoover is a metaphor taken from the popular brand of vacuum cleaners, to describe how an abuse victim trying to assert their own rights by leaving or limiting contact in a dysfunctional relationship, gets “sucked back in” when the perpetrator temporarily exhibits improved or desirable behavior.

Hysteria - An inappropriate over-reaction to bad news or disappointments, which diverts attention away from the real problem and towards the person who is having the reaction.

Identity Disturbance - A psychological term used to describe a distorted or inconsistent self-view

Imposed Isolation - When abuse results in a person becoming isolated from their support network, including friends and family.

Impulsiveness - The tendency to act or speak based on current feelings rather than logical reasoning.

Infantilization - Treating a child as if they are much younger than their actual age.

Intimidation - Any form of veiled, hidden, indirect or non-verbal threat.

Invalidation - The creation or promotion of an environment which encourages an individual to believe that their thoughts, beliefs, values or physical presence are inferior, flawed, problematic or worthless.

Lack of Conscience - Individuals who suffer from Personality Disorders are often preoccupied with their own agendas, sometimes to the exclusion of the needs and concerns of others. This is sometimes interpreted by others as a lack of moral conscience.

Lack of Object Constancy - An inability to remember that people or objects are consistent, trustworthy and reliable, especially when they are out of your immediate field of vision.

Low Self-Esteem - A common name for a negatively-distorted self-view which is inconsistent with reality.

Manipulation - The practice of steering an individual into a desired behavior for the purpose of achieving a hidden personal goal.

Masking - Covering up one's own natural outward appearance, mannerisms and speech in dramatic and inconsistent ways depending on the situation.

Mirroring - Imitating or copying another person's characteristics, behaviors or traits.

Moments of Clarity - Spontaneous periods when a person with a Personality Disorder becomes more objective and tries to make amends.

Mood Swings - Unpredictable, rapid, dramatic emotional cycles which cannot be readily explained by changes in external circumstances.

Munchausen's and Munchausen by Proxy Syndrome - A disorder in which an individual repeatedly fakes or exaggerates medical symptoms in order to manipulate the attentions of medical professionals or caregivers.

Name-Calling - Use of profane, derogatory or dehumanizing terminology to describe another individual or group.

Neglect - A passive form of abuse in which the physical or emotional needs of a dependent are disregarded or ignored by the person responsible for them.

"Not My Fault" Syndrome - The practice of avoiding personal responsibility for one's own words and actions.

No-Win Scenarios - When you are manipulated into choosing between two bad options

Objectification - The practice of treating a person or a group of people like an object.

Obsessive-Compulsive Behavior - An inflexible adherence to arbitrary rules and systems, or an illogical adherence to cleanliness and orderly structure.

Panic Attacks - Short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.

Parental Alienation Syndrome - When a separated parent convinces their child that the other parent is bad, evil or worthless.

Parentification - A form of role reversal, in which a child is inappropriately given the role of meeting the emotional or physical needs of the parent or of the family’s other children.

Passive-Aggressive Behavior - Expressing negative feelings in an unassertive, passive way.

Pathological Lying - Persistent deception by an individual to serve their own interests and needs with little or no regard to the needs and concerns of others. A pathological liar is a person who habitually lies to serve their own needs.

Perfectionism - The maladaptive practice of holding oneself or others to an unrealistic, unattainable or unsustainable standard of organization, order, or accomplishment in one particular area of living, while sometimes neglecting common standards of organization, order or accomplishment in other areas of living.

Projection - The act of attributing one's own feelings or traits to another person and imagining or believing that the other person has those same feelings or traits.

Proxy Recruitment - A way of controlling or abusing another person by manipulating other people into unwittingly backing “doing the dirty work”

Push-Pull - A chronic pattern of sabotaging and re-establishing closeness in a relationship without appropriate cause or reason.

Raging, Violence and Impulsive Aggression - Explosive verbal, physical or emotional elevations of a dispute. Rages threaten the security or safety of another individual and violate their personal boundaries.

Relationship Hyper Vigilance - Maintaining an unhealthy level of interest in the behaviors, comments, thoughts and interests of others.

Riding the Emotional Elevator - Taking a fast track to different levels of emotional maturity.

Sabotage - The spontaneous disruption of calm or status quo in order to serve a personal interest, provoke a conflict or draw attention.

Scapegoating - Singling out one child, employee or member of a group of peers for unmerited negative treatment or blame.

Selective Memory and Selective Amnesia - The use of memory, or a lack of memory, which is selective to the point of reinforcing a bias, belief or desired outcome.

Selective Competence - Demonstrating different levels of intelligence, memory, resourcefulness, strength or competence depending on the situation or environment.

Self-Harm - Any form of deliberate, premeditated injury, such as cutting, poisoning or overdosing, inflicted on oneself.

Self-Loathing - An extreme hatred of one's own self, actions or one's ethnic or demographic background.

Self-Victimization - Casting oneself in the role of a victim.

Sense of Entitlement - An unrealistic, unmerited or inappropriate expectation of favorable living conditions and favorable treatment at the hands of others.

Shaming - The difference between blaming and shaming is that in blaming someone tells you that you did something bad, in shaming someone tells you that you are something bad.

Silent Treatment - A passive-aggressive form of emotional abuse in which displeasure, disapproval and contempt is exhibited through nonverbal gestures while maintaining verbal silence.

Situational Ethics - A philosophy which promotes the idea that, when dealing with a crisis, the end justifies the means and that a rigid interpretation of rules and laws can be set aside if a greater good or lesser evil is served by doing so.

Sleep Deprivation - The practice of routinely interrupting, impeding or restricting another person's sleep cycle.

Splitting - The practice of regarding people and situations as either completely "good" or completely "bad".

Stalking - Any pervasive and unwelcome pattern of pursuing contact with another individual.

Stunted Emotional Growth - A difficulty, reluctance or inability to learn from mistakes, work on self-improvement or develop more effective coping strategies.

Testing - Repeatedly forcing another individual to demonstrate or prove their love or commitment to a relationship.

Thought Policing - Any process of trying to question, control, or unduly influence another person's thoughts or feelings.

Threats - Inappropriate, intentional warnings of destructive actions or consequences.

Triangulation - Gaining an advantage over perceived rivals by manipulating them into conflicts with each other.

Triggering -Small, insignificant or minor actions, statements or events that produce a dramatic or inappropriate response.

Tunnel Vision - The habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities.

Verbal Abuse - Any kind of repeated pattern of inappropriate, derogatory or threatening speech directed at one individual by another.

Borderline Mother Types

BPD Statistics

An estimated 2% of the US population is estimated to meet the clinical criteria for BPD. However, prevalence results vary widely as shown below. A number of studies have been performed to determine the prevalence of personality disorders and BPD. Prevalence results indicate that BPD affects anywhere between 0.5 and 5.9% of adults

People who have a first-degree relative with BPD are five times more likely to develop BPD themselves. Those who suffer child abuse are also more likely to develop BPD.

Some people who suffer from BPD are prone to suicidal behaviors and self-injury, especially as adolescents. About 8%-10% of diagnosed BPD patients commit suicide.

See Our Statistics section for more statistics on Personality Disorders.

Click here for some statistics on the possible origins of BPD.

BPD Treatment

There is no known cure for BPD. As a result, families of people who suffer from BPD are often left to fend for themselves and rely on their own resources.

However, some treatments do exist which have proven effective in managing symptoms. The most common approach is the combination of SSRI medication and DBT Therapy.

Dialectical Behavioral Therapy - Dialectical Behavioral Therapy (DBT) is a psychosocial treatment which combines intensive individual and group therapy.

SSRI's - Selective Serotonin Reuptake Inhibitors. Popular SSRI's include Celexa, Lexapro, Prozac, Paxil, & Zoloft.

BPD Possible Causes

The causes for BPD are not precisely known. However, recent research has turned up some clues. Further study is necessary to definitively establish a cause. However, theories do exist.

There is some evidence relating the prevalence of BPD to the kind of environment a child grew up in. A significant percentage of people who suffer from BPD were also abused as children. However, this kind of correlation does not always prove that the environment they grew up in contributed to their own disorder.

There is a higher incidence of personality disorders in those who have parents who suffer from a personality disorder. This has led some scientists to suspect there may be a genetic link for BPD.

BPD is more commonly diagnosed in females than males. Read our section on the Amygdala for some information on gender differences in neural activity which may some day lead to a greater understanding of why certain disorders may afflict one gender more than another.

The Amygdala and it's Link to BPD

The Amygdala is a small region of the brain which plays a key role in emotional regulation, emotional memory and responses to emotional stimuli.

Recent technological advances have given neurologists two new ways to create 3-D images of the brain. These techniques are known as Positron Emission Tomography (PET Scanning) and functional Magnetic Resonance Imaging (fMRI). By scanning a person's brain while prompting them to think in a certain way, scientists are unlocking clues as to which regions of the brain are responsible for different kinds of thought.

Much of this work has focused on the amygdala - a small region deep in the brain shown below. There is one amygdala the right side of the brain and one on the left.