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Borderline or emotionally unstable personality disorder is characterized by being impulsive, having fluctuating and strong emotions, having poor self-esteem, being self-destructive and entering into unstable relationships.

Photo: by Sharon McCutcheon on Unsplash

People with borderline personality disorder exhibit constant mood swings and often have outbursts of anger. They often take the mind out of themselves and injure themselves. Suicide threats and suicide attempts are not uncommon.


Symptoms of borderline personality disorder

A personality disorder is characterized by abnormalities in the personality. The condition manifests itself already in adolescence and continues into adulthood. 

A person with borderline personality disorder has a persistent pattern of instability in interpersonal relationships, self-esteem and affects, and marked impulsivity that starts in early adulthood  

The person is characterized by distinct variations in mood, an unusual degree of instability in mood, and "black and white" thinking. The person can easily switch between idealizing others and devaluing them. Relationships with others are chaotic and unstable, and in the same way, self-esteem, identity and behavior are characterized by large fluctuations.

The person may have periods with dissociation. The symptoms occur especially in close personal relationships, so-called attachment relationships. In impersonal contexts, the function may be inconspicuous. The difficulties therefore mainly lead to difficult relationships with family, friends and colleagues. Self-harm is not uncommon. Without treatment, symptoms can worsen and in extreme cases lead to suicide attempts. 


According to the diagnostic instrument SCID-II, borderline personality disorder is characterized by

  1. Desperate efforts to avoid a real or imagined danger of being abandoned. 
  2. A pattern of unstable and intense interpersonal relationships that is characterized by alternation between extremes of over-idealization and devaluation. 
  3. Marked and persistent unstable self-image or sense of self. 
  4. Impulsivity in at least two areas that are potentially self-destructive (e.g. wasting money, sexuality, alcohol or drug abuse, wild driving, overeating). 
  5. Repeated suicide attempts, and/or self-harming behaviors or threats thereof. 
  6. Affective instability due to marked tendency to emotional reactions (e.g. intense episodic dysphoria, irritability, or anxiety that usually lasts a few hours and only rarely more than a few days). 
  7. Chronic feeling of emptiness.    
  8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent tantrums, constant anger, repeated fights). 
  9. Transient stress-triggered paranoid thoughts or severe dissociative symptoms.  


Causes of borderline personality disorder

As with other mental disorders, the causes of borderline are complex and to some degree unknown. However, one finding is that many of these people have a history of trauma, abuse or neglect in childhood. Researchers have suggested various possible other causes such as a genetic predisposition, neurobiological factors, or various environmental factors.

There is research that suggests that borderline and post-traumatic stress disorder (PTSD) are closely related. Furthermore, evidence suggests that borderline may be a consequence of a combination that may include a traumatic childhood, vulnerable temperament, and stressful events in adolescence or adulthood.


What helps with borderline personality disorder?

The treatment of personality disorders aims to create better social functioning and adaptation. In addition, attempts are made to reduce acute symptoms, such as psychosis. Furthermore, support is provided to ride out crises in relation to those closest to them.

In the treatment context, personality disorders are divided into two groups: mild and severe personality disorders. The mild personality disorders include avoidant, obsessive-compulsive and dependent personality disorders, while the rest are considered among the most severe.

The main treatment for the mild personality disorders is long-term psychotherapy. This is done by a specialist. Some will need additional treatment for depression and anxiety.

In the case of severe personality disorders, hospitalization and medical treatment in crises may be necessary, in addition to long-term psychotherapy. Supportive talks with a general practitioner may also be relevant.

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