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Borderline Personality Disorder

In the past, people thought that someone with borderline personality disorder (BPD) was “on the borderline” between psychosis and neurosis (anxiety/depression). Today, we know much more about BPD, and there is more research on BDP than any other personality disorder.1

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But there is a lot of stigma around personality disorders. People living with borderline personality disorder may be given hurtful labels. But no one is ever just their diagnosis, whether they’re living with a personality disorder or any other mental illness. There is hope and there is help.

What is it?

What is a personality disorder?

A personality disorder is a pattern of feelings, thoughts and behaviours that may have been with you for a long time. Personality disorders affect the way you understand yourself, the way you react to the world around you, the way you cope with emotions and the way you navigate relationships.2 Having a personality disorder does not mean that there is something wrong with your personality—it simply means that you have a pattern of feelings, thoughts and emotions for a long time that cause problems.

What is borderline personality disorder?

Borderline personality disorder is a mental illness that affects the way to relate to other people and the way you relate to yourself. If you’re living with borderline personality disorder, you might feel like there’s something fundamentally wrong with who you are—you might feel ‘flawed’ or worthless, or you might not even have a good sense of who you are as a person. Your moods might be extreme and change all the time, and you might have a hard time controlling impulses or urges. You may have a hard time trusting others and you may be very scared of being abandoned or alone.3

BPD is made up of five groups of symptoms: unstable behaviour, unstable emotions, unstable relationships, unstable sense of identity and awareness problems.4,5

Unstable behaviour means that you often act on impulses or urges, even when they hurt you or other people. Some examples of impulse control problems are:

Unstable emotions mean that your moods can be extreme and change very quickly. Some examples of unstable emotions are:

Unstable relationships mean that you have a hard time maintaining relationships with other people. Some example of relationship problems are:

Unstable sense of identity means that you don’t have a good sense of who you are as a person. Some examples of an unstable sense of identity include:

Awareness problems mean that, from time to time only and often in response to a stressful event, you experience sensations or feelings that aren’t based in reality. Some examples of awareness problems are:

There are many different combinations of symptoms, so BPD can look very different among people with the illness.6 To diagnose BPD, mental health clinicians look for patterns of behaviour that last for a long time and have caused distress or problems with relationships or other areas of life, such as work.7

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Could I have borderline personality disorder?2

If you have several of these symptoms and you’ve noticed them for a long time, the best person to talk to is a doctor or mental health professional. BPD can look like many other illnesses, so you should never try to diagnose yourself (or other people).9

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Who does it affect?

About 1% to 2% of the general population has BPD. It’s usually diagnosed in teens and young adults, though it may also be diagnosed later in life. It seems to affect more women than men.2

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What can I do about it?

Treatment for BPD can be very effective. It may include a combination of therapy (counselling), medication and self-help.

Therapies

Several different therapies may help:

Medication

Medications won’t resolve BPD, but they can help manage some troubling symptoms. Atypical antipsychotics, mood stabilizers and certain antidepressants may help.

Self-help

There are many things you can do to help manage BPD. Learning about the illness can help you understand what’s going on. It’s always a good idea to get enough sleep, eat well and exercise regularly. Finding help for other issues like a substance use problem or another mental illness can also help you cope with BPD.3,9

BPD can take some time to treat. It’s important to build a trusting and open relationship with a counsellor or doctor and keep a consistent, long-term treatment plan.9

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Where do I go from here?

In addition to talking to your family doctor, check out the resources below for more information about borderline personality disorder.

BC Partners for Mental Health and Addictions Information
Visit www.heretohelp.bc.ca for the Managing Mental Illnesses series, more info sheets and personal stories about personality disorders. You’ll find information, tips and self-tests to help you understand mental health. You’ll also find the Borderline Personality Disorder issue of Visions Journal.

Canadian Mental Health Association, BC Division
Visit www.cmha.bc.ca or call 1-800-555-8222 (toll-free in BC) or 604-688-3234 (in Greater Vancouver) for information and community resources.

Resources available in many languages:
*For each service below, if English is not your first language, say the name of your preferred language in English to be connected to an interpreter. More than 100 languages are available.

1-800-SUICIDE
If you are in distress or are worried about someone in distress who may hurt themselves, call 1-800-SUICIDE 24 hours a day to connect to a BC crisis line, without a wait or busy signal. That’s 1-800-784-2433.

Alcohol & Drug Information and Referral Service
If you’re concerned about your alcohol or drug use or concerned about some else’s use, call the Alcohol and Drug Information and Referral Service at 1-800-663-1441 (toll-free in BC) or 604-660-9382 (in Greater Vancouver). This service is available seven days a week, 24 hours a day.

HealthLink BC
Call 811 or visit www.healthlinkbc.ca to access free, non-emergency health information for anyone in your family, including mental health information. Through 811, you can also speak to a registered nurse about symptoms you’re worried about, or talk with a pharmacist about medication questions.

Crisis lines aren’t only for people in crisis. You can call for information on local services or if you just need someone to talk to. If you are in distress, call310-6789(do not add 604, 778 or 250 before the number) 24 hours a day to connect to a BC crisis line, without a wait or busy signal. The crisis lines linked in through 310-6789 have received advanced training in mental health issues and services by members of the BC Partners for Mental Health and Addictions Information.

Footnotes:
  1. Boschen, M.J. and Warner, J.C. (2009). Publication trends in individual DSM personality disorders: 1971-2015. Australian Psychologist44(2). 136-142.
  2. American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR (4th ed.). Washington, DC: Author.
  3. Mayo Clinic. (2012). Borderline Personality Disorder. Rochester, MN: Author. www.mayclinic.com/health/borderline-personality-disorder/DS00442.
  4. Paris, J. (2005). Borderline personality disorder. Canadian Medical Association Journal, 172(12), 1579-1583.
  5. O’Grady, C.P. and Skinner, W.J. (2007). A Family Guide to Concurrent Disorders. Toronto: Centre for Addiction and Mental Health.
  6. Chapman, A.L. and Gratz, K.L. (2007). The Borderline Personality Disorder Survival Guide: Everything you need to know about living with BPD. Oakland, CA: New Harbinger Publications.
  7. Andrews, G., Goldner, E.M., Parikh, S.V. and Bilsker, D. (2000). Management of Mental Disorders 2 (Canadian Edition. Sydney: WHo Collaborating Centre for Mental Health and Substance Abuse.
  8. Wilkinson-Ryan, T. and Westen, D. (2000). Identity disturbance in borderline personality disorder: An empirical investigation. The American Journal of Psychiatry157(4), 528-541.
  9. Healthwise. (2013). Borderline personality disorder. Victoria, BC: HealthLink BC. www.healthlinkbc.ca/healthtopics/content.asp?hwid=ty6802.
  10. Arehart-Treichel, J. (2007, November 2). Better mental health may be upside of getting old. Psychiatric News42(21), 17.
  11. Ross, C.A. (2007). Borderline personality disorder and dissociation. Journal of Trauma and Dissociation8(1), 71-80.
  12. Zanarini, M., Frankenburg, F., Dubo, E. et al. (1998). Axis I comorbidity of borderline personality disorder. American Journal of Psychiatry155(12), 1733-1739.
  13. Dimeff, L. and Linehan, M.M. (2001). Dialectical behavior therapy in a nutshell. California Psychologist34, 10-13.
  14. Hadjipavlou, G. and Ogrodniczuk, J.S. (2010). Promising therapies for borderline personality disorder. Canadian Journal of Psychiatry55(4), 202-210.
  15. Friedel, R.O. (2004). Borderline Personality Disorder Demystified: An essential guide for understanding and living with BPD. New York: Marlowe & Company.
© 2014

This info sheet was prepared by CMHA BC Division on behalf of the BC Partners for Mental Health and Addictions Information and HeretoHelp. Funding was provided by BC Mental Health and Substance Use Services, an agency of the Provincial Health Services Authority. For more resources visit HeretoHelp.bc.ca.

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