Topic Overview

What is borderline personality disorder?

Borderline personality disorder is a mental illness that causes intense mood swings, impulsive behaviours, and severe problems with self-worth. It can lead to troubled relationships in every area of a person's life.

Most of the time, signs of the disorder first appear in childhood. But problems often don't start until early adulthood. Treatment can be hard, and getting better can take years. Problems with emotions and behaviours are hard to improve. But with treatment, most people with severe symptoms do get better over time.

What causes this disorder?

Experts don't know exactly what causes borderline personality disorder. Problems with chemicals in the brain that help control moods may play a role. It also seems to run in families.

Often, people who get it faced some kind of childhood trauma such as abuse, neglect, or the death of a parent. The risk is higher when people who had childhood trauma also have problems coping with anxiety or stress.

What are the symptoms?

Everyone has problems with emotions or behaviours sometimes. But if you have borderline personality disorder, the problems are severe, repeat over a long time, and disrupt your life. The most common symptoms include:

  • Intense emotions and mood swings.
  • Harmful, impulsive behaviours. These may include things like substance abuse, binge eating, out-of-control spending, risky sexual behaviour, and reckless driving.
  • Relationship problems. You may see others as either "good" or "bad" and may shift from one view to the other suddenly, for minor reasons. This can make relationships very difficult.
  • Low self-worth.
  • A frantic fear of being left alone (abandoned). This fear may lead to frantic attempts to hold on to those around you. Or it may cause you to reject others before they can reject you.
  • Aggressive behaviour.

Other symptoms may include:

  • Feeling empty inside.
  • Problems with anger, such as violent temper tantrums.
  • Hurting yourself, such as cutting or burning yourself.
  • Suicide attempts and suicidal thoughts.
  • Times when you feel paranoid or lose a sense of reality (psychosis).

It's easy to confuse this disorder with other mental illnesses. And they may overlap. So if you think that you or someone you know may have borderline personality disorder, see a doctor. Don't try to diagnose yourself.

How is it treated?

Borderline personality disorder can be hard to treat. It's common for symptoms to return. And many people with the disorder have troubled relationships with their counsellors and doctors.

But you can take steps to help control the disorder. Long-term treatment can reduce symptoms and harmful behaviours and help you better manage your emotions. Treatment may include:

  • Counselling and therapy. It's important to find a counsellor you can build a stable relationship with. This can be hard, because your condition may cause you to see your counsellor as caring one minute and cruel the next, especially when he or she asks you to try to change a behaviour. Try to find a counsellor who has special training in dialectical behavioural therapy (DBT) to treat this disorder.
  • Medicines, such as antidepressants, mood stabilizers, and antipsychotics. In combination with counselling or therapy, they may be helpful in treating symptoms of borderline personality disorder.
  • Healthy habits, such as getting enough sleep, eating healthy foods, getting regular exercise, and avoiding alcohol and drugs. These habits can help reduce stress and anxiety. And they can help make your symptoms less severe and less frequent.

Many people find relief from harmful symptoms within the first year of treatment.footnote 1 And about half of those treated find that they no longer have most of the behaviours after about 10 years of treatment.footnote 1

Unfortunately, many people don't seek treatment for mental health problems. They may think that their symptoms aren't bad enough or that they can work things out on their own. But getting treatment is key to improving your symptoms and the quality of your life.

People with this disorder often have other mental health problems such as depression, eating disorders, or substance abuse. Treatment can help with these problems too.

How can family and friends help? What can they do to cope?

Accepting that a loved one has a personality disorder can be hard. You may feel helpless. But there are things you can do to help. Show love, and learn as much as you can about the illness. Understand that the behaviour you may see—which may include anger directed at you—is caused by the illness, not by the person you love.

Know when to get help. This disorder can cause a person to become angry, violent, or suicidal. Take these situations seriously. Call for help if you think the person may be in danger or may harm someone else.

Finding your own support is important too. Ask your local health unit about local support organizations, or contact the Canadian Mental Health Association. For more information, go to www.cmha.ca.

Other Places To Get Help

Organizations

Canadian Mental Health Association
www.cmha.ca
Provincial and Territorial Helplines and Websites (Canada)

If you want to save this information but don't think it is safe to take it home, see if a trusted friend can keep it for you. Plan ahead. Know who you can call for help, and memorize the phone number.

Be careful online too. Your online activity may be seen by others. Do not use your personal computer or device to read about this topic. Use a safe computer such as one at work, a friend's house, or a library.

Many of the resources below have toll-free phone numbers and provide help 24 hours a day, 7 days a week in multiple languages. In an emergency, call 911.

Canada-wide resources

  • To find a suicide prevention crisis centre phone number or website in your province, visit the Canadian Association for Suicide Prevention's webpage at http://suicideprevention.ca/thinking-about-suicide.
  • To find a rape crisis or women's centre phone number or website in your province, visit the Canadian Association of Sexual Assault Centres' webpage at www.casac.ca/content/anti-violence-centres.
  • Kids and teens can call Kids Help Phone at 1-800-668-6868 or visit http://org.kidshelpphone.ca.

Alberta

  • Provincial Health Information Line. HEALTHLink Alberta. Call 8-1-1 or visit https://myhealth.alberta.ca.
  • Alberta Human Services: Connect to Support and Services. Call one of the numbers below or visit http://humanservices.alberta.ca/abuse-bullying/14839.html.
    • Family Violence Info Line. Call 310-1818.
    • Child Abuse Hotline. Call 1-800-387-5437.
    • Bullying Helpline. Call 1-888-456-2323.
  • Sexual Assault Centre of Edmonton (SACE). Call 780-423-4121 or visit www.sace.ab.ca.
  • Mental Health Helpline. Call 1-877-303-2642.
  • Addiction Services Helpline. Call 1-866-332-2322.

British Columbia

  • Provincial Health Information Line. HealthLinkBC. Call 8-1-1 or visit www.healthlinkbc.ca.
  • VictimLink BC. Call 1-800-563-0808 or visit http://www2.gov.bc.ca/gov/content/justice/criminal-justice/victims-of-crime/victimlinkbc.
  • Child Abuse Prevention Website: Helpline. Call 310-1234 or visit www.safekidsbc.ca/helpline.htm.
  • BC Mental Health and Substance Use Services. Call 310-6789 or visit www.bcmhsus.ca.
  • Crisis Intervention and Suicide Prevention Centre of British Columbia. Call 1-800-784-2433 or visit http://crisiscentre.bc.ca.

New Brunswick

  • Provincial Health Information Line. Tele-Care: Call 8-1-1 or visit www2.gnb.ca/content/gnb/en/departments/health/Tele-Care.html.
  • Emergency Social Services. Visit www2.gnb.ca/content/gnb/en/departments/social_development/about_us/emergency_socialservices.html to find the number for the office nearest you or call 1-800-442-9799.
  • Fredericton Sexual Assault Crisis Centre. Call (506) 454-0437 or visit www.fsacc.ca.
  • Suicide Prevention CHIMO Helpline. Call 1-800-667-5005 or visit www2.gnb.ca/content/gnb/en/departments/health/Suicide_Prevention.html.

Ontario

  • Provincial Health Information Line. Telehealth Ontario: Call 1-866-797-0000 or visit www.ontario.ca/page/get-medical-advice-telehealth-ontario .
  • Assaulted Women's Helpline. Call 1-866-863-0511 or visit www.awhl.org.
  • Distress Centres Ontario. Visit www.dcontario.org/help.html to find the phone number for a crisis line in your calling area.
  • Drug and Alcohol Helpline. Call 1-800-565-8603 or visit www.drugandalcoholhelpline.ca.
  • Mental Health Helpline. Call 1-866-531-2600 or visit www.mentalhealthhelpline.ca.

Saskatchewan

  • Provincial Health Information Line. HealthLine. Call 8-1-1 or visit www.saskatchewan.ca/residents/health/accessing-health-care-services/healthline.
  • Family Violence Outreach. Go to www.justice.gov.sk.ca/FVO for a list of community-based organizations and their contact information, or visit www.justice.gov.sk.ca/IVAP.
  • Child Abuse and Neglect. Go to www.saskatchewan.ca/residents/justice-crime-and-the-law/child-protection/child-abuse-and-neglect for a list of local child protection offices and their contact information.
  • Mental Health and Addiction Services. Go to www.saskatchewan.ca/residents/health/accessing-health-care-services/mental-health-and-addictions-support-services for a list of local mental health and addictions services.

Yukon

  • Provincial Health Information Line. HealthLine: Call 8-1-1 or visit www.hss.gov.yk.ca/811.php. If you are calling from a satellite phone, you can dial 1-604-215-4700 to reach the Health Services Representative at HealthLink BC.
  • Family and Children's Services. Call 1-800-661-0408, ext. 3002, or visit www.hss.gov.yk.ca/family_children.php.
  • Victim Services/Family Violence Prevention Unit. Call 1-800-563-0808. Or visit the Department of Justice "Need Help? Phone Directory" at www.justice.gov.yk.ca/prog/cor/vs/phonedir.html.
  • Alcohol and Drug Services. Call 1-855-667-5777 or visit http://hss.gov.yk.ca/ads.php.

Other provinces

Check your local phone book or provincial or territorial website.

References

Citations

  1. American Psychiatric Association (2000). Personality disorders. In Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev., pp. 706–710. Washington, DC: American Psychiatric Association.

Other Works Consulted

  • Skodol AE, Gunderson JG (2008). Personality disorders. In RE Hales, SC Yudofsky, eds., The American Psychiatric Publishing Textbook of Psychiatry, 5th ed., pp. 821–859. Washington, DC: American Psychiatric Publishing.
  • Coid J, et al. (2009). Borderline personality disorder: Health service use and social functioning among a national household population. Psychological Medicine, 39(10): 1721–1731.
  • Gunderson J (2011). Borderline personality disorder. New England Journal of Medicine, 364(21): 2037–2042.
  • Gunderson JG (2008). Borderline Personality Disorder: A Clinical Guide, 2nd ed., Washington, DC: American Psychiatric Publishing.
  • Oldham JM (2005). Guideline Watch: Practice Guideline for the Treatment of Patients With Borderline Personality Disorder, 2nd ed., pp. 1–9. Arlington, VA: American Psychiatric Association.

Credits

ByHealthwise Staff
Primary Medical Reviewer Sarah Marshall, MD - Family Medicine
Donald Sproule, MDCM, CCFP - Family Medicine
Specialist Medical Reviewer Lisa S. Weinstock, MD - Psychiatry

Current as ofJuly 26, 2016