What Is Borderline Personality Disorder?

Written by Nichole Owens
Medically Reviewed by Smitha Bhandari, MD on June 25, 2025
4 min read

Borderline personality disorder (BPD) is a mental health condition where you struggle to control your emotions. It causes you to see yourself in a negative way, make rash decisions, have extreme mood swings, and act in ways that push others away.

Borderline personality disorder can be passed down through your genes or caused by chemical changes in the brain.

You have a higher risk for BPD if you experienced childhood abuse, neglect, or trauma. 

 

A person living with BPD will experience at least five of these symptoms over time:

  • Intense mood swings that last hours or days
  • A strong fear of abandonment
  • A pattern of unstable, intense relationships
  • Extreme anger or trouble controlling anger
  • Constant feelings of emptiness
  • A shifting sense of self-worth
  • Suicide attempts or acts of self-harm, such as cutting
  • Substance abuse
  • Destructive behaviors, such as reckless driving or spending

“Often, BPD is misunderstood and stigmatized because it presents as relational instability, push-pull behaviors, and intense emotional reactions,” says Victoria Grinman, PhD, a psychotherapist and counselor who specializes in posttraumatic growth, neurodiversity, and relational wellness.

“But beneath the surface, BPD is fundamentally about deep insecurity, a heightened fear of abandonment, and a profound struggle with self-worth.”

There are four types of borderline personality disorder:

Impulsive BPD. You act without thinking. Examples include overeating, overspending, breaking things, and getting into fights.

Discouraged BPD. You have a strong fear of being abandoned and may keep your feelings bottled up. You may also be clingy, harm yourself, or think about suicide.

Self-destructive BPD. You practice self-hate and self-harm (cutting or burning).

Petulant BPD. You have strong mood swings and feelings of being unworthy or unloved. You may be easily irritated or manipulative.

Your doctor may use several tools to see if you have BPD, including:

  • A detailed interview with you
  • A mental health exam where you answer several questions
  • Your medical history and an exam
  • A discussion about your symptoms

Psychotherapy is the most often recommended treatment for BPD.

One type — dialectical behavior therapy — helps people living with BPD learn how to balance their emotions and logic. It focuses on mindfulness, dealing with feelings that cause distress, and having effective relationships with others.

While medication can help manage some of the BPD symptoms, such as anxiety or depression, it’s not part of frontline treatment.

“The true pain and dysfunction often stem from relational trauma, meaning that healing typically requires relationally based therapeutic work,” says Grinman. “As I say, when trauma is born in relationship, it is healed in relationship, too.”

With treatment, you can control your symptoms and live a full life. Here are some ways to manage BPD:

  • Keep all scheduled appointments with your therapist.
  • Get enough sleep.
  • Eat a healthy diet.
  • Exercise for at least 30 minutes each day.
  • Pay attention to people or things that trigger you.
  • Talk to your doctor if you have thoughts of hurting yourself.

Grinman says that to support a loved one living with BPD, it is important to have compassion for the emotional struggles behind their behaviors, such as an intense fear of abandonment.

She offers these tips on how you can show your support:

  • Take care of your own emotional health.
  • Acknowledge your loved one’s feelings without agreeing with their behaviors.
  • Set clear, kind boundaries.
  • Expect emotional outbursts, but make room for repair.
  • Encourage them to get professional help.

Borderline personality disorder is a mental condition where a person has an intense fear of abandonment and a constant struggle with self-worth. It’s marked by intense mood swings, unstable emotions, and sometimes careless behavior or self-harm. It is treatable with therapy, and many people who seek and stick with treatment are able to live full, productive lives.

Can people with BPD live a normal life?

Yes. With treatment, many people with this condition can live productive lives.

Who does borderline personality disorder affect?

Symptoms of borderline personality disorder typically start during the teen years, but anyone can develop this mental health condition, especially if they:

  • Are over 18
  • Female
  • Have a family history of BPD
  • Deal with anxiety, depression, or eating disorders
  • Lived with abuse, neglect, or trauma as a child

How common is borderline personality disorder?

It’s rare, affecting less than 2% of people in the U.S.