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Borderline Personality Disorder

What is Borderline Personality Disorder (BPD)?

Borderline Personality Disorder, or BPD, is a mental illness that results in extreme swings in mood, priorities, and personality. BPD contributes to negative perceptions of oneself and others. It also causes a person to think in extremes.

BPD is a condition that affects all aspects of life and can often lead to abusive relationships and make it hard to build interpersonal and professional relationships.1

How is BPD Diagnosed?

Psychologists and psychiatrists diagnose BPD after therapy and a thorough review of a patient’s medical and family history. A large part of the diagnoses comes from BPD symptoms as described by the client. As such, BPD diagnoses require a listening ear and time to build trust between client and provider.

The other factor in BPD diagnoses is a borderline personality disorder test. The BPD test is used to identify common co-occurring BPD symptoms. The borderline personality criteria are important to ensure a patient is not misdiagnosed. Numerous mental illnesses can be confused for BPD and vice versa. The clinical term and test, Borderline Personality Disorder DSM 5, was last changed in 2013. As science progresses, so will the criteria for understanding BPD.

Statics on Borderline Personality Disorder

  • 75% of people living with BPD are women1
  • Over 2 million American have BPD
  • BPD in men is often misdiagnosed as a different mental illness
  • 20% of people in inpatient care have BPD2
  • 64% of patients with BPD have or had an experience with substance dependency

Signs and Symptoms of Borderline Personality Disorder

The intensity of BPD symptoms will vary individually, but these are the most common.

Physical Signs3

  • Constantly “Reinventing” themselves through haircuts, fashion, and other bodily changes
  • Extreme tiredness
  • Physical pains
  • Self-harm
  • Heart complications
  • Eating disorders

Behavioral Signs3

  • Fear of abandonment
  • Suicidal thoughts
  • Mood swings
  • Lack of forethought and planning
  • Feelings of isolation

Causes of Borderline Personality Disorder

There is no set cause of borderline personality disorder. Science suggests one of the most significant contributors is genetics. Genetics plays a major role in mental health as some people have a higher likelihood of developing mental illness.

The secondary cause of BPD are irregularities in brain patterns and brain chemistry. Specifically, it can impact the ability to commit, plan, or control base impulses.

The Complexity of Diagnosing BPD

A borderline personality disorder is not always easy to diagnose. A significant part of the diagnoses is based on talk therapy and psychologist experience. In addition, borderline personality disorder symptoms are similar to other mental illnesses.3

Conditions That Complicate a BPD Diagnosis

  • PTSD: Post-traumatic stress disorder arises from traumatic events and leaves scarring and long-lasting changes to the brain. Similar to borderline personality disorder, post-traumatic stress disorder can cause poor sleeping and behavioral changes.
  • Depression: Clinic depression can worsen feelings of isolation, brain fog, and suicidal ideation. Depression, much like BPD, can lead to self-harm.
  • Bipolar: Clients with bipolar disorder often experience extreme emotional swings. On one end, they have high energy levels, and, on the other, they can barely muster the energy for day-to-day tasks. Similar to borderline personality disorder, bipolar disorder can cause poor decision-making and negative self-perception.
  • Psychosis: Psychosis can cause hallucinations, eroding self-awareness, and paranoia.

How is BPD Related to Addiction?

Mental health issues increase the likelihood of addiction. The connection between BPD and addiction can be circular. The intense feelings of BPD can cause a client to consume drugs or alcohol as a means of escape. BPD and other mental illnesses impact judgment.

Signs and Symptoms of Addiction


  • Changes in behavior
  • Flaking on responsibilities
  • Lack of personal hygiene.
  • Poor finances
  • Erratic behavior


  • Depression
  • Trouble sleeping
  • Daytime tiredness
  • Liver and kidney issues
  • Brain fog
  • Poor memory

Why Does BPD Cause Addiction?

BPD, like other mental illnesses, can cause abnormalities in brain chemistry. For example, positive chemicals such as serotonin or endorphins are required to feel happy, calm, content, etc. A client with BPD may produce far less of the required chemicals needed to maintain level thinking.

This effect often leads to drug and alcohol abuse to feel happy, confident, and a bevy of other emotional states a BPD-affected client may not usually feel. Drug and alcohol use combined with mental illnesses is viewed as a form of self-medication.

In addition, self-isolation and negative thoughts can make daily tasks unbearable; alcohol and drugs may be used as a form of escape.

Can Substance Abuse Cause BPD?

Substance abuse cannot cause BPD. However, drug and alcohol abuse can aggravate existing mental illnesses and intensify the effects of BPD. Mental illness can also make it difficult to commit to treatment and maintain recovery. Both addiction and BPD are life-long diseases that require continued attention.

Treating BPD as a Co-Occurring Disorder

BPD causes several health complications and often co-occurs with mental illnesses such as depression, addiction, and insomnia, to name a few.

How Psychiatrists Help

Psychiatrists are specially trained in drug recovery and other mental illnesses. They also help establish a long-term plan for maintaining recovery and act as an initial support system. If a psychiatrist cannot help due to cultural barriers, time, preference, etc. then they can recommend peers.


Psychotherapy, a form of cognitive-behavioral therapy, assists in uncovering triggers for drug use, teaching healthy coping mechanisms, and uncovering the cause of trauma. Psychotherapy can also teach a client how to communicate with themselves and others properly.


Detox can be dangerous. Symptoms of withdrawal can cause severe long-term health complications. Having medical oversight helps ease the symptoms of withdrawal and reduce cravings.


Medications can be prescribed to treat the side effects of mental illnesses such as insomnia, brain fog, and mood swings.

It’s possible to live a long, happy life in recovery with BPD. All it takes is a commitment to change and time.



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