Borderline Personality Disorder (BPD)
Medical Author: Roxanne Dryden-Edwards, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
What is borderline personality disorder?
Borderline personality disorder (BPD) is a mental disorder that belongs to
the group of mental illnesses called personality disorders. Therefore, like
other personality disorders, it is characterized by a consistent pattern of
thinking, feeling and interacting with others and with the world that tends to
cause problems for the sufferer. Specifically, BPD tends to be associated with a
pattern of unstable ways of seeing oneself, feeling, behaving, and relating to
others that interferes with the individual's ability to function. Also, as with
other personality disorders, the person is usually an adolescent or adult before
they can be assessed as meeting meet full symptom criteria for BPD.
Historically, BPD has been thought to be a set of symptoms that include both
mood problems (neuroses) and distortions of reality (psychosis), and therefore
was thought to be on the borderline between mood problems and schizophrenia.
However, it is now understood that while BPD may straddle those symptom
complexes, it is more closely related to other personality disorders in terms of
how it may develop and run in families. Contrary to what the
medical community thought in the past, BPD is now understood to occur equally in
men and women, rather than primarily in women. The frequency with which it
occurs is also thought to be considerably higher than previously thought,
affecting nearly 6% of adults over the course of a lifetime.
What other disorders often occur with BPD?
Men with BPD are more likely to also have a substance-use disorder and women
are more likely to have eating disorders. In adolescents,
BPD tends to co-occur with more anxious and odd personality disorders like
schizotypal and passive aggressive personality disorder, respectively. Adults may be more likely to have antisocial personality disorder
along with BPD. Interestingly, even people who have some
symptoms (traits) of BPD but do not meet full diagnostic criteria for the
disorder can experience both traits of that disorder and of narcissistic
personality disorder.
Although there has been some controversy as to whether or not BPD is truly
its own disorder or a variation of bipolar disorder, research supports the
theory that BPD, like virtually every medical or mental-health disorder can
appear (present) in nearly as many unique and complex ways as there are people
who have it. In other words, some individuals with BPD will have that disorder
alone, while others will have it in combination with bipolar or another mental
disorder, and still others will appear to have BPD but really qualify for the
diagnosis of bipolar disorder and visa versa.
BPD is not recognized worldwide. It is most closely diagnosed as emotionally
unstable personality disorder in the International Classification of Disease, or
ICD-10. Although countries like China and India recognize mental disorders that
have some symptoms in common with BPD, its existence is not formally recognized.
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