Borderline personality disorder: how to recognize and treat it.
Borderline personality disorder (BPD) is a complex psychological condition that affects how a person thinks and relates to others. It is characterized by intense emotional swings, fear of abandonment, impulsivity, and difficulty maintaining stable relationships.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) , borderline personality disorder is one of the most studied personality disorders and also one of the most challenging to treat. People with BPD often experience emotions very intensely and can rapidly alternate between love and anger, idealization and devaluation, which directly impacts their emotional and social lives.
Main symptoms of borderline personality disorder
Symptoms of borderline personality disorder can vary, but generally include:
Emotional instability: abrupt mood swings that can occur within hours.
Intense fear of abandonment: the person fears being rejected or left, even when there are no real signs of this.
Impulsive behaviors: excessive spending, substance abuse, uncontrolled eating, or risky behavior.
Unstable self-image: difficulty in maintaining a consistent perception of oneself.
Intense and unstable relationships: alternating between idealizing and devaluing partners, friends, or family members.
Chronic feelings of emptiness: a feeling of lack of purpose or of not belonging.
Intense and inappropriate anger: outbursts of irritation that may be disproportionate to the reason.
Self-destructive behaviors: self-harm, suicidal thoughts or attempts.
These symptoms typically appear in late adolescence or early adulthood and may intensify during periods of stress.
Causes and risk factors of borderline personality disorder.
Borderline personality disorder has multifactorial causes, meaning there is no single factor responsible for its development. Among the main factors are:
Biological and genetic factors: studies indicate that people with a family history of personality disorders or depression are more likely to develop BPD.
Family environment and childhood trauma: adverse experiences, such as physical or emotional abuse or neglect, are common in the history of people with borderline personality disorder.
Neurobiological factors: alterations in brain areas related to the control of emotions and impulses have also been observed.
These combined elements help explain why some people are more vulnerable to developing the disorder than others.
How borderline personality disorder affects relationships
The impact of borderline personality disorder on relationships is profound. A person with BPD tends to see others in extreme ways—either as entirely good or entirely bad. This “all or nothing” view causes frequent breakups and crises of mistrust.
An intense fear of rejection leads to behaviors such as excessive clinginess, jealousy, a constant need for validation, and, in some cases, attempts at control. Paradoxically, the same fear of abandonment can generate impulsive actions that end up pushing away those close to them.
Partners, friends, and family often feel confused and emotionally exhausted because they don’t understand the cycle of instability. Therefore, psychological treatment is essential not only for the patient but also for improving interpersonal relationships.
Diagnosis of borderline personality disorder
The diagnosis should be made by a psychologist or psychiatrist , based on clinical evaluation and a structured interview. The professional analyzes the symptoms, life history, and the impact of the behavior on daily life.
It is important to emphasize that a borderline personality disorder diagnosis does not define who a person is , but rather indicates a pattern of emotional functioning that can be treated and transformed with professional support.
How to treat borderline personality disorder
Although borderline personality disorder is considered chronic, it has effective treatment . The main therapeutic resource is psychotherapy , which helps the patient understand and regulate their emotions, improve their self-image, and develop skills to deal with others in a healthier way.
Among the most commonly used approaches are:
1. Dialectical Behavior Therapy (DBT)
Developed by Marsha Linehan, DBT is one of the most effective therapies for treating borderline personality disorder. It combines techniques from cognitive behavioral therapy with principles of acceptance and mindfulness . The
focus is on teaching the patient to cope with intense emotions, reduce impulsive behaviors, and improve relationships.
2. Cognitive-behavioral therapy (CBT)
CBT helps individuals identify distorted thoughts and negative beliefs about themselves and others. Over time, the patient learns to replace them with more realistic interpretations, reducing self-criticism and impulsivity.
3. Psychodynamic therapy
This approach seeks to understand how past experiences and unconscious patterns influence current behavior. It is especially useful for working through trauma and identity issues.
4. Drug treatment
Although there is no specific medication for borderline personality disorder, psychiatrists may prescribe medication to alleviate associated symptoms such as depression, anxiety, or impulsivity. Medication should always be used as a complement to psychotherapy.
The role of the psychologist in treatment.
The psychologist plays an essential role in supporting people with borderline personality disorder. They help the patient recognize their emotional patterns, understand their reactions, and build a more stable identity.
Furthermore, the therapist acts as a support system, offering a safe environment where the individual can express themselves without fear of judgment. This therapeutic bond is fundamental to the progress of the treatment.
How can family members and partners help?
Living with someone who has borderline personality disorder can be challenging, but empathy and knowledge about the disorder make all the difference. Some important attitudes include:
Avoid excessive judgment and criticism.
Establish clear and consistent boundaries.
Encourage psychological treatment and self-care.
Seek family therapy or support groups when necessary.
The involvement of the support network contributes to the recovery process and improves the quality of life for everyone involved.
Final considerations
Borderline personality disorder is a serious but treatable condition. With proper support, it’s possible to learn to regulate emotions, develop healthier relationships, and build a life with more balance and purpose.
Psychotherapy is the most effective way to understand and transform the emotional and behavioral patterns characteristic of the disorder. The sooner treatment begins, the greater the chances of significant improvement and emotional stability.
