Borderline personality disorder
Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD) or emotional intensity disorder (EID) impacts how a person thinks, feels, behaves and relates to others.
BPD is the most common personality disorder, with estimates suggesting 1 in 50 people in the UK are affected by it. It is associated with significant emotional distress, with around 4 in 5 experiencing suicidal thoughts. Individuals with BPD may often face strong mood swings, struggle with self-image and find it hard to maintain stable relationships. They may fear being abandoned, feel empty inside and act impulsively – sometimes through self-harm or risky behaviours.
If you live with BPD, you may find your way of coping with emotions is different from others around you and that these emotions are hard to control. You may find your emotions confusing, tiring and isolating. This can lead to other mental health problems, such as anxiety and depression. However, through open conversations, access to appropriate support and treatment and prioritising self-care, it is possible to live well and thrive with BPD.
common myths about BPD
People with BPD are just attention seekers
BPD is not about seeking attention. It is a complex mental health condition that stems from emotional instability and a fear of abandonment. What may appear as ‘attention-seeking’ is often a way of expressing distress or trying to cope with overwhelming feelings.
A BPD diagnosis is for life
A common misconception is BPD is untreatable. However, with the right support, those with BPD can lead happy and fulfilling lives. Talking therapies, such as Dialectical Behavioural Therapy (DBT), are effective treatments for BPD.
causes
There is no single reason why someone develops BPD, but there are some factors that can increase the risk:
- Family history and genetics: Research suggests the likelihood of developing BPD increases if a close relative also lives with the condition.
- Trauma: Experiencing traumatic life events, such as going through abuse, neglect or the loss of a loved one – especially in childhood – can increase risk. In fact, 71% of individuals with BPD have experienced some form of trauma during their childhood.
- Social challenges: Experiences such as being bullied, repeated harm in relationships or growing up in a deprived or unstable environment can also play a role in developing BPD.
symptoms
People with BPD may experience a wide range of symptoms, including:
- Intense emotions: Individuals with BPD often experience intense, unstable emotions, such as anger.
- Fear of abandonment: A fear of being abandoned or rejected can lead to frantic efforts to avoid real or imagined abandonment, sometimes resulting in intense or turbulent relationships.
- Identity disturbance: Confused feelings about who you are and your identity.
- Impulsivity and recklessness: This may include substance use, reckless driving, binge eating or excessive spending.
- Self-harm or suicidal thoughts: Individuals with BPD may engage in self-harm or thoughts of suicide, often to cope with emotional distress.
If you think you or someone you know may have BPD, it’s important to seek support from your GP or a mental health professional.
diagnosis
Often, BPD is left undiagnosed or is misdiagnosed because of the similarity in symptoms with other mental health conditions, such as bipolar. Almost 40% of people diagnosed with BPD were incorrectly diagnosed with another disorder previously. Hazel was misdiagnosed with bipolar initially before receiving a BPD diagnosis, read more about her experience here.
To find out more about getting a diagnosis or support for BPD in Scotland, visit the NHS Inform website.
“After being diagnosed with Borderline Personality Disorder, I lost all my confidence and was not in a good place. I shut myself away from the world. Having Change Mental Health support has helped me to leave the house and regain that confidence and self-esteem.
“My self-management has improved and now I am delivering talks to Mental Health Nursing students at universities and colleges. Raising awareness of borderline personality disorder (BPD) will help other people and those with a mental illness to understand the condition more.”
Mo, who has BPD, receives support from our Kaleidoscope service in Dumfries. You can read her story here.
how can I support myself?
With a combination of self-help strategies and professional treatment, it’s possible to recover from BPD. In fact, approximately 50% of people with BPD no longer meet the diagnostic criteria after 10 years when receiving the right support.
Professional help
The first-line recommended treatment for BPD is talking therapy. These therapies address unhelpful thought patterns and behaviours and help employ useful coping strategies. Dialectical behavioural therapy (DBT) is the most evidence-based, so is often recommended first. However, cognitive behavioural therapy (CBT) or mentalisation-based therapy may also be suggested, depending on the support needs and preferences.
There is no medication to treat BPD. However, as 87% of people with BPD also have another mental health condition, such as anxiety, depression or bipolar, your doctor may recommend medication, such as selective serotonin reuptake inhibitors (SSRIs) or mood stabilisers, to help manage those symptoms.
Self-help
On top of therapy, there are also self-care activities you can do to help your symptoms:
- Emotion regulation strategies: Finding ways to manage difficult emotions, like anger or frustration, is really important. Channelling them into other activities such as exercise, writing your thoughts in a journal or listening to music can relieve tension and make these moments of heightened emotions more manageable.
- Establish a routine: Form a daily routine for structure and purpose, with consistent wake-up and mealtimes. Research shows that routine can be especially helpful for individuals with BPD for providing stability, minimising feelings of chaos and helping to manage in everyday life.
- Take a moment to breathe: Before reacting, pause briefly to consider how you want to respond. Incorporating breathing exercises into your daily routine can help to regain control over your emotions and bring a sense of calm.
- Join a supportive community: Connecting with others who understand what you’re going through can be really helpful. You could join a local peer support group or community to share experiences and emotions in a safe space. Find your nearest Change Mental Health service here.
- Reach out: You don’t have to manage everything on your own. Sharing how you feel with a trusted friend, family member, or loved one can provide comfort and support when things feel overwhelming.
how can I support others?
If you support someone with BPD, it’s important to know how to respond during crises or difficult situation while protecting your own wellbeing and boundaries. Here are a few practical tips that may help:
Prioritise safety
Life-threatening behaviours, such as suicidal thoughts, self-harm, risky actions or aggression, should always be taken seriously and addressed first. If you think they are at immediate risk of harming themselves or someone else, call 999 or take them to the nearest A&E.
Listen with empathy
Focus on understanding their experience from their point of view rather than making assumptions. Ask open, supportive questions like: “Can you help me understand what’s going on for you right now?” Show them that you care and reassure them that you’re there to support them.
Offer solutions, but only if they ask
Sometimes people simply need to feel heard, rather than having their situation solved straight away. Encouraging them to talk about what might help can be more supportive than trying to fix things immediately. Jumping in with solutions too quickly can feel dismissive. Often a compassionate ear is what’s most needed in that moment. However, if they do ask for help or ideas, you can then gently suggest ways you might be able to support them.
Educate yourself
BPD is one of the most misunderstood mental health conditions. By taking the time to learn more about BPD, it helps foster understanding and acceptance while also reducing stigma.
Paying attention to language is an important part of this. Terms like ‘attention-seeking’, ‘crazy’ or ‘manipulative’ can reinforce shame and discourage people from seeking help. Using person-first, non-judgmental language, such as ‘a person with BPD’, and recognising behaviours as expressions of distress, helps promote empathy and respect.
support
Our National Advice and Support Service can help you and people you care for with mental health concerns and money worries.
We can link and signpost you to relevant local and national support, including our own Change Mental Health services, as well as supporting with debt, grants and benefits.
The service is open Monday to Friday, 10am to 4pm (closed for lunch between 12.30pm to 1.30pm). Contact 0808 8010 515, email advice@changemh.org or fill in the form on the service webpage.
For full details about the service, visit the National Advice and Support Service webpage.
other support
Borderline Arts is a UK-based charity that focuses specifically on BPD.
NHS Inform serves as Scotland’s primary health information resource, allowing you to be more informed about mental health conditions.
Samaritans (116 123) is a 24-hour anonymous service available every day of the year. If you prefer not to speak on the phone, you can email Samaritans at jo@samaritans.org.
