Borderline Personality Disorder (BPD) is a complex mental health condition that has been the subject of much discussion and research. Characterized by intense emotions, impulsive behaviors and unstable relationships, it presents a challenge not only for those who live with it but also for their loved ones and healthcare providers.

This article will present what Borderline Personality Disorder is, the distinction between BPD and bipolar disorder, the symptoms, the diagnosis criteria as per DSM-5, types of BPD, treatment options including medication and ways to support someone with the condition.

What Is Borderline Personality Disorder?

Borderline Personality Disorder is a mental health disorder that impacts the way you think and feel about yourself and others, causing problems in everyday life. It includes self-image issues, difficulty managing emotions and behavior and a pattern of unstable relationships.

Borderline personality disorder vs bipolar

One common point of confusion is the difference between Borderline Personality Disorder and bipolar disorder. Although both BPD and bipolar disorder share some symptoms, including mood swings and impulsivity, they are distinct conditions.

Bipolar disorder is primarily a mood disorder that causes extreme mood swings, including emotional highs (mania or hypomania) and lows (depression). BPD, on the other hand, is a personality disorder that involves a long-term pattern of varying moods, self-image and behavior.

Symptoms of Borderline Personality Disorder

Understanding the symptoms of BPD is important for early detection and treatment. Common symptoms include:

Emotional instability

People with BPD may experience intense mood swings and can feel a great sense of insecurity and instability. These mood swings are often intense and can last from a few hours to a few days.

Fear of abandonment

Those with BPD may have an extreme fear of abandonment or instability, and they may go to great lengths to avoid real or imagined separation or rejection.

Unstable relationships

BPD often causes relationships to be intense and short-lived. Individuals may idealize someone one moment and then suddenly believe the person doesn’t care enough or is cruel.

Impulsive behaviors

Impulsivity is a key symptom of BPD, often manifesting as risky behaviors like overspending, substance abuse, reckless driving or binge eating.

Self-harming behavior

Self-harm, including suicidal threats or attempts, can occur in people with BPD, often as a response to fear of separation or rejection.

Chronic feelings of emptiness

Individuals with BPD may describe feeling empty, which can lead to a deep sense of dissatisfaction and boredom.

Diagnosing Borderline Personality Disorder (DSM-5 Criteria)

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) provides criteria for diagnosing BPD. A healthcare provider will assess if a person meets at least five of the nine criteria to diagnose BPD, which includes:


  1. Frantic efforts to avoid real or imagined abandonment.
  2. A pattern of unstable and intense interpersonal relationships.
  3. Identity disturbance with markedly or persistently unstable self-image.
  4. Impulsivity in at least two areas that are potentially self-damaging.
  5. Recurrent suicidal behavior, gestures or self-harming behavior.
  6. Affective instability due to a marked reactivity of mood.
  7. Chronic feelings of emptiness.
  8. Inappropriate, intense anger or difficulty controlling anger.
  9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

Types of Borderline Personality Disorder

BPD is not a one-size-fits-all diagnosis. There are several types or subtypes of BPD recognized by clinicians to describe different symptom patterns, including:

Discouraged borderline

Characterized by depressive symptoms, this type might involve a high level of dependency on others and a significant fear of abandonment.

Impulsive borderline

Individuals with this subtype exhibit more of the impulsive behaviors associated with BPD and can appear charismatic and engaging.

Petulant borderline

Petulant borderlines may be unpredictable and prone to feelings of unworthiness, anger, and fear of abandonment but with a strong desire for intimacy.

Self-destructive borderline

This type is marked by self-hatred and a pattern of self-destructive behavior, including self-harm.

Medication for Borderline Personality Disorder

While there is no specific medication approved to treat BPD, certain medications can help with symptoms or co-occurring problems:


For symptoms such as depression, anger, impulsivity and anxiety, SSRIs (Selective Serotonin Reuptake Inhibitors) are often prescribed.

Mood stabilizers

These medications may be used to level mood swings and reduce irritability and aggression.


In lower doses, these medications may help with symptoms such as disorganized thinking, paranoia and severe anxiety.

It’s important to note that medication is typically more effective when combined with psychotherapy.


Supporting Someone with Borderline Personality Disorder

Knowing how to help someone with BPD can be challenging. Here are a few suggestions:

Educate yourself

The more you understand about BPD, the better equipped you’ll be to offer support and understand their behaviors.

Encourage treatment

Professional treatment is vital for someone with BPD. Encourage them to seek help and stick with their treatment plan.

Offer support

Provide emotional support and listen without judgment. This can help people with BPD feel heard and validated.

Set boundaries

Establishing clear boundaries is crucial for both your wellbeing and that of the person with BPD.

Get Help for Borderline Personality Disorder

Borderline Personality Disorder is a complex condition that affects millions of people and those around them. Understanding the symptoms, types and treatment options available, including medication and therapy, is key to managing BPD effectively. 

If you or someone you know is struggling with BPD, it’s important to seek professional help and remember that there is hope for a better future. Holly Hill Hospital, located in Raleigh, NC, can help. Our inpatient and outpatient mental health programs are designed to help with a variety of mental health issues. Call us today at 919-849-5048 to get started on your journey to better mental health, today. 

In case of a mental health crisis, CALL 988 or seek the nearest emergency room.

Holly Hill Hospital

Holly Hill Hospital is an inpatient and outpatient psychiatric and addictive disease health system for patients of all ages. Located in Raleigh, North Carolina, we pride ourselves on helping patients return to their families and communities happier and healthier for nearly 40 years. We give our patients excellent coping and recovery skills.

We have several different nurturing and beautiful locations, which includes our main, adult and children’s locations. Some of our services comprise of our child, adolescent, young adult, adult and geriatrics programs. Through these programs we provide treatment for dual diagnosis/co-occurring disorders, depression, addiction treatment and more.