Borderline personality disorder (BPD) is a mood disorder characterized by impulsiveness, distorted self-image and an intense fear of abandonment. People with BPD may also display frequently changing interests or values, feelings of emptiness, and difficulty maintaining stable relationships. Because clients experience the disorder differently and may not experience all symptoms, borderline personality disorder can be a difficult illness to diagnose.
Government statistics indicate that about 1.6% percent of the U.S. population suffers from BPD, but due to under-diagnosis, the National Alliance on Mental Illnesses indicates that the number could be as high as 5.9%. Three times as many women are diagnosed with the disorder as men, but this is believed to be likely due to overdiagnosis for women and underdiagnosis for men.
What Causes Borderline Personality Disorder?
Although research into borderline personality disorder is still relatively new, genetics appears to be the primary factor. Close relatives of people diagnosed with the disorder are five times more likely to exhibit symptoms themselves, according to the National Institute of Mental Health. However, heredity isn’t the only cause. Two more factors play into the diagnosis as well:
Brain Abnormalities: Neuroimaging has shown that people with borderline personality disorder have a smaller hippocampus, the area responsible for memory. They also have a smaller, more active amygdala, a characteristic shared by people with obsessive-compulsive disorder. The prefrontal complex, which regulates emotional control, is also less active.
Environmental Factors: A strong correlation has been shown between childhood abuse, particularly sexual abuse, and borderline personality disorder. A history of abuse and neglect, including the loss of a caregiver is also reported by people with BPD.
Types of Borderline Personality Disorder
Most clients, but not all, fall into one of four sub-types of borderline personality disorder. These include:
Discouraged Borderline: Characterized by submissive and avoidant personality traits. These clients tend to feel depressed, vulnerable and powerless. Their relationships are marked by humility and intense loyalty toward friends.
Petulant Borderline: This sub-type is characterized by negativity, particularly relating to the self. These clients often feel slighted or wronged by others and may jump to conclusions about how others perceive them.
Impulsive Borderline: Impulsive borderline personality types are capricious, social, and often flighty. This subtype is characterized by dramatic mood swings and fear of loss.
Self-Destructive Borderline: This sub-type is characterized by self-loathing and anxiety. These clients are often high-strung, moody and isolationist. In work and personal relationships, they may have not know how to display tact or deferential behavior.
Borderline Personality Disorder Treatment
Treatment for borderline personality disorder starts with a thorough assessment, including knowledge of a client’s personal history. Once diagnosed, psychotherapy is the most common treatment to manage BPD symptoms, with a focus on dialectical behavior therapy (DBT). This method, which focuses on changing self-harming behaviors, is specific to BPD. The four pillars of treatment are:
Mindfulness: Treatment starts with acceptance of therapy and a willingness to change
Distress Tolerance: This includes a number of methods and coping mechanisms to self-soothe and distract from unpleasant emotions.
Emotion Regulation: This area of treatment focuses on identifying and labeling emotions, reducing vulnerability, and changing black-and-white thinking.
Interpersonal Effectiveness: This final pillar deals with relationships, helping clients learn assertiveness and interpersonal conflict.
Transference therapy, which disrupts black-and-white thinking, is another important part of treating BPD.
Borderline Personality Disorder and Drug Addiction
Borderline personality disorder is strongly characterized by impulsiveness, which is linked to drug abuse. In fact, about half of people with borderline personality disorder have reported problems with drug abuse. However, because many of the signs of addiction alone overlap with BPD, the disorder can be very difficult to diagnose. Individuals suffering from drug addiction will often display impulsive, self-destructive behavior, which are also signs of borderline personality disorder. Both groups are also likely to display mood swings, dramatic “highs” and “lows,” manipulation and unstable relationships. Individuals with the following symptoms are more likely to display the following symptoms, which are not typically associated with addiction:
- An intense fear of abandonment, regardless of whether or not that abandonment is real.
- Feelings of emptiness, or feeling “lost” and unstable.
- Mood instability, particularly regarding sense of self.
- Suicidal behavior
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Dual Diagnosis Treatment
Individuals who suffer from signs of borderline personality disorder benefit from dual diagnosis treatment, which recognizes the disorder as separate from addiction, requiring dedicated, personalized treatment. At Sprout Health Group, we have made dual diagnosis treatment a cornerstone of our offering, allowing individuals who suffer from mental illness and personality disorders to get the treatment they need to manage those conditions while also getting dedicated treatment for their addiction.
If you or a loved one display symptoms of borderline personality disorder and are suffering from addiction, we can help. Get in touch to learn how our treatment centers can help you manage your dual diagnosis and and get dedicated, personalized treatment for long-term recovery.
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Written By: Sprout Editorial Team
The Sprout Health Group editorial team is passionate about addiction treatment, recovery and mental health issues. Every article is expert-reviewed.