If you are reading this article, you may be curious about borderline personality disorder (BPD). Maybe you’re wondering if BPD explains your strong emotions. You could also be thinking about your relationship problems or behavior patterns. Or perhaps someone you love received a diagnosis of BPD, and you’re trying to understand what this means for them.
Either way, you’re not alone in seeking answers. When people search “what is borderline personality disorder,” they’re often looking for clarity during a confusing and painful time. Borderline personality disorder affects approximately 1.4% of the adult population in the US, though some research suggests the actual prevalence may be higher.¹
Many people with BPD feel misunderstood or stigmatized, and they often don’t know where to find help. At Pasadena Villa Outpatient, we understand — and we aim to provide clear, compassionate, and scientifically accurate information about what borderline personality disorder is and how it affects people’s lives. Understanding this condition is the first step toward healing and recovery.
Understanding Borderline Personality Disorder
Borderline personality disorder is a mental health condition that causes ongoing problems with emotions, self-image, behavior, and relationships. This disorder can cause significant suffering, requiring professional treatment to help those affected.
It’s important to recognize that borderline personality disorder is not a character flaw, a choice, or simply “being dramatic.” People with borderline personality disorder often experience intense emotional responses that can change rapidly. They may worry about being abandoned, struggle to maintain stable relationships, or feel unsure about their identity.
The term “borderline” has historical roots dating back to when mental health professionals believed this condition existed on the border between psychosis and neurosis. While we now understand BPD much more clearly, the name has remained — even though it doesn’t fully capture the nature of the disorder.
Core Symptoms of Borderline Personality Disorder
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, BPD is identified by a pervasive pattern of instability that typically manifests in at least five of the following ways:
1. Intense Fear of Abandonment
People with borderline personality disorder often experience overwhelming anxiety about being left alone or rejected, and this fear can lead to frantic efforts to avoid real or imagined abandonment.
2. Unstable Relationships
Relationships with family members, romantic partners, and friends tend to alternate between extremes of idealization (“you’re perfect”) and devaluation (“you’re terrible”). These shifts can happen quickly and without warning.
3. Unstable Self-Image
A person with BPD may struggle with questions like “Who am I?” or “What do I believe in?” Their sense of self, goals, values, and career aspirations may shift frequently.
4. Impulsive Behaviors
This might include reckless spending, substance use, unsafe sexual behavior, binge eating, or dangerous driving — actions that can have serious consequences but provide temporary relief from emotional pain.
5. Suicidal Behavior or Self-Harm
Research indicates that approximately 70% of individuals with BPD engage in self-harming behaviors, and between 8-10% die by suicide.² These behaviors are often attempts to cope with overwhelming emotional pain rather than attention-seeking actions.
6. Emotional Instability
Moods can change dramatically within hours or even minutes, cycling between intense sadness, anxiety, irritability, and occasionally euphoria.
7. Chronic Feelings of Emptiness
Many individuals with borderline personality disorder describe feeling hollow, lost, or like something essential is missing inside them.
8. Intense, Inappropriate Anger
This might manifest as frequent displays of temper, constant anger, or physical altercations, often followed by shame and guilt.
9. Stress-related paranoia or dissociation
During times of high stress, some with BPD may experience temporary paranoid thoughts or feelings of being disconnected from themselves or their surroundings.
What Causes Borderline Personality Disorder?
Like most mental health conditions, borderline personality disorder doesn’t have a single cause. Instead, research supports a biopsychosocial model, meaning BPD develops through the interaction of multiple factors:
- Biological factors – Differences in brain regions involved in emotion regulation and impulse control
- Genetic vulnerability – Family and twin studies suggest moderate heritability
- Environmental factors – Childhood trauma, neglect, invalidating environments, or chronic stress increase risk
Of course, not everyone with a history of trauma develops BPD, and not everyone with BPD has experienced trauma.
The Impact on Daily Life + Relationships
Living with borderline personality disorder can be exhausting and painful. The intense emotions, relationship difficulties, and unstable sense of self can make everyday activities feel overwhelming. You might find yourself constantly questioning your decisions, feeling misunderstood by others, or experiencing relationships that seem to repeat the same painful pattern.
For family members and loved ones, understanding borderline personality disorder is equally important. The behaviors associated with this condition — the emotional intensity, fear of abandonment, rapid mood shifts — aren’t manipulative tactics or deliberate attempts to cause harm. They’re symptoms of a legitimate mental health condition.
Treatment + Hope for Recovery
Here’s the most important thing to know about borderline personality disorder: it’s treatable, and recovery is possible. Research consistently shows that with appropriate treatment, individuals with BPD can experience significant improvement in their symptoms and quality of life.
Dialectical behavior therapy (DBT), a treatment specifically developed for borderline personality disorder, has demonstrated strong effectiveness in reducing self-harm behaviors, suicide attempts, and hospitalization rates while improving overall functioning.⁴
A long-term study following individuals with BPD over 10 years found that 88% achieved remission from the disorder at some point during the study period, and most maintained that remission.⁵ This research offers genuine hope. With proper treatment and support, the majority of those with borderline personality disorder can recover and build meaningful, stable lives.
Finding Support at Pasadena Villa Outpatient
If you’re struggling with borderline personality disorder or supporting someone who is, specialized outpatient treatment can make a significant difference. At Pasadena Villa Outpatient, we understand the unique challenges of BPD and are committed to providing evidence-based, compassionate care that addresses the whole person.
Our treatment programs incorporate therapies proven effective for borderline personality disorder, delivered by mental health professionals who specialize in personality disorders and complex emotional regulation challenges. We work with you to develop skills for managing intense emotions, building healthier relationships, and creating a more stable sense of self.
Moving Forward with Understanding
Borderline personality disorder is challenging, but it doesn’t define you. With proper treatment, support, and understanding, healing is not just possible — it’s probable. You deserve that hope, and the chance to build a more stable, fulfilling life.
To learn more about treatment options for borderline personality disorder at Pasadena Villa Outpatient, reach out to our compassionate admissions team today. Recovery begins with understanding, and understanding begins with taking that first step toward help.
References
- Grant, B. F., Chou, S. P., Goldstein, R. B., Huang, B., Stinson, F. S., Saha, T. D., Smith, S. M., Dawson, D. A., Pulay, A. J., Pickering, R. P., & Ruan, W. J. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 69(4), 533-545.
- Gunderson, J. G., Stout, R. L., McGlashan, T. H., Shea, M. T., Morey, L. C., Grilo, C. M., Zanarini, M. C., Yen, S., Markowitz, J. C., Sanislow, C., Ansell, E., Pinto, A., & Skodol, A. E. (2011). Ten-year course of borderline personality disorder: Psychopathology and function from the Collaborative Longitudinal Personality Disorders study. Archives of General Psychiatry, 68(8), 827-837.
- Torgersen, S., Lygren, S., Øien, P. A., Skre, I., Onstad, S., Edvardsen, J., Tambs, K., & Kringlen, E. (2000). A twin study of personality disorders. Comprehensive Psychiatry, 41(6), 416-425.
- Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., Korslund, K. E., Tutek, D. A., Reynolds, S. K., & Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63(7), 757-766
- Zanarini, M. C., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G. (2012). Attainment and stability of sustained symptomatic remission and recovery among patients with borderline personality disorder and axis II comparison subjects: A 16-year prospective follow-up study. American Journal of Psychiatry, 169(5), 476-483.