Understanding and Addressing Borderline Personality Disorder

Available with English captions and subtitles in Spanish.

Borderline personality disorder (BPD) is a complex and largely misunderstood mental health condition.

While widely believed to be rare, it is actually more common than many better-known disorders. And while people with BPD often experience intense emotional instability and tend to struggle with beliefs and thoughts about themselves and others, the condition is much more treatable than generally thought.

Unfortunately, these kinds of awareness gaps create confusion and stigma that can keep people from getting the help they need. So, just what is the truth about BPD? How can we recognize it in ourselves and others? And who’s at risk of developing this disorder?

Audience Questions

Karen L. Jacob, PhD, explains how borderline personality disorder is diagnosed and treated, provides tips for supporting someone living with the condition, and answers audience questions about the causes and symptoms of BPD.

  • How long has the borderline personality disorder (BPD) diagnosis been around?
  • How do you define BPD? Are there certain criteria that need to be met for the diagnosis?
  • What are Marsha Linehan’s five criteria or areas of interest when assessing somebody for BPD?
  • What does it mean to have dysregulated thoughts/cognitions?
  • What does it mean to have dysregulated emotions?
  • What does it mean to have a dysregulated sense of self?
  • What does it mean to have behavioral dysregulation?
  • What does it mean to have interpersonal dysregulation?
  • Does someone have to be dysregulated in all of these areas to be diagnosed with BPD? Are these dysregulated areas interdependent?
  • How common or uncommon is BPD?
  • What do we know about the potential causes of BPD, whether environmental factors, genetics, or brain abnormalities?
  • How young can someone be diagnosed with BPD?
  • Can BPD start in one’s thirties?
  • What age do people typically get diagnosed with BPD?
  • Is there a natural waxing and waning of the disorder over the course of time?
  • Are there specific BPD diagnostic assessment tools that professionals use?
  • Why is there sometimes confusion between BPD and bipolar disorder?
  • How does complex PTSD play into BPD characteristics?
  • How does substance use disorder affect BPD?
  • Is it common for social anxiety disorder to be coupled with BPD?
  • If someone is concerned that a loved one might be struggling with BPD, what would be a flag that professional assessment could be warranted?
  • How is dialectical behavioral therapy (DBT) used in the treatment of BPD?
  • Are there other treatment approaches used for BPD?
  • Should treatment for BPD be done at an outpatient level, as part of a partial program, in a residential program, or a combination of all the above?
  • What medications are used for BPD and what symptoms do the medications address?
  • How can a family member assist someone who is refusing treatment?
  • What can someone with BPD expect after they’ve been through some treatment?
  • Is there any evidence that children with parents who were diagnosed with BPD are more likely to develop BPD themselves?
  • What are some of the more common myths about BPD?
  • How treatable is BPD?
  • What triggers or activates the disorder itself?
  • What can family members do to rebuild a relationship to safely include a loved one with BPD?
  • When is it appropriate for clinicians to refer out, as opposed to treating BPD themselves?
  • What training should school systems, teachers, and other faculty members use in order to recognize BPD on campus?
  • Is BPD linked to ADHD?
  • What do you most want people to know about identifying, treating, and addressing borderline personality disorder?

The information discussed is intended to be educational and should not be used as a substitute for guidance provided by your health care provider. Please consult with your treatment team before making any changes to your care plan.

Resources

You may also find this information useful:

About Dr. Jacob

Karen L. Jacob, PhD, is the program director of McLean’s residential treatment program for individuals with borderline personality disorder and other severe personality disorders, including those who experience co-occurring psychiatric conditions, such as substance use, eating disorders, depression, or anxiety.

Dr. Jacob’s clinical training has been primarily in cognitive behavior therapy (CBT) for patients struggling with mood, anxiety, and personality disorders, as well as in mindfulness, mentalization, dialectical behavior, and biofeedback therapies. She has an extensive research training background, having studied topics including diabetes, adoption, attachment, panic disorder, and psychotherapy outcomes.

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