Borderline personality disorder

Alternative names 
Personality disorder - borderline

Borderline personality disorder is a condition characterized by impulsive actions, mood instability, and chaotic relationships.

Causes, incidence, and risk factors

Personality disorders are chronic patterns of behavior that impair relationships and work. The cause of borderline personality disorder (BPD) is unknown. People with BPD are impulsive in areas that have a potential for self-harm, such as drug use, drinking, and other risk-taking behaviors.

Risk factors for BPD include abandonment issues in childhood or adolescence, sexual abuse, disrupted family life, and poor communication within the family. This personality disorder tends to occur more often in women and among hospitalized psychiatric patients.


Relationships with others are intense and unstable, swinging wildly from love to hate and back again. People with BPD will engage in frantic efforts to avoid real or imagined abandonment.

BPD patients may also have uncertainties about their identity or self-image. They tend to see things in terms of extremes, either all good or all bad. Such people also typically view themselves as victims of circumstance and take little responsibility for themselves or their problems.

Other symptoms include:

  • Frequent displays of inappropriate anger  
  • Recurrent suicidal gestures such as wrist cutting, overdosing, or self-mutilation  
  • Feelings of emptiness and boredom  
  • Intolerance of being alone  
  • Impulsiveness with money, substance abuse, sexual relationships, binge eating, or shoplifting

Signs and tests

Personality disorders are diagnosed based on psychological evaluation and the history and severity of the symptoms.


Self-destructive behavior can be changed in social and therapeutic environments such as group therapy. Peer reinforcement of appropriate behavior may be more successful than one-on-one counseling because difficulties with authority figures often prevent learning in such situations. Group therapy can also be helpful in modifying specific impulsive behaviors.

Medications can help to level mood swings and to treat depression or other disorders which may accompany this condition.

Expectations (prognosis)

Borderline personality disorder has a poor outlook because noncompliance with treatment is common.


  • Drug abuse  
  • Suicide attempts  
  • Eating disorders  
  • Depression

Calling your health care provider

Call your health care provider if you or your child is has symptoms suggestive of borderline personality disorder.

Johns Hopkins patient information

Last revised: December 6, 2012
by Dave R. Roger, M.D.

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