Borderline Personality Disorder (BPD)
Borderline Personality Disorder (BPD)
Borderline Personality Disorder (BPD)
This resource explains borderline personality disorder (BPD), also known as emotionally
unstable personality disorder (EUPD), including possible causes and how you can access
treatment and support. Includes tips for helping yourself, and guidance for friends and
family..
Contents
What is BPD?…………………………………………………………………………….….........…......2
What causes BPD?…………………………………………………………………………………...….3
What's it like to live with BPD?...................................……....................................................4
Could my diagnosis be wrong?...........................……...........................................................7
How can I help myself?.....................................…….............................................................7
What treatments can help?………..........................……....................................................….11
How can other people help?………................................……............................................…14
Useful contacts………..........................................……...........................................................15
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Borderline personality disorder (BPD) is also known as emotionally unstable
personality disorder (EUPD). If you clicked on BPD or EUPD in our mental health A-Z
then you’ve reached the right page. It’s your choice which of these terms you want to
use, but your doctor or care team might use either.
We hope you will find the information in these pages useful when considering
different options for care and support. Please do tell us your thoughts via the 'was
this page useful?' button.
What is BPD?
Borderline personality disorder (BPD) is a type of personality disorder. You might be
diagnosed with a personality disorder if you have difficulties with how you think and feel
about yourself and other people, and are having problems in your life as a result.
“Having BPD is like the emotional version of being a burn victim. Everything in the world
hurts more than it seems to for everyone else and any 'thick skin' you are supposed to
have just isn't there.”
When is it diagnosed?
You might be given a diagnosis of BPD if you experience at least five of the following
things, and they've lasted for a long time or have a big impact on your daily life:
You feel very worried about people abandoning you, and would do anything to stop
that happening.
You have very intense emotions that last from a few hours to a few days and can
change quickly (for example, from feeling very happy and confident to suddenly
feeling low and sad).
You don't have a strong sense of who you are, and it can change significantly
depending on who you're with.
You find it very hard to make and keep stable relationships.
You feel empty a lot of the time.
You act impulsively and do things that could harm you (such as binge eating, using
drugs or driving dangerously).
You often self-harm or have suicidal feelings.
You have very intense feelings of anger, which are really difficult to control.
When very stressed, you may also experience paranoia or dissociation.
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Different views on diagnosis
Because you only need to experience five of these difficulties to be given a diagnosis of
BPD or EUPD, it can be a very broad diagnosis which includes lots of different people
with very different experiences.
Some people find it helpful to have a diagnosis because they feel it explains and helps
people to understand their difficulties, or gives them a sense of relief and validation.
Others feel their diagnosis isn’t helpful, disagreeing entirely with the current system of
diagnosing personality disorders and finding it stigmatising and unhelpful. For example,
some people prefer not to describe their experiences as medical problems, or would
rather see them as a response to difficult life events. Our page on why personality
disorder is a controversial diagnosis has more information.
“Even though I haven’t been offered much support, just having a diagnosis helps me feel
my suffering is validated.”
“I don’t necessarily tell people I have BPD because I don’t like labelling myself, I just say I
have depression and anxiety because it’s easier. But I know I have BPD. I feel things so
intensely sometimes it means I lose control of all my senses. It’s one of the worst
feelings, but I have learnt how to cope with it.”
“One of the things I struggled with was a feeling of “why me”, in the sense of “others
have experienced far worse than me and can deal with it – why can’t I?”. Over time I’ve
come to realise that lots of low level issues in my life are as valid a reason for struggling
as a few bigger traumas.”
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If you had difficult childhood experiences like these they may have caused you to develop
particular coping strategies, or beliefs about yourself and other people, which might
become less helpful in time and cause you distress. You might also be struggling with
feelings of anger, fear or sadness.
You might also experience BPD without having any history of traumatic or stressful life
events, or you might have had other types of difficult experiences.
If you already experience some of these difficulties, then experiencing stress or trauma
as an adult could make things worse. (Our pages on how to manage stress and post-
traumatic stress disorder have some tips on how to cope.)
Genetic factors
Some evidence suggests that BPD could have a genetic cause, because you’re more
likely to be given this diagnosis if someone in your close family has also received it. But
it’s very hard to know if difficulties associated with BPD are inherited from your parents
or caused by other factors, such as the environment you grow up in or the ways of
thinking, coping and behaving that you learn from the people around you.
It’s possible that a combination of factors could be involved. Genetics might make you
more vulnerable to developing BPD, but often it's due to stressful or traumatic life
experiences that these vulnerabilities are triggered and become a problem.
“Being a man with BPD feels like a lonely place – it is often thought of as a female
condition, but affects men too. For me, what helps when I’m having a bad time is more
“practical” than emotional – immersing myself in a book, throwing myself into something
practical – not avoiding my emotions but delaying them for a little until I feel more able to
cope with them.”
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difficult feelings and behaviour towards yourself
difficult feelings and behaviour towards others
alcohol and substance misuse
BPD and other mental health problems
experiences of facing stigma
“My experience is that I have to keep my emotions inside, because I get told I am
overreacting. So I end up feeling like I'm trapped inside my body screaming while no one
can hear me.”
“My BPD diagnosis affects every part of my life… my relationships, identity, career
choices, moods etc. I’ve had such identity issues that I’ve changed my name twice by
deed poll… it’s a terrible, painful feeling to not know who you are. It is a real struggle
some days to battle everything that is going on.”
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ending relationships with friends or partners because you think they might leave
you
anxiously looking out for signs that people might reject you.
See our page on self-care for BPD for some ideas on how to cope with difficult feelings.
“It feels like there is something missing from inside me and no one understands when I try
to explain how I feel.”
“BPD can be exhausting. My mind is a constant rollercoaster of emotions but when the
emotions are happy and exhilarating it is the best feeling in the world.”
“It took a long time to get my BPD/EUPD diagnosis because of also having other
disorders, but I'm at a happy place now in life thanks to a variety of factors.”
This can be very upsetting and frustrating, especially if someone who feels this way is a
friend, colleague, family member or a health care professional.
But it's important to remember that you aren't alone, and you don't have to put up with
people treating you badly. Here are some options for you to think about:
Show people this information to help them understand more about what your
diagnosis really means.
Get more involved in your treatment. Our pages on seeking help for a mental
health problem provide guidance on having your say in your treatment, making
your voice heard, and steps you can take if you're not happy with your care.
Know your rights. Our pages on legal rights provide more information.
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Take action with Mind. See our campaigning page for details of the different ways
you can get involved with helping us challenge stigma.
Find out more about BPD and stigma on the Time to Change website.
“The stigma is the worst for me. I'm a caring and empathetic soul who would do anything
for the people I love.”
bipolar disorder
complex post-traumatic stress disorder (PTSD)
depression
psychosis
antisocial personality disorder (ASPD)
Depending on your mood and what's going on in your life when you speak to a mental
health professional, they might find it hard to understand which diagnosis best fits your
experiences and might offer you treatment for something other than BPD. It's also
possible to experience BPD and other mental health problems at the same time.
“I had the wrong diagnosis for nearly 30 years and felt like a freak, because when
reading up about the diagnosis I was given there was no mention of [my other
symptoms].”
See our pages on seeking help for a mental health problem for information on how to
make sure your voice is heard, and what you can do if you're not happy with your doctor.
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If you experience BPD you might feel like every day is a struggle, but in fact there are
lots of things that could help, both now and in the longer term:
If you're feeling overwhelmed, it might help to focus on one feeling at a time. Here are
some ideas that you could try to see if they work for you. Different things work at
different times for different people, so try to be kind to yourself if some things don’t work
for you. Over time, you might develop your own tips to add to this list too.
How you're
What you could do to get through it
feeling
anxious, panicky, make yourself a hot drink and drink it slowly, noticing the
tense taste and smell, the shape of the mug and its weight in
your hand
take ten deep breaths, counting each one out loud
write down everything you can think of about where you
are right now, such as the time, date, colour of the walls
and the furniture in the room
take a warm bath or shower – this can help change your
mood by creating a soothing atmosphere and a distracting
physical sensation.
See our page on self-care for anxiety and panic attacks for more
tips.
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dissociative, chew a piece of ginger or chili
spaced out clap your hands and notice the stinging sensation
drink a glass of ice cold water.
wanting to self- rub ice over where you want to hurt yourself
harm stick sellotape or a plaster on your skin and peel it off
take a cold bath.
See our page on helping yourself cope with self-harm for more
tips.
Talk to someone
Keep a mood diary
Plan for difficult times
Make a self-care box
Try peer support
Look after your physical health
Find specialist support for any connected issues
“With time, you do learn to cope with [BPD] better. I have struggled for 15 years, but
every year I seem to get stronger and better at coping with it!”
Talk to someone
It can be hard to reach out when you’re not feeling well, but it might help to share difficult
thoughts. If you don’t feel you can talk to the people around you, you could try contacting
a helpline. For example, you can talk to Samaritans for free on 116 123 or
jo@samaritans.org about anything that’s upsetting you. (See our page on telephone
support for more information about different helplines.)
“I now work within mental health and am trying to break the stigma. I still self-harm and
have suicidal ideation but I have hope. I think trying to live using the recovery drivers of
CHIME (Connections, Hope, Identity, Meaning and Empowerment) really helped me.”
You could also make a note of what's going well. It's really important to be kind to
yourself and recognise difficult steps you’ve taken, or new things you’ve tried.
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“If I am feeling very bad but can't put into words how I feel or why, I wear a particular
bracelet. My closest friends and family know that this means I am having a rough time at
the moment and might need some TLC.”
The National Institute for Health and Care Excellence (NICE) – the organisation that
produces guidelines on best practice in healthcare – recommends that everyone with BPD
has a crisis plan. This should include possible triggers, self-help strategies and details for
getting support, and should be shared with you and your GP.
(See our on planning for a crisis and making a support plan for more information).
“Sometimes I have good periods where my symptoms don’t really trouble me – at other
times, they can be overwhelming. It’s sometimes hard not to beat myself up for the
relapses, but that’s something I need to keep working on. It’s ok to struggle sometimes.”
For example:
favourite books, films or CDs
a stress ball or fiddle toy
helpful sayings or notes of encouragement
pictures or photos you find comforting
a soft blanket or cosy slippers
a nice-smelling candle or lavender bag.
Watch Madeline talk about her self-care box, which contains all sorts of things that help
her when she's going through tough times with her mental health.
“There are positive sides too; I believe that I experience pleasant emotions more strongly
than others, and my friends value my sincerity.”
“Although it can sometimes be triggering, going online and talking to people who also
have BPD is useful, supportive and reassuring that I really am not alone.”
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Look after your physical health
Looking after your physical health can make a difference to how you feel emotionally. For
example, it can help to:
Try to get enough sleep. Sleep can help give you the energy to cope with difficult
feelings and experiences. (See our pages on coping with sleep problems for more
information.)
Think about your diet. Eating regularly and keeping your blood sugar stable can
make a difference to your mood and energy levels. (See our pages on food and
mood for more information.)
Try to do some physical activity. Exercise can be really helpful for your mental
wellbeing. (See our pages on physical activity for more information.)
Spend time outside. Spending time in green space can boost your wellbeing. (See
our pages on ecotherapy for more information.)
Avoid drugs and alcohol. While you might want to use drugs or alcohol to cope
with difficult feelings, in the long run they can make you feel a lot worse and can
prevent you from dealing with any underlying problems that the drug or alcohol
use may have been masking. (See our pages on recreational drugs and
alcohol for more information).
Talking therapies
Talking therapies are thought to be the most helpful treatment for BPD, although more
research is needed into the types of treatments that are most effective.
The National Institute for Health and Care Excellence (NICE) – the organisation that
produces guidelines on best practice in health care – suggests that the following kinds of
talking treatments may be helpful:
Dialectical Behaviour Therapy (DBT) – uses individual and group therapy to help
you learn skills to cope with difficult emotions. So far, NICE has recommended this
treatment for women with BPD who often self-harm, and it’s also thought to be
helpful for other groups (see our pages on DBT for more information.)
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Mentalisation-Based Therapy (MBT) – aims to help you recognise and understand
your and other people's mental states, and to examine your thoughts about
yourself and others. You can read more about MBT on the NHS Choices pages on
BPD.
Read one blogger's experience of Dialectical Behaviour Therapy (DBT) and the difference
this has made to her life.
Read Jessica's experience of taking part in group Mentalisation Based Therapy (MBT).
“DBT helped me hugely to understand myself and my emotions, and to learn that it’s all
ok. No matter what is happening... it’s going to pass. For the first time in 10 years I've
come off antidepressants and feel great. I won’t ever be 100% stable, but I can accept
myself for who I am.”
NICE says that other types of talking therapy could potentially be helpful, including:
Cognitive Behavioural Therapy (CBT) – aims to help you understand how your
thoughts and beliefs might affect your feelings and behaviour. (See our pages
on CBT for more information.)
Cognitive Analytic Therapy (CAT) – combines CBT's practical methods with a focus
on the relationship between you and your therapist. This can help you look at how
you relate to people, including yourself, and what patterns have developed for
you.
Other talking therapies – such as schema-focused cognitive therapy,
psychodynamic therapy, interpersonal therapy or arts therapies. (See our pages
on talking therapies and arts therapies for more information.)
“I have educated myself about emotions, I have learned from books, therapy,
psychologists, friends. The most important thing is that it is never too late to learn.”
Therapeutic communities
Therapeutic communities are specially designed programmes where you work with a
group of other people experiencing mental health problems to support each other to
recover. You might live together some or all of the time, or meet up regularly.
Activities can include different types of individual or group therapy, as well as household
chores and social activities. The Consortium for Therapeutic Communities provides a
directory of therapeutic communities in the UK.
Medication
Psychiatric medication isn’t recommended for treating ongoing symptoms of BPD. This is
because there aren’t any drugs that are known to be effective. However, you might take
medication for other mental health problems you’re experiencing.
In a crisis situation your doctor might prescribe you a sleeping pill or minor tranquilliser to
help you feel calmer, but they shouldn’t prescribe these for longer than a week.
“I have found the right medication regime and try to keep my life structured. It is not easy
but recovery is possible.”
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Medication really helps some people but isn’t right for others. Before deciding to take
any drug, it's important to make sure you have all the facts you need to make an
informed choice.
See our pages on things to consider before taking medication and your right to refuse
medication for more information. Our pages on coming off medication give guidance
on how to come off medication safely.
If you receive NHS treatment, it should be in line with NICE guidelines. These say that:
Anyone with possible BPD should have a structured assessment with a specialist
in mental health before being given a diagnosis.
You should have a say in the type of treatment you’re offered. If you’re not getting
the type of treatment you think would most help you, it could help to talk to an
advocate. (See our pages on advocacy for more information.)
You can read the full guidelines and additional recommendations for BPD in English or
Welsh on the NICE website. For details of specialist services in the UK, see the UK
Department of Health’s personality disorder website.
“I was helpless and hopeless for a long time but when I finally got my head around the
fact that only I could make a difference and that there was no magic wand, something
clicked.”
We know how frustrating and difficult it can be to cope with services that don't
provide the exact help you need, exactly when you need it. That's why we're
campaigning to improve crisis care across the country.
You can learn more about our crisis care campaign here, and read about the different
ways you can take action with Mind.
Can I go private?
Waiting times for talking treatments on the NHS can unfortunately be long. If you feel that
you don’t want to wait, or that you would like to see a therapist who specialises in the
types of experiences you have had (which is often not available on the NHS), you may
choose to see a therapist privately. (See our pages on seeking private sector therapy for
more information.)
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“It began changing for me when one hospital suggested that there was a way forward,
that I didn't have to feel so broken forever. It wasn't plain sailing from there, but just
realising there was hope... and that other people had gone on to achieve amazing things
really inspired me.”
Try to be patient. If your loved one is struggling to deal with their emotions, try not
to get involved in an argument in the heat of the moment. It could be better to wait
until you both feel calmer to talk things through.
Don't judge them. Try to listen to them without telling them that they're overreacting
or that they shouldn't feel the way they do. Whether or not you understand why
they feel like this, and regardless of whether you feel it's reasonable, it is still how
they're feeling and it's important to acknowledge it.
Be calm and consistent. If your loved one is experiencing a lot of overwhelming
emotions, this could help them feel more secure and supported and will help in
moments of conflict.
“One thing that I find helps is when others validate my emotions, as I often feel guilty for
having them.”
Help remind them of all their positive traits. When someone you care about is
finding it hard to believe anything good about themself, it can be reassuring to
hear all the positive things you see in them.
Try to set clear boundaries and expectations. If your loved one is feeling insecure
about being rejected or abandoned, or seems worried about being left alone, it can
be helpful to make sure you both know what you can expect from each other.
Plan ahead. When the person you're supporting is feeling well, ask them how you
can help them best when things are difficult. See our pages on supporting
someone who feels suicidal, and supporting someone who is self-harming for
more information.
“I have a friend who [...] goes for hot chocolate with me every week. To know there is
somebody who cares and has time for you, even when you're not sure who you are...
that means the world.”
Learn their triggers. Talk to your loved one and try to find out what sort of
situations or conversations might trigger negative thoughts and emotions.
Learn more about BPD, and help to challenge stigma. BPD is a complicated
diagnosis, and your loved one might sometimes have to deal with other people's
misconceptions on top of trying to manage their mental health problem. Our pages
on what is BPD? and BPD experiences contain more information.
Help them seek treatment and support. See our page on how to support someone
to seek help for more information.
Help them find an advocate. See our pages on advocacy in mental health for more
information.
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Take care of yourself. Looking after someone else can sometimes be difficult and
stressful. It's important to remember that your mental health is important too. See
our pages on coping when supporting someone else, managing stress and
maintaining your wellbeing for more information on how to look after yourself.
Useful contacts
Our helplines
Our Infolines provide information and support by phone, email and text. Click here for
contact details and opening times.
Local Minds
Local Minds provide services such as talking therapies, peer support, and advocacy. Click
here to find your nearest branch.
Elefriends
Our supportive online community for anyone experiencing a mental health problem. Click
here to find out more.
FRANK
0300 123 6600
talktofrank.com
Free 24-hour national drugs helpline.
Harmless
info@harmless.org.uk
harmless.org.uk
User-led organisation for people who self-harm, and their friends and families.
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NHS Choices
nhs.uk
Provides information on treatments for BPD which are available through the NHS.
Personality disorder
personalitydisorder.org.uk
Website commissioned by the UK department of health.
Samaritans
116 123 (freephone)
jo@samaritans.org
samaritans.org
Freepost RSRB-KKBY-CYJK
PO Box 90 90
Stirling FK8 2SA
24-hour emotional support for anyone struggling to cope.
If you require this information in Word document format for compatibility with screen
readers, please email: publications@mind.org.uk
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