What it is:
Borderline personality disorder (BPD) is a disorder characterized by significant difficulty with intense and rapidly shifting emotions often called mood concerns. Though many disorders involve experiencing intense emotions, individuals with borderline personality disorder (BPD) struggle most significantly with their emotions within relationships. This results in problems with relational emotions like anger (towards themselves and others), shame, disgust, envy, jealousy, and disappointment. Their emotions can impact their ability to effectively choose, form, maintain, or leave relationships in values-consistent or healthy ways. Some people may describe this as “attachment issues.” Individuals with BPD have a tendency to respond impulsively to their emotions during or after interpersonal conflict and this is particularly true when someone with BPD feels judged, invalidated, or abandoned within a relationship.
The patterns of difficulties with emotions in relationships are most likely to occur or be most severe in romantic relationships. However, to meet criteria for the disorder, these patterns should be present across multiple romantic relationships and/or across multiple types of relationships, such as with coworkers, friends, and family members.
Difficulties with emotions in relationships can lead to several areas of skills deficits, including:
- Difficulties with regulating or decreasing emotions
- Difficulties with impulsivity, particularly in areas of self-injury or suicidality
- Deficits in relationship skills, including setting limits with others or respecting the boundaries of others
- An unstable or unclear sense of self, including a sense of emptiness
Borderline Personality Disorder (BPD) is a formal diagnosis and one usually diagnosed in adulthood. At times, it can be difficult to differentiate BPD symptoms from similar presentations, like bipolar disorder. On the flip side, some individuals with PTSD, ADHD, or Autism can be misdiagnosed with BPD. It’s also possible to have more than one of these concerns or diagnoses. If diagnostic labels or clarity is important to you, we recommend a full psychodiagnostic assessment for BPD.
Does This Sound Familiar?
- I seem to have more intense, chaotic, or high conflict relationships than those around me.
- I use drugs, alcohol, sex, shopping or other impulsive behaviors to feel better when I am upset.
- I am very hot and cold with how I feel about people in my life- love them or hate them.
- I have engaged in some type of self-harm behavior (e.g. cutting, burning) when upset about a relationship.
- When I am upset, I do or say things that I regret later.
- I constantly fear that those I care about will abandon or leave me.
- People tell me that my anger at them is inappropriate or an overreaction.
- When I like someone, I have a hard time not being around them constantly.
- I have a hard time keeping relationships.
- I have attempted or considered suicide in response to a relationship stressor or conflict.
- The way I see myself changes a lot.
Associated Concerns:
- Co-occurring disorders are the rule and not the exception for adults with BPD. Emotion dysregulation in relationships often results in co-occurring difficulties with depression, anxiety, shame, anger, eating disorders, or substance use disorders. It is also very common for individuals with BPD to struggle with self-harm and suicidal thoughts.
- There is also a very significant link to traumatic experiences or PTSD in those with BPD. The link suggests both that trauma can be a contributor to later development of dysregulation and that dysregulation can put individuals at risk for relational trauma (abusive relationships in particular).
Specialty Services at TAP:
Below are a list of empirically supported assessments or therapies that one or more of our specialists could provide. Click on an intervention to learn more!