Borderline personality disorder (BPD) is a severe mental health condition that influences how people see themselves and how they interact with the world around them. Like other personality disorders, BPD is a long-term condition with treatment that focuses on managing symptoms and improving quality of life rather than “curing” the disorder.
The American Psychiatric Association describes BPD as “a pervasive pattern of instability of interpersonal relationships, self-image, and affects and marked impulsivity, beginning by early adulthood and present in a variety of contexts.” People with BPD show their symptoms in various ways including:
- Powerful attempts to avoid abandonment, whether it is real or imagined
- Many unstable and unpredictable relationships
- An unstable self-image
- Impulsivity that could result in harm from overspending, overeating, reckless driving or substance abuse
- Self-injury and suicidal thoughts and acts
- Mood instability with intense depression, irritability and anxiety
- Feeling empty or alone
- Poor anger control
- Paranoia and periods of dissociation where one disconnects from their thoughts and feelings
Of course, not every person will display all the signs and symptoms of borderline personality disorder, but someone needs to have at least five of the ones listed to receive the diagnosis.
To truly understand the impact of BPD, it helps to learn some borderline personality disorder facts and statistics.
Prevalence of Borderline Personality Disorder
Like other personality disorders, BPD is challenging to track as the condition is misdiagnosed, underdiagnosed or the individual never seeks treatment for their symptoms. Based on the best estimates, the prevalence of borderline personality disorder in the United States is about 1.6 percent, but this number could actually be quite higher at 5.9 percent, based on borderline personality disorder demographics.
Different clinical settings yield higher numbers of people with BPD. For example, in outpatient mental health settings, people with borderline personality disorder make up about 10 percent of the population. In inpatient psychiatric hospitals, the number climbs to 20 percent.
Symptoms of BPD usually begin in early adulthood and may decrease later in adulthood as people in their 30s and 40s achieve stability. Studies from different countries reveal varied prevalence rates of BPD.
BPD Occurrence by Gender
Borderline personality disorder gender differences are significant. Borderline personality disorder in women is much more common than borderline personality disorder in men. About 75 percent of people diagnosed with BPD are women.
BPD is a challenging condition to accurately diagnose quickly because the range of symptoms frequently results in BPD misdiagnosis. Borderline personality disorder misdiagnosis takes various forms including:
- People without BPD receiving the diagnosis
- People with BPD receiving another diagnosis
- People with BPD receiving no diagnosis at all
The problem is BPD shares many symptoms with other mental health conditions like depression, anxiety and bipolar disorder, so it can be impossible for a professional to see the total clinical picture of the individual at first. Because of this, clients and professional should be patient in finding the proper diagnosis and allow flexibility to adjust over time.
Borderline Personality Disorder and Co-Occurring Conditions
Not only does BPD share symptoms with other mental health conditions, frequently mental health conditions occur with BPD simultaneously. Called borderline personality disorder co-occurring disorders, these additional mental concerns can cloud symptoms.
BPD also shares symptoms with other personality disorders like histrionic personality disorder and antisocial personality disorder. This confusion is why it is essential to seek personalized mental health treatment from a professional, rather than trying to diagnose yourself or a loved one.
BPD and Bipolar
BPD commonly co-occurs with bipolar disorder, which can make each disorder more severe and unpredictable. Borderline personality disorder and bipolar create mood, irritability and behavioral changes that affects each segment of an individual’s life.
People with both conditions are said to have bipolar and borderline personality disorder dual diagnosis and must address each condition in a comprehensive and concurrent way.
BPD and Suicide
Suicide is a major concern for individuals with borderline personality disorder. It is common for people to show signs of borderline personality disorder and suicidal behavior, especially during their early adult years.
In fact, self-harm behaviors like cutting and burning are widespread in people with BPD, and according to the American Psychiatric Association, the borderline personality disorder suicide rate is between 8 and 10 percent, meaning about 1 in 10 people with BPD will complete suicide during periods of flaring symptoms.
BPD and Trauma
When people investigate risk factors or other situations that seem to trigger symptoms, experts begin seeing a link between borderline personality disorder and childhood trauma. Though it is impossible to say that borderline personality disorder is caused by trauma, it certainly seems like an influence, along with other issues like abandonment and disruption in life.
With the connection between trauma and the development of borderline personality disorder, it can be helpful to avoid risky situations when possible or make efforts to find appropriate treatment following a trauma to eliminate or limit the risks of BPD.
Borderline Personality Disorder and PTSD
Since there is an association between BPD and trauma, it should not be a surprise that borderline personality disorder and PTSD (post-traumatic stress disorder) share a connection as well, since traumas create the condition. People with BPD are likely to have PTSD and people with PTSD are more likely to develop BPD.
BPD and Substance Abuse
Increased levels of substance abuse is a risk for people with many mental health conditions, and BPD is no different. It could be that borderline personality disorder triggers substance abuse as a way to cope with uncomfortable feelings.
Rates of borderline personality disorder and substance abuse are very high. One survey found that about 50% of people with BPD abused substances within the last year. Borderline personality disorder combined with alcohol or other drug use can complicate the process of identifying and attributing symptoms and starting the appropriate treatment.
Although the condition is serious, the borderline personality disorder prognosis is better than many assume. What experts know for sure is that the BPD prognosis is much better for people in mental health treatment than the prognosis for untreated BPD.
Evidence regarding borderline personality disorder statistics shows that people in structured treatment can begin showing symptom improvements within the first year of treatment.
Statistics on Borderline Personality Disorder Treatment and Outlook
One type of borderline personality disorder treatment approach stands out with the most evidence of client improvement – dialectical behavioral therapy (DBT). DBT is a very structured treatment style that requires consistency and dedication from the client and the treatment team.
DBT may focus on co-occurring issues like mood disorders, PTSD and substance use disorders, or the individual can receive separate treatment for those issues. Aside from counseling, prescribers may recommend medication management to alleviate some symptoms of BPD and the other disorders. Targeting the whole person, not just their BPD, is one way to improve the borderline personality disorder treatment outlook.
Follow up studies of people with BPD receiving treatment found a borderline personality disorder treatment success rate of about 50% over a 10-year period. BPD takes time to improve, but treatment does work.
If you or someone you know is dealing with the signs and symptoms of BPD, or you wish to prevent the condition from developing, consider calling The Recovery Village for more information about the condition and possible treatment options.
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition.” 2013. MentalHealth.gov. “Borderline Personality Disorder.” August 22, 2017. Accessed on February 2, 2019. Substance Abuse and Mental Health Services Administration. “An Introduction to Co-Occurring Borderline Personality Disorder and Substance Abuse Disorders.” 2014. Accessed February 3, 2019. Ten Have, M., Verheul, R., Kaasenbrood, A., van Dorsselaer, S., Tuithof, M., Kleinjan, M., & de Graaf, R. “Prevalence rates of borderline personality disorder symptoms: a study based on the Netherlands Mental Health Survey and Incidence Study-2.” July 19, 2016. Accessed on February 3, 2019.
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition.” 2013.
MentalHealth.gov. “Borderline Personality Disorder.” August 22, 2017. Accessed on February 2, 2019.
Substance Abuse and Mental Health Services Administration. “An Introduction to Co-Occurring Borderline Personality Disorder and Substance Abuse Disorders.” 2014. Accessed February 3, 2019.
Ten Have, M., Verheul, R., Kaasenbrood, A., van Dorsselaer, S., Tuithof, M., Kleinjan, M., & de Graaf, R. “Prevalence rates of borderline personality disorder symptoms: a study based on the Netherlands Mental Health Survey and Incidence Study-2.” July 19, 2016. Accessed on February 3, 2019.