Have you ever heard someone mention “BPD” and wondered what on earth they were talking about?
BPD stands for borderline personality disorder, a mental health condition that’s often misunderstood but very real and very human. If you or someone you know lives with BPD, understanding what it is (and what it isn’t) can make a big difference.
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What is borderline personality disorder (BPD)?
Borderline personality disorder is a complex mental health condition that affects the way a person thinks and feels about themselves and others. It can cause problems with self-image, managing emotions, relationships and behaviour.
The term “borderline” can be a bit confusing. It originated in the 1930s, when clinicians thought the symptoms were on the “borderline” between neurosis and psychosis. These days, we understand BPD much better, but the name has stuck around, though it might not be the most helpful.
Other terms used instead of BPD
Instead of BPD, some people may refer to emotionally unstable personality disorder (EUPD) or emotional intensity disorder (EID). It is very much down to the person and their preference, and the term they feel best describes their condition.
For the purposes of our blog, we have chosen to use BPD as this is the most common and recognisable name.
How common is BPD?
BPD is more common than you might think. Around 1 in 100 people in the UK are estimated to have it, though some research suggests this number could be higher. It affects people of all genders, though it’s more commonly diagnosed in women. This is possibly due to differences in how symptoms are expressed or perceived.
What are the signs and symptoms?
Everyone’s experience with BPD is unique, but there are a few key signs that professionals look out for.
Emotional instability
People with BPD often feel emotions more intensely and for longer than others. A minor setback might feel like a huge failure, and mood shifts can happen quickly – sometimes over hours, sometimes in minutes.
Fear of abandonment
A strong fear of being rejected or left, whether real or imagined, is common. This can lead to frantic efforts to avoid abandonment, like clinging to people, pushing them away or reacting strongly to perceived slights.
Difficult relationships
Relationships can be intense and stormy. People with BPD may idealise someone one moment and then feel deeply hurt or betrayed the next. This pattern is sometimes called “splitting” – seeing others as all good or all bad.
Unstable sense of self
Someone with BPD might struggle with their identity. They might feel like they don’t know who they are, or their self-image could shift depending on who they’re with or how they’re feeling.
Impulsive behaviour
Spending sprees, risky sex, binge eating, reckless driving or substance misuse – impulsivity can be a way of coping with intense emotions, even if it leads to regrettable consequences.
Self-harm and suicidal thoughts
Many people with BPD self-harm or have thoughts of suicide. These behaviours are often a way to express or manage overwhelming emotional pain.
Chronic feelings of emptiness
A deep sense of emptiness – like something’s missing inside – is often reported. It can feel like being hollow or emotionally numb.
Intense anger
People with BPD can struggle with anger that feels out of proportion. It may come out as rage or simmer just beneath the surface, often triggered by feelings of rejection or hurt.
Paranoia or dissociation
In moments of stress, someone with BPD might feel paranoid or disconnected from reality. They may feel as though they’re outside their body or that the world around them isn’t real.
What causes BPD?
There isn’t a single cause for BPD. Like many mental health conditions, it’s usually the result of a mix of biological, psychological and environmental factors.
Childhood experiences
Many people with BPD report having experienced trauma during childhood, such as neglect, abuse, or separation from caregivers. However, not everyone with BPD has had a traumatic past, and not everyone who experiences trauma develops BPD.
Genetics and brain function
There’s some evidence that BPD can run in families. Certain brain areas involved in emotion regulation and impulse control may function differently in people with BPD.
Personality and temperament
Some people are naturally more sensitive or emotionally intense. If this temperament combines with a difficult environment, it might increase the risk of developing BPD.
How is BPD diagnosed?
Diagnosing BPD isn’t about ticking a few boxes on a form. It involves talking through symptoms with a qualified mental health professional, often a psychiatrist or psychologist.
They’ll ask about your experiences, emotional patterns, relationships and history. A diagnosis is typically made if someone meets several of the criteria outlined in diagnostic manuals like the DSM-5 (used in the US) or ICD-11 (used internationally).
BPD can sometimes be misdiagnosed as depression, bipolar disorder or other mental health conditions. Getting the right diagnosis matters as it can open the door to more effective support.
Living with BPD: What’s it like?
Living with BPD can sometimes feel like being on an emotional rollercoaster – fast, unpredictable and exhausting. But it’s also important to say that life with BPD is not all struggle. Many people with BPD are deeply compassionate, emotionally intelligent and capable of forming incredibly meaningful relationships. The intensity that BPD brings can show up as great passion, fierce loyalty and profound empathy.
Still, the day-to-day experience can be tough.
Emotions on full volume
One of the most defining features of BPD is emotional intensity. Feelings that might mildly upset someone else can hit someone with BPD like a tidal wave. Joy, anger, fear, sadness – it’s all turned up loud.
This isn’t just being “overly sensitive.” The brain actually processes emotions differently, and recovery often means learning how to sit with these emotions rather than being swept away by them.
Relationships can feel like a minefield
People with BPD often crave close, meaningful relationships but also fear them. The thought of someone leaving or rejecting them can feel unbearable. This fear can lead to behaviour that pushes others away, even when all they want is closeness. It’s a painful paradox: loving deeply but constantly bracing for loss.
It’s not uncommon for people with BPD to feel like they’re “too much” for others or that they sabotage relationships without meaning to. That said, with self-awareness, communication and support, healthy relationships are absolutely possible.
Identity can feel fragile
Imagine waking up one day feeling confident and independent, then going to bed convinced you’re worthless and lost. People with BPD often experience a fragile or shifting sense of self. They might change opinions, interests or goals depending on who they’re with or how they’re feeling that day.
It can feel like you don’t really know who you are or that you’re always adapting to fit in, stay safe or be liked. This can lead to feelings of emptiness or disconnection from yourself.
The exhausting mental dialogue
The internal world of someone with BPD is often loud and busy. Thoughts can spiral quickly: “Did I say the wrong thing?” “Do they hate me?” “Why am I like this?” That inner critic can be relentless. Add to that the tendency to overanalyse social cues or misinterpret situations, and it’s easy to see why social interactions can be draining.
But many people with BPD also have incredible insight. Once they learn how to manage those thoughts, they can become some of the most self-aware and emotionally attuned individuals out there.
The strength behind the struggle
It’s easy to focus on the symptoms, but let’s not forget the strength it takes to face each day with BPD. Many people are managing their symptoms while working, parenting, studying or building relationships. That resilience often goes unrecognised.
Yes, life with BPD can be intense, but that intensity can also be channelled into creativity, advocacy, empathy and connection. With support, the same traits that feel like weaknesses can become sources of power.
What support and treatment is available?
BPD might feel overwhelming, but help is available and recovery is possible. Treatment often focuses on managing emotions, building relationships and understanding yourself better.
Talking therapies
The main form of treatment for BPD is psychological therapy. Medications can help with specific symptoms (like anxiety or depression), but therapy is the cornerstone.
Dialectical Behaviour Therapy (DBT)
DBT was developed specifically for BPD. It focuses on balancing acceptance with change and includes skills like:
- Mindfulness
- Emotional regulation
- Distress tolerance
- Interpersonal effectiveness
It’s usually offered in group and individual formats over several months.
Mentalisation-Based Therapy (MBT)
MBT helps people understand and reflect on their own thoughts and feelings, and those of others. It can improve relationships and emotional regulation.
Cognitive Behavioural Therapy (CBT)
While not designed specifically for BPD, CBT can help with symptoms like anxiety, depression and negative thought patterns.
Schema Therapy and Transference-Focused Psychotherapy
These are longer-term therapies that explore the roots of unhelpful patterns, often from childhood. They’re less common but can be very effective.
Medication
There’s no specific medication for BPD, but antidepressants, mood stabilisers or antipsychotics may be prescribed to manage certain symptoms.
It’s worth noting that medication is usually seen as a supporting tool, not a primary treatment.
Crisis support
Because BPD can involve intense emotional distress, knowing where to turn in a crisis is vital. Services like NHS 111, crisis teams or Samaritans (116 123, free to call) are there to help.
What helps someone with BPD?
Whether you’re supporting a loved one or navigating BPD yourself, there are a few principles that make a big difference.
Learn about BPD
Understanding the condition helps reduce shame and stigma. It’s easier to be compassionate (to yourself or others) when you understand what’s going on.
Set healthy boundaries
People with BPD often struggle with boundaries, but clear, kind limits can be grounding and supportive.
Validate emotions
Feelings might seem extreme, but they’re real. Saying “I understand this feels really hard” can be more helpful than trying to fix it.
Encourage professional help
Therapy really can change lives but it takes time, patience and effort. Encouraging someone to seek help is one of the best things you can do.
Practise self-care
If you’re supporting someone with BPD, look after your own wellbeing too. Burnout helps no one.
Is recovery possible?
Absolutely. While BPD doesn’t have a “cure” in the traditional sense, people can and do recover.
Recovery might mean fewer symptoms, better relationships, or a stronger sense of self. It often involves ups and downs, but many people report significant improvement over time, especially with consistent therapy and support.
Some studies even suggest that symptoms tend to reduce with age, especially with early intervention.
What about stigma?
Stigma around BPD is, unfortunately, still alive and well but it doesn’t have to be. It’s one of the most misunderstood mental health conditions, and that misunderstanding can lead to harmful stereotypes, judgement and exclusion.
The “difficult” label
People with BPD are often labelled as “difficult”, “manipulative” or “attention-seeking”. This can happen in everyday life, but sadly it also happens in healthcare settings.
These labels aren’t just unkind; they’re also inaccurate and damaging. Behaviours that might be seen as manipulative are often survival strategies rooted in fear, pain or trauma. A frantic text or emotional outburst might come from a place of panic, not calculation.
People with BPD often feel deep shame about their struggles. Being dismissed or misunderstood only deepens that shame and discourages them from seeking help.
The media doesn’t help
Popular media often portrays BPD in extreme or negative ways. Characters with BPD are shown as unstable, dangerous or destructive. Rarely do we see the nuance; the human behind the diagnosis. These portrayals can reinforce fear and create a culture of silence around what it actually means to live with BPD.
Self-stigma is real too
Living in a world that misunderstands you can make you turn on yourself. Many people with BPD internalise the stigma and feel broken, unworthy or unlovable. This self-stigma can be even more painful than what comes from others and it can make recovery harder.
That’s why it’s so important to challenge these narratives. BPD is a treatable condition, not a character flaw. People with BPD deserve the same compassion, respect and access to care as anyone else.
Shifting the conversation
The good news? Things are changing. More people are speaking up about living with BPD, sharing their stories and fighting the stigma head-on. Social media, blogs and support groups are giving space for honest conversations and real connection.
Mental health professionals are also moving away from outdated views, recognising that people with BPD need empathy, not judgement.
If you’re reading this, you’re part of that shift. Whether you have BPD or love someone who does, talking about it is powerful. Education, compassion and curiosity go a long way in breaking down stigma and making room for healing.
Final thoughts: What is BPD?
BPD is complicated, but it’s not a life sentence. With understanding, support and the right treatment, people with BPD can thrive.
If you’re living with BPD, know that you’re not alone. You’re not “too much”, and your feelings are valid. If you’re supporting someone with BPD, your patience and care matter more than you know.
Mental health is never black and white, and BPD is no exception. But by talking about it, learning and listening, we take a step closer to a world that makes space for everyone.
