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Borderline Personality Disorder

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More than one in five U.S. adults live with a mental illness. Unfortunately, mental illness is a health topic that many have difficulty talking about. There are different types of mental illness which can make life a challenge. Some of the most common are personality disorders. Borderline personality disorder (BPD) is a type of personality disorder that makes it difficult to control emotions. The disorder often includes dramatic mood swings, impulsive behavior, and difficulty managing relationships with others. Many people who live with BPD see the world as black and white. Everything is either all good or all bad. There is no between. This includes how they feel about themselves.

Emotional control is key for living a happy and productive life. Swinging from highs and lows is dangerous. It can cause someone to act on an impulse and not use their thinking brain. Those with BPD are more likely to commit acts of self-harm. The risk of suicide is also much higher when compared to people who aren’t living with BPD.

Types of Borderline Personality Disorder

Borderline personality disorder is different in everyone. Research has shown that there are actually several types of BPD. You may identify with one of the types, or multiple. Here are the different types of borderline personality disorder:


This type of BPD is characterized by problems regulating emotions. Affective BPD involves frequent, serious mood swings that can fluctuate on a daily or even hourly basis. This type of BPD can make it difficult to maintain relationships due to feelings of stress, anxiety, and depression.


Those who suffer from impulsive BPD struggle with a loss of control. Rather than emotions, however, it usually involves losing control over behavior. This could include making risky decisions like self-harm, unprotected sex, poor eating habits, or abusing drugs and alcohol. Those with impulsive BPD act on these impulses without fully thinking through the consequences of their actions.


Anger is a common manifestation of BPD. Those who suffer from the aggressive type may find they have trouble with angry outbursts. Usually, this anger does not match the situation; it’s an inappropriate response. For example, something as simple as a neutral facial expression can set someone with aggressive BPD off. These perceived slights can lead to a pattern of physical altercations when someone acts on impulse and not their constructive, thinking brain.


Dependent BPD is a form of the disorder where someone grows overly attached and needy in their relationships with others. A lack of independence can lead someone to struggle with setting boundaries and to experience fear of abandonment. Those with dependent BPD often dislike spending time alone.


One of the key signs of BPD is a struggle with identity and how someone views themselves. Empty BPD is characterized by issues with trust and self-identity. It often stems from a childhood in a home where caregivers were neglectful, traumatic, or unsupportive. Those with empty BPD may struggle setting goals or feeling like they have direction or purpose in life.

Signs and Symptoms of Borderline Personality Disorder

Someone with borderline personality disorder may exhibit the below signs and symptoms of the disorder. Not everyone experiences all symptoms of borderline personality disorder. The symptoms of an unstable personality can also vary in severity depending on the individual and their mental state.

The signs and symptoms of BPD include:

  • Intense mood swings that can last for hours or even days
  • Constant feelings of loneliness or emptiness
  • Unsafe behavior like reckless driving, unprotected sex, substance abuse, and more
  • Feeling suicidal or thoughts of self-harm
  • Development of an eating disorder
  • Outbursts of intense anger at inappropriate times
  • Dissociation, or feeling like you aren’t apart of your own body
  • Difficulty with romantic relationships or within the family, causing emotional pain

If you experience suicidal thoughts, seek help immediately. There are options for safe and effective treatment that help control impulsive behavior and can improve your sense of self.

When Does Someone Need Treatment for BPD?

It’s important to get treatment for borderline personality disorder. The longer you wait, the more serious your mental health issues can become. Getting help for BPD should be a priority when it’s clear the disorder is causing issues. When mood swings, reckless behavior, thoughts of self-harm, drug or alcohol abuse, and difficulty maintaining relationships become the norm, they are signs that it’s time to speak with mental health professionals and find treatment for your borderline personality disorder.

What Are the Risk Factors for Borderline Personality Disorder?

Those who study the disorder have identified that social, genetic, and environmental factors all play a role in BPD. Having a family history of the disorder can raise your risk of developing it. A traumatic experience can also be a factor. Trauma or abuse during childhood is something many with BPD experienced. There is even data to suggest that the way the brain works can play a role. Even if someone has these risk factors, they may never develop the disorder. The opposite is also true: Those without risk factors can find themselves living with borderline personality disorder.

Borderline Personality Disorder vs. Bipolar Disorder

Borderline personality disorder and bipolar disorder are both mental illnesses. They are often mistaken for each other. Though they share certain characteristics, it is important to understand the differences between these two disorders to diagnose and treat them.

Both BPD and BD involve mood swings, but they differ in intensity and duration. With BPD, mood swings tend to be shorter but more severe. With BD, the swings are longer but less intense. Those suffering from BD often experience symptoms of depression or mania for weeks or months at a time. People with BPD may switch back and forth between emotions throughout the day.

The Connection Between Borderline Personality Disorder and Addiction

Borderline personality disorder is one of the most common co-occurring mental disorders, meaning people with BPD are more likely to report a history of alcohol and drug use. Studies suggest that individuals with BPD may turn to substances as a form of self-medication to cope with their symptoms. Drugs and alcohol may help curb feelings of emptiness or loneliness, impulsivity, and mood swings.

Substance abuse can provide an escape—but only temporarily. The issue is that substance abuse can be dangerous over time. It carries a risk for physical, mental, and emotional health issues. Addiction can make every aspect of life more difficult. You may start slipping in work or school performance. You may struggle maintaining relationships with people you care about. You may find your health takes a turn due to substance misuse. These reasons all point towards getting help as soon as possible for BPD.

Treating Borderline Personality Disorder

There are safe and effective treatments for borderline personality disorder, like dialectical behavior therapy (DBT) or cognitive behavioral therapy (CBT).

DBT focuses on developing healthy coping skills to manage difficult emotions, while CBT works to identify negative thoughts and replace them with healthier thought patterns. Both therapies can be beneficial in treating BPD and co-occurring addiction.

Medications such as antidepressants may also be used to treat BPD. They help curb self-destructive behavior, emotion dysregulation, chronic feelings of intense fear, and suicidal behavior. These medications are prescribed by a therapist and closely monitored to ensure they’re working as intended.

If you need help with mental health or addiction issues, Footprints to Recovery offers levels of care for all. We craft individual recovery plans that use evidence-based and holistic methods to help. Here are some of the levels of care that can help you manage your borderline personality disorder:

Medical detox – When borderline personality disorder causes someone to develop a substance use disorder, the first step in recovery is ridding the body of drugs or alcohol. Medical detox is overseen by trained professionals. They are available 24/7 to offer medical care, guidance, and support to those withdrawing from alcohol or drugs. Depending on the substance used and for how long, detox symptoms can be severe. Having addiction treatment clinicians on hand aids the process.

Residential treatment – Attending an inpatient recovery program is the most intensive level of care offered at Footprints to Recovery. Clients live full time in a treatment environment with support from medical and mental health professionals available ‘round the clock. Clients attend group and individual therapy sessions to learn valuable coping skills.

Partial hospitalization program (PHP) – PHP is more flexible than inpatient treatment. You can live at home and still attend school or work, but you also attend treatment at the facility for up to six hours a day. PHP offers more flexibility for those with other obligations.

Intensive outpatient program (IOP)  Intensive outpatient programs are the next step in recovery. You live at home but still attend treatment. IOP can help you return to living in society. It teaches valuable coping skills and other mechanisms to be used should you ever feel like things are spiraling out of control again.

Outpatient rehab – Outpatient rehab offers the most flexibility with recovery. Someone may only visit the facility once or twice a week for treatment. The rest of the time, they are out functioning in the world.

Aftercare for Borderline Personality Disorder

Following completion of the levels of care, one of the final steps in recovery is participating in an aftercare program. Aftercare programs are less intense than the other levels of care and involve spending less time at a treatment facility. Aftercare for BPD is about taking the skills and tools learned during treatment forward in life. Your support system at the treatment center is available around the clock should you need help or guidance as you go out into the world with a new, positive outlook.

Does Insurance Pay for Borderline Personality Disorder Treatment?

Wondering how to pay for treatment should never deter you from getting the help you need. Footprints to Recovery offers mental health and addiction treatment services, many of which may be fully or partially covered by insurance. Every insurance policy and plan is different, so speaking with the team at Footprints to Recovery can help you verify what kind of treatments are available. You can also pay out-of-pocket or work with your team of treatment counselors on a payment plan.

Are you living with borderline personality disorder? Request an appointment to get help. The team of mental health professionals at Footprints to Recovery is available. A free consultation and insurance verification can offer more information about how a mental health treatment center could be right for you.

Questions about treatment options?

Our admissions team is available 24/7 to listen to your story and help you get started with the next steps.

David Szarka
Medically Reviewed by David Szarka, MA, LCADC
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