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Borderline personality disorder

Borderline personality disorder (BPD) can cause a wide range of symptoms.

There are 4 main areas of symptoms:

  • emotional instability – the psychological term for this is "affective dysregulation"
  • disturbed patterns of thinking or perception – "cognitive distortions" or "perceptual distortions"
  • impulsive behaviour
  • intense but unstable relationships with others

Emotional instability

If you have BPD, you may experience some of these intense negative emotions:

  • rage
  • sorrow
  • shame
  • panic
  • terror
  • long-term feelings of emptiness and loneliness

You may have severe mood swings over a short space of time.

You may also feel suicidal and then feel positive a few hours later. Some people feel better in the morning and some in the evening. The pattern varies. The key sign is that your moods swing in unpredictable ways.

If you have suicidal thoughts

  • Call your GP or the out-of-hours GP service. If you've taken an overdose or cut or burned yourself dial 999.
  • Call the Samaritans on 116 123. They provide emotional support 24 hours every day. The service is for people experiencing feelings of distress or despair.
  • Contact a friend, family member or someone you trust.

Call 999 if you have seriously harmed yourself – for example, by taking a drug overdose – for an ambulance.

If you have BPD, tell someone you trust about your condition. Give them the contact details of your care team. Then you can ask them to contact the team if they become concerned about your behaviour.

Disturbed patterns of thinking

Different types of thoughts can affect you.

Upsetting thoughts

Thinking you're a terrible person or feeling you don't exist.

Brief episodes of strange experiences

Hearing voices outside your head for minutes at a time.

Prolonged episodes of abnormal experiences.

Voices outside your head and beliefs that no one can talk you out of.

These types of beliefs may be psychotic and a sign you're becoming more unwell. It's important to get help if you experience these.

Impulsive behaviour

If you have BPD, there are two types of impulses you may find difficult to control.

An impulse to self-harm

Such as cutting your arms with razors or burning your skin with cigarettes. In severe cases this impulse can lead to feeling suicidal. You may attempt suicide.

Related topics


An impulse to engage in risky behaviours

Impulsive behaviours could include:

  • binge drinking
  • drug abuse
  • going on a spending spree
  • having unprotected sex with strangers

Unstable relationships

You may feel that other people abandon you when you most need them. You may also feel that they get too close and smother you. You would typically have difficulty trusting. This is sometimes accompanied by an irrational fear of other people's intentions.

When people fear abandonment, it can lead to feelings of intense anxiety and anger.

You may make frantic efforts to prevent being alone, such as:

  • constantly texting or phoning a person
  • suddenly calling that person in the middle of the night
  • clinging on to that person and refusing to let go
  • making threats to harm or kill yourself if that person ever leaves you

You may feel others are smothering, controlling or crowding you. This can provoke intense fear and anger. You may then respond by acting in ways to make people go away. This might involve you withdrawing, rejecting them or using verbal abuse.

These two patterns may result in an unstable "love-hate" relationship with certain people.

You may seem to be stuck with a very rigid "black-white" view of relationships. Either a relationship is perfect and that person is wonderful. Or the relationship is doomed and that person is terrible. People with BPD seem unable to accept any sort of "grey area" in their personal lives and relationships.

Emotional relationships can involve "go away" and "please don't go" states of mind. This is confusing for you and your partners. It can often lead to break-ups.

Content supplied by the NHS and adapted for Ireland by the HSE.

page last reviewed: 23/09/2018
next review due: 23/09/2021

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