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BPD 101

Borderline personality disorder (BPD) is one of the most misunderstood mental health conditions – often misrepresented in media, misdiagnosed by clinicians and misjudged in everyday life. But behind the stigma is a deeply complex experience. One shaped by trauma, emotional intensity and a longing for connection. Whether you’re living with BPD, supporting someone who is, or simply seeking to understand, here’s a simple round up of the condition and the support available.

What is BPD?

Borderline personality disorder (sometimes referred to as Emotionally Unstable Personality Disorder) is a complex mental health condition that affects how a person thinks, feels and relates to others. It’s characterised by emotional dysregulation, unstable relationships and a fragile sense of self. While someone with BPD won’t always experience them all, symptoms include:

  • Frantic efforts to avoid abandonment – real or imagined
  • Unstable and intense interpersonal relationships, often swinging between idealisation and devaluation
  • Identity disturbance – shifting self-image, values or goals
  • Impulsivity in areas like spending, sex, or substance use
  • Recurrent suicidal behaviour, gestures, or threats, or self-harm
  • Rapid mood swings and emotional sensitivity
  • Chronic feelings of emptiness
  • Difficulty controlling anger
  • Transient, stress-related paranoia or dissociation

It’s not “just mood swings.” It’s a pervasive pattern that affects every aspect of a person’s life, from relationships to work to self-worth.

Key statistics

  • Around 2 in 100 people in England are estimated to experience BPD at some point in their lives.
  • 75% of diagnosed cases are women, though this may reflect gender bias in diagnosis.
  • Many people with BPD have experienced childhood trauma, neglect or unstable caregiving environments.
  • People with BPD are at high risk for self-harm and suicide. Globally, up to 10% die by suicide and 75% engage in self-harming behaviours.
  • BPD is one of the most stigmatised mental health diagnoses, with clinicians reporting lower empathy and higher frustration compared to other conditions.

What causes BPD?

There’s no single cause, but contributing factors include:

  • Early trauma – abuse, neglect, or abandonment
  • Genetics – family history of BPD or other mental health conditions
  • Neurobiology – differences in brain areas related to emotion regulation
  • Invalidating environments – where emotions are dismissed or punished

BPD is often a survival response to chronic emotional pain. It’s not a character flaw – it’s a coping mechanism that needs support, not shame.

Treatment and recovery

While recovery is not linear, BPD is treatable. Many people go on to lead stable, fulfilling lives. Key approaches include:

  • Dialectical Behavioural Therapy (DBT) focuses on emotion regulation, distress tolerance, mindfulness and interpersonal effectiveness
  • Mentalisation-Based Therapy (MBT) helps individuals understand their own and others’ mental states
  • Schema Therapy targets deep-rooted patterns and beliefs
  • Medication may help with co-occurring conditions like depression or anxiety, but it’s not a primary treatment for BPD

Common misconceptions

  • “People with BPD are manipulative” → No. Many behaviours stem from fear and trauma, not malice.
  • “BPD is untreatable” → False. With the right support, recovery is possible.
  • “Only women have BPD” → Not true. Men are often misdiagnosed or under diagnosed due to gender bias.
  • “It’s just attention-seeking” → Harmful and wrong. Emotional pain should never be dismissed.

Resources and support