Do you or a loved one experience intense emotional dysregulation or rapid shifts in mood? Are you prone to impulsive behavior, unexplained outbursts, or black-and-white thinking? Or do you struggle with a distorted self-image?
These are just some signs of borderline personality disorder (BPD). While recognized by psychiatrists as far back as the 1930s, BPD often goes misdiagnosed or improperly treated, even today.
Borderline personality disorder is a serious and often misunderstood mental health condition, but itโs also highly treatable. That’s why itโs so important to understand and recognize the symptoms of borderline personality disorder.
Fortunately, a brain-based, integrative approach to treating BPD can lead to lasting recovery. Borderline personality disorder treatment and healing are possibleโusing natural, non-pharmaceutical strategies.
The key is to employ a holistic, or whole-person, approach. For example, functional brain imaging with a SPECT scan helps avoid misdiagnosis and pinpoint root causes of symptoms to guide an effective treatment plan. And targeted treatments contribute to long-term healing.
This blog will demystify the condition by exploring borderline personality disorder symptoms, causes, treatments, and moreโincluding tips on how to support a loved one with this diagnosis.
Borderline personality disorder is frequently mistaken for bipolar disorder, posttraumatic stress disorder (PTSD), or depression, which can lead to years of ineffective treatment.
The roots of borderline personality disorder stretch back to 1938, when psychiatrist Adolph Stern first used the term โborderline personality.โ
According to clinical guidelines of BPD, Stern wished to describe patients who โfit frankly neither into the psychotic nor into the psychoneurotic group.โ The word โborderlineโ was used because it seemed to โborderโ on these other conditions.
It wasnโt until the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders, in 1980, that it received its own entry. Even today, however, it remains one of the most misunderstood and stigmatized mental health conditions.
Unlike mood disorders, BPD is a personality disorder, characterized by emotional dysregulation. Extreme shifts in mood and behavior, with difficulty controlling emotions, are common symptoms. The resulting periods of anger, anxiety, or depression may last a few hours or days.
Borderline also tends to be associated with a distorted self-image, as well as rapid and unexplainable changes in values and interests. This may lead to extreme views of people and situations, as seen in black-and-white thinking.
When interacting with a person with borderline personality disorder, you may notice symptoms like emotional outbursts, impulsiveness, and mood swings. All the issues listed above can affect an individualโs education, career, and relationships.
BPD usually begins not in childhood, but in a personโs late teens or early 20s. Borderline personality disorder symptoms include:
Those with BPD may also show signs of other mental health issues, including depression, bipolar disorder (BD), anxiety disorders, or eating disorders. And BPD is frequently mistaken for bipolar disorder, posttraumatic stress disorder (PTSD), or depression.
Moreover, people with borderline personality who are not properly treated may self-medicate with drugs, including alcohol. This tends to worsen symptoms or lead to addiction, which generates its own problems.
Related: 9 Things Not to Do If You Have Borderline Personality Disorder
More women than men are diagnosed with BPD, at a ratio of 75% to 25%. Still, some experts believe that males are simply undiagnosed or misdiagnosed. Menโs borderline personality disorder symptoms are more likely to be labeled as PTSD or depression.
Other research has pointed out that symptoms stemming from female hormonal changes, as well as chronic infections like Lyme disease, can be mistaken for BPD.
Related: Can Lyme Disease Change Your Personality?
With many mental health overlaps possible, itโs important to address any co-occurring issues that occur with BPD. Only then can a person begin the healing processโand find optimal success with treatment.
When comparing BPD vs. bipolar disorder, itโs easy to see why misdiagnosis is a common pitfall. Both conditions have symptoms such as intense emotions, mood instability, and impulsivity.
However, bipolar disorder is characterized by cycles of manic and depressive episodes. Mania is associated with extremely elevated mood, racing thoughts, and grandiose ideas. Depressive episodes bring low energy and mood, loss of interest in pleasurable activities, and suicidal thoughts.
These bipolar disorder cycles tend to last longer than the rapid mood shifts associated with BPD. However, there is also a form of BD called rapid-cycling bipolar disorder, in which shifts are accelerated.
To reduce confusion, a study established that certain symptoms are present in BPD but not usually in BD, even the rapid-cycling type. These BPD symptoms include:
Furthermore, dramatic mood changes in BPD generally stem from identifiable triggers (stressful events), while bipolar disorder cycles may not follow a predictable pattern. Ultimately, accurate diagnosis is critical to ensure that the correct condition is being addressed with treatment.
According to a 2024 comprehensive review, 0.7 percent to 2.7 percent of the general adult population will develop borderline personality disorder over the course of a lifetime. Among those receiving psychiatric services, that number jumps to 12 percent to 22 percent.
The review notes that research strongly suggests links between the development of BPD and influences like genetic factors, trauma, and adverse childhood experiences (ACEs).
Related: The Long-Term Consequences of Adverse Childhood Experiences (ACEs)
All the potential underlying neurobiological factors are still being studied. Still, the review listed several attributes possibly associated with BPD, including:
Another study estimates that heredity makes up 46% of the risk for developing BPD, while 54% stems from environmental factors.
Press Play for Dr. Amenโs Take on BPD
In this episode of โช@PursuitOfWellnessPodcast with Mari Llewellyn, Dr. Amen describes why he is not a fan of borderline personality disorder as a diagnosis and gives his opinion on a better way to think about the condition and how to treat it.
Click below to tune in:
Brain imaging is an effective way to pinpoint the root causes of symptoms while assessing possible co-occurring conditions and BPD. At Amen Clinics, brain SPECT imaging is combined with a whole-person evaluation to guide clinicians in creating a personalized treatment plan.
SPECT, which stands for single photon emission computed tomography, measures blood flow and activity and shows abnormal brain activity in individuals with BPD and/or bipolar disorder. Over decades of performing scans, Amen Clinics has determined that borderline personality disorder is often associated with abnormal activity in the areas of the brain involved with fear, emotions, and impulsivity.
If symptoms are related to outside causesโsuch as chronic infections or mild traumatic brain injuriesโinstead of BPD, a SPECT scan can help identify them. Brain scans are also helpful for understanding co-existing conditions that could affect the course of treatment.
Some people are surprised to learn that natural treatment for BPD, rather than prescription medication, is the #1 recommendation for counteracting borderline personality disorder symptoms.
Brain-healthy, evidence-backed lifestyle interventions should complement professional treatment for best results. Here are some natural strategies that will help individuals with borderline personality disorder:
Related: Cognitive Behavioral Therapy: What Is It and Who Can Benefit?
Family support for BPD will help you thrive despite a borderline diagnosisโwhether your own or a loved oneโs. If you donโt know how to assist a family member with BPD, here are some practical strategies that can help:
Emotional dysregulation and mood swings are hallmark signs of borderline personality disorder. But you donโt need to tiptoe around your loved one in fear. Suppressing your thoughts and feelings to avoid a confrontation isnโt a healthy or sustainable solution over the long term.
Set healthy boundaries with yourself. Rather than being swept up in your loved oneโs emotional ups and downs, repeat the 3 Cs:
I didnโt cause it.
I canโt cure it.
I canโt control it.
Understanding what you are and are not responsible for will prevent you from taking on negative feelings, like guilt and remorse.
When someone struggles with BPD, it can be tempting to isolate. To push back against the feelings of hopelessness that accompany this disorder, ensure your loved one stays connected. Suggest meetups with family, friends, or support groups to provide encouragement and understanding.
Someone with BPD can get angry and lash out verbally. Rather than retaliating, remain calm and focus on the emotions behind what theyโre sharing. Simply acknowledging their pain can help build trustworthy relationships and reduce reactivity.
When recovering from BPD, understand that healing takes time. Pace yourself for a marathon, not a sprint. Set realistic goals along the way but understand that setbacks are part of the process. Take baby stepsโand celebrate wins, big or small.
Ultimately, itโs important to set healthy boundaries and learn communication techniques to best help your loved one with BPD. Armed with these strategies, family members can empower themselves to offer supportโwithout suffering from burnout or enabling harmful behaviors.
While untreated cases can be devastating, properly diagnosed BPD is highly treatable. With the right interventions, many patients dramatically improve within two to 10 years, often no longer meeting criteria for the diagnosis.
In fact, according to a decades-long study with results published in 2025, BPD is now considered the most treatable major mental health condition. After following more than 300 people diagnosed with BPD since 1992, researchers found that proper treatment, especially psychotherapy, can promote healthy, productive lives in these patients.
Borderline personality disorder, bipolar disorder, and other mental health conditions canโt wait. At Amen Clinics, we provide personalized, science-backed treatment plans designed to target the root causes of your symptoms. Our 360-approach includes brain SPECT imaging, clinical evaluations, innovative therapeutic techniques, medications (when necessary), and holistic lifestyle recommendations to promote the health of your brain, body, and mind. Speak to a specialist today at 888-288-9834 or visit our contact page here.
Yes. At Amen Clinics, weโve seen many people improve through a comprehensive treatment plan that includes therapy, targeted nutraceuticals, brain-healthy habits, and functional brain imaging for BPD. Medication may help in some cases, but itโs not the only path to healing.
While both involve mood changes, borderline personality disorder is defined by rapid, emotionally reactive shifts often triggered by relationships or fear of abandonment. Bipolar disorder involves longer mood cycles and distinct episodes of mania or depression. Accurate diagnosis is essential, and thatโs why we use brain SPECT imaging to help distinguish between the two.
We donโt rely on guesswork or labels. Our approach includes brain SPECT imaging, a thorough assessment of your biological, psychological, social, and spiritual health, and a customized treatment plan that supports long-term transformation. We treat the whole person, not just the symptoms.
National Collaborating Centre for Mental Health (UK). Borderline Personality Disorder: Treatment and Management. Leicester (UK): British Psychological Society (UK); 2009. (NICE Clinical Guidelines, No. 78.) 2, BORDERLINE PERSONALITY DISORDER. Available from: https://www.ncbi.nlm.nih.gov/books/NBK55415/
Eisenlohr-Moul TA, DeWall CN, Girdler SS, Segerstrom SC. Ovarian hormones and borderline personality disorder features: Preliminary evidence for interactive effects of estradiol and progesterone. Biol Psychol. 2015 Jul;109:37-52. doi: 10.1016/j.biopsycho.2015.03.016. Epub 2015 Mar 30. PMID: 25837710; PMCID: PMC4516641.
Leichsenring F, Fonagy P, Heim N, Kernberg OF, Leweke F, Luyten P, Salzer S, Spitzer C, Steinert C. Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry. 2024 Feb;23(1):4-25. doi: 10.1002/wps.21156. PMID: 38214629; PMCID: PMC10786009.
Skoglund, C., Tiger, A., Rรผck, C. et al. Familial risk and heritability of diagnosed borderline personality disorder: a register study of the Swedish population. Mol Psychiatry 26, 999โ1008 (2021). https://doi.org/10.1038/s41380-019-0442-0
Highly Treatable: Lessons Learned From Decades-Long Borderline Personality Disorder Study. March 28, 2025. McLean Hospital. https://www.mcleanhospital.org/news/highly-treatable-lessons-learned-decades-long-borderline-personality-disorder-study