Understanding Borderline Personality Disorder: Symptoms, Causes, and Treatment Options

Borderline Personality Disorder (BPD) is one of the most challenging mental health conditions to live with — both for those experiencing it and for the people who care about them. BPD is marked by intense emotional swings, unstable relationships, and difficulties with self-image. These struggles can feel overwhelming, leaving individuals feeling misunderstood, isolated, and at times hopeless.

But BPD is also highly treatable. With the right therapy, people with BPD can build stable relationships, regulate emotions, and create meaningful, fulfilling lives. At Groundbreaker Therapy, we specialize in providing Dialectical Behavior Therapy (DBT) — the most effective, evidence-based treatment for BPD — along with additional integrative approaches tailored to each client’s needs.

What Is Borderline Personality Disorder?

Borderline Personality Disorder is a mental health condition characterized by patterns of instability in emotions, self-image, and relationships. People with BPD often experience:

• Intense fear of abandonment
• Difficulty controlling anger
• A tendency toward impulsive or risky behaviors
• Periods of emotional highs and lows that can feel unbearable
• Rapid changes in how they see themselves or others

BPD affects about 1–2% of the population and often begins in late adolescence or early adulthood. Many people with BPD also struggle with co-occurring conditions such as depression, anxiety, post-traumatic stress disorder (PTSD), or substance use.

With effective therapy, however, individuals with BPD can experience significant improvements, often reducing symptoms to the point where the diagnosis no longer applies.

Common Symptoms of Borderline Personality Disorder

BPD symptoms can vary, but they typically include:

Emotional Symptoms

• Intense mood swings lasting hours or days
• Feelings of emptiness or loneliness
• Intense anger or difficulty controlling anger
• Rapidly shifting feelings toward others (idealization followed by devaluation)

Behavioral Symptoms

• Impulsive actions such as overspending, reckless driving, binge eating, or substance use
• Self-harm behaviors such as cutting or burning
• Suicidal thoughts or attempts in response to stress or rejection

Interpersonal Symptoms

• Fear of abandonment and frantic efforts to avoid it (real or imagined)
• Unstable relationships often swing between closeness and conflict
• Extreme sensitivity to perceived rejection or criticism

Self-Image Symptoms

• Distorted or unstable sense of identity
• Sudden shifts in goals, values, or career aspirations
• Chronic feelings of worthlessness or self-hatred

What Causes Borderline Personality Disorder?

BPD does not have a single cause — it develops from a mix of biological, psychological, and environmental factors.

Contributing causes and risk factors include:

• Genetics: Having close relatives with BPD or other personality disorders.
• Brain differences: Abnormalities in areas that regulate emotion and impulse control.
• Trauma and early environment: Childhood abuse, neglect, or unstable family relationships.
• Personality traits: High sensitivity, impulsivity, or difficulty self-regulating emotions.

It’s important to note: people with BPD did not “choose” their condition. It’s not a flaw in character — it’s a complex disorder that requires understanding and treatment.

Borderline Personality Disorder Diagnosis

BPD is diagnosed through a clinical evaluation with a licensed mental health professional. The process involves:

• Reviewing the history of emotional, behavioral, and relational challenges.
• Assessing for at least five of the nine diagnostic criteria outlined in the DSM-5 (including emotional instability, identity disturbance, chronic emptiness, impulsivity, and fear of abandonment).
• Ruling out other conditions with overlapping symptoms (such as bipolar disorder, PTSD, or ADHD).
• Considering co-occurring conditions like anxiety, depression, or substance use.

Accurate diagnosis allows for the right treatment plan — one that focuses on skills training, emotional regulation, and long-term stability.

Borderline Personality Disorder Treatment Options

What Is Best for Borderline Personality Disorder?

The most effective treatment for BPD is Dialectical Behavior Therapy (DBT). DBT was originally developed specifically to treat BPD and has decades of research showing it reduces self-harm, suicidal ideation, impulsive behavior, and emotional reactivity. DBT is widely regarded as the gold standard because it balances acceptance (“you are doing your best”) with change (“you can learn new skills to do better”).

While medication may help with co-occurring conditions such as depression or anxiety, therapy is the cornerstone of BPD treatment.

Groundbreaker’s Approach to BPD

At Groundbreaker Therapy, we provide specialized DBT along with other modalities to meet each client’s unique needs.

Our specialties include:

• Dialectical Behavior Therapy (DBT): Comprehensive DBT, including individual therapy and skills training in mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.
• Mental Health Counseling for Professionals: Helping professionals in law, healthcare, business, and the arts manage high-pressure environments while addressing emotional intensity.
• Anxiety & Depression Treatment: Supporting clients who experience overlapping symptoms alongside BPD.
• Young Professionals’ Mental Health: Guidance for adults in their 20s and 30s navigating identity, relationships, and careers.
• College Mental Health: Tailored support for students navigating academic stress, relationships, and self-identity struggles.

Additional therapies we integrate as needed:

• Dialectical Behavior Therapy (DBT):  Gold standard for BPD. Specifically developed for this condition, DBT teaches emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness.
• Schema Therapy:  Strong evidence for treating BPD. Targets maladaptive schemas and deep-rooted attachment wounds, driving unstable self-image and relationships.
• Cognitive Behavioral Therapy (CBT):  Can help with challenging negative thinking patterns and improving coping skills, though usually most effective when combined with other approaches.
• Integrative Therapy: Allows blending DBT, schema, CBT, and relational approaches to address the complex needs of BPD.
• Relational Therapy: Supports repairing attachment disruptions and improving interpersonal dynamics — often central struggles in BPD.

Each treatment plan is individualized, combining DBT’s proven effectiveness with integrative techniques that strengthen resilience and self-acceptance.

Living With Borderline Personality Disorder

While BPD can feel overwhelming, many people recover and go on to lead stable, satisfying lives. With therapy, clients often:

• Learn to recognize emotional triggers before they escalate.
• Reduce impulsivity and self-destructive behavior.
• Build healthier, more stable relationships.
• Develop a stronger sense of identity and self-worth.
• Improve communication and conflict resolution skills.
• Use DBT skills to manage intense emotions in daily life.

Recovery is a journey — but with consistent therapy, progress is real and lasting.

How Groundbreaker Therapy Can Help

At Groundbreaker Therapy, we understand how painful and confusing living with BPD can be. We provide:

• Specialized DBT expertise for clients with BPD.
• Comprehensive, compassionate care for professionals, students, and young adults.
• Evidence-based, integrative approaches that go beyond symptom reduction to help you thrive.
• A safe and validating environment where you can heal without judgment.
• Flexible scheduling with in-person and virtual options.

You don’t have to feel trapped by unstable emotions or relationships. With the right treatment, healing is possible. Schedule a consultation with Groundbreaker Therapy today and start building the life you deserve — one defined by stability, clarity, and connection.

References

• Mayo Clinic – Borderline Personality Disorder: Symptoms and Causes
• National Institute of Mental Health – Borderline Personality Disorder
• American Psychiatric Association – Borderline Personality Disorder
• Cleveland Clinic – Borderline Personality Disorder: Symptoms, Causes & Treatment
• Johns Hopkins Medicine – Borderline Personality Disorder