Managing Borderline Personality Disorder


Layla Team

March 22, 2023

What is Borderline Personality Disorder (BPD)?

Borderline personality disorder (BPD) is a mental health diagnosis that affects the way people think and feel about themselves and the world around them. BPD is a complex mental health challenge - people living with the disorder struggle with emotional regulation, and often have other mental health diagnoses. 

Symptoms for Borderline personality disorder may include:

  • Strong emotions (ex. anger, fear, happiness, or shame)
  • Intense mood swings
  • Impulsive and “risky” behaviours (ex. unsafe sex, gambling, or drug use)
  • Fear of abandonment
  • Suicidal thoughts 

People with Borderline personality disorder tend to experience emotions and events in extremes (either all good or all bad). A BPD adult diagnosis can make it difficult to maintain stable employment and healthy relationships without the right supports in place.

What causes Borderline Personality Disorder?

We don’t know exactly what causes borderline personality disorder, but research suggests a mix of genetic and environmental factors. Possible causes of Borderline personality disorder include:

  1. Genetics: BPD is sometimes seen to run in families, suggesting that there is a genetic component to the disorder.
  2. Early life experiences: People with BPD may have grown up in unstable environments where their emotions were dismissed or ignored, contributing to challenges with healthy emotional regulation. A diagnosis of post-traumatic stress disorder (PTSD), particularly due to childhood trauma or abuse, also increases the risk of developing BPD later in life.
  3. Brain structure: Some research suggests that BPD may be related to abnormalities in parts of the brain's limbic system, which controls emotions.

How does Borderline Personality Disorder affect relationships? 

The symptoms of borderline personality disorder can make romantic, friendship and family relationships difficult to manage. Understanding borderline personality disorder in relationships can be challenging for both the person with BPD and those around them. Common issues that may arise in a relationship with someone with borderline personality disorder can include the following: 

  1. Frequent arguments and conflict. Intense emotions associated with BPD, like anger, anxiety, sadness and fear, can be overwhelming for all parties. These strong emotions can contribute to arguments and ongoing conflict.
  2. Jealousy and possessiveness. People with borderline personality disorder often have a strong fear of abandonment. This can cause them to be overly dependent on their partner or friends. They may also be jealous and possessive, which can hurt the relationship over time.
  3. Unrealistic expectations. People with borderline personality disorder often see things in black-and-white, which can make it tricky to understand the nuances in a relationship. This can lead to unrealistic expectations of what a relationship should be like. This can also lead to disappointment when people don’t live up to these expectations.
  4. Relationship stress due to impulsivity. It’s common for people with borderline personality disorder to engage in impulsive behaviours like substance abuse, drinking, reckless driving, or spending sprees. These behaviours can be harmful for the individual with BPD, and can cause stress and strain in their close relationships.

How does Borderline Personality Disorder affect work?

While it is possible for someone with borderline personality disorder to work and succeed in their career, borderline personality disorder can make it harder to get and maintain employment. Emotional instability and impulsive behaviours in people with borderline personality disorder can interfere with their reliability, professionalism and achievement in the workplace. The following behaviours may show up in people with borderline personality disorder in the workplace:

  1. Tension and conflict with colleagues. Individuals with BPD often struggle with interpersonal relationships due to intense feelings, mood swings and abandonment issues. This can make working in a team setting or receiving constructive feedback from others very challenging. 
  2. Impulsivity. People with borderline personality disorder may be more likely to quit a job on the spot or make other quick decisions without considering the consequences. This can impact their ability to maintain employment for long periods of time.
  3. Absenteeism. Individuals with borderline personality disorder or more likely to have comorbid conditions, like anxiety disorders or mood disorders. These overlapping challenges may increase the likelihood of them missing work or showing up late. 
  4. Self-sabotaging behavior. People with borderline personality disorder may struggle with self-sabotaging behaviour, such as missing deadlines or underperforming even if they are capable of doing better. This can impact their ability to advance in their careers.
borderline personality disorder

Borderline Personality Disorder Treatment and Management

It is important to remember that borderline personality disorder is manageable. People with borderline personality disorder can be very successful in their relationships and careers with the appropriate treatment and support. 

Treatment for BPD usually involves a combination of psychotherapy and medication. Specifically, DBT, or Dialectical Behavior Therapy, is one type of therapy that has been found to be very effective in treating borderline personality disorder. DBT is a form of psychotherapy that combines elements of mindfulness, acceptance, and strategies for change in order to help people manage their symptoms and create the life they want. DBT can be effective in treating BPD because it specifically addresses the following areas:

Developing mindfulness skills. Mindfulness is the intentional practice of focusing our minds on the present moment and working to accept our thoughts and emotions without judgment. Mindfulness helps us avoid dwelling on the past or worrying about the future. Developing stronger mindfulness skills can be helpful for managing the strong emotional responses often experienced by people with BPD. 

Learning emotional regulation skills. Emotion regulation skills increase our ability to ride the wave of our emotions and better navigate emotionally escalated situations in a value-aligned manner. 

Exploring distress tolerance skills. Distress tolerance skills are a central component of DBT. These skills focus on the ability to tolerate and get through crisis situations without making things worse and to accept reality as it is in this Moment.

Improving interpersonal skills. People with BPD sometimes struggle with maintaining positive, healthy relationships. Learning skills for improving interpersonal interactions through DBT can provide a roadmap for more stable and happier relationships with loved ones. 

Living with borderline personality disorder can be challenging, but it is possible for people with BPD to lead happy, meaningful and fulfilling lives. With the right support systems in place, people living with BPD can manage their symptoms and control the impacts of the disorder on their daily lives. 

References and External Links:

- Facing mental health challenges? Layla is here to help - Individuals, couples, and families use Layla for personalized, convenient therapy. Layla matches you to a suitable therapist and manage the therapy process in a warm, dependable manner, supporting you on your journey to better health. Learn more here

- New to therapy? Here's your beginner guide - Starting therapy can evoke feelings of vulnerability, but knowing what to expect can help. The journey is individualized, with no exact right or wrong way. During the first session, typically administrative matters are discussed, goals are set, and you and your therapist will get to know each other. Fit between you and you therapist is very important for your outcomes, and it's okay to switch if the fit isn't right. Therapy is adjusted to your timeline and constraints, and can range from weekly to monthly sessions. Reflecting on what you wish to accomplish can guide the process.

- Are you seeking a Psychological Assessment? Layla offers virtual psychological assessments for adults covering ADHD, PTSD, Mood Disorders, Anxiety Disorders, BPD, Somatic Symptom Disorder, and Illness Anxiety Disorder. Conducted by Registered Psychologists, the service involves a 90-minute video interview, psychometric tests, and a debrief meeting. Learn more here

Disclaimer: The content on this blog is for informational purposes only and should not be considered healthcare or medical advice, diagnosis, or treatment. Consult with a healthcare professional for appropriate support.