Disease: Borderline Personality Disorder (BPD)

    Borderline personality disorder facts

    • Borderline personality disorder is a personality disorder characterized by consistently problematic ways of thinking, feeling, and interacting, impulsivity, negative self-image and fear of abandonment, leading to difficulties with interpersonal relationships.
    • BPD affects men as often as women in general, women more than men in treatment populations.
    • Antisocial personality disorder in adults, substance-abuse problems in men, eating disorders in women, and anxious and odd personality disorders in adolescents tend to co-occur with BPD.
    • There has been some controversy about whether or not BPD is its own disorder or a variation of bipolar disorder, but in many countries, there is more agreement on the existence of BPD.
    • Like most other mental disorders, it is understood to be the result of a combination of biological vulnerabilities, ways of thinking, and social stressors (biopsychosocial model).
    • BPD sufferers are more likely to have a learning problem or certain temperaments as children, or come from families of origin where divorce, neglect, sexual abuse, substance abuse, or death occurred.
    • In order to be diagnosed with BPD, the sufferer must experience at least five of the following symptoms: unstable self-image, relationships or emotions, severe impulsivity, repeated suicidal behaviors or threats, chronic feelings of emptiness, inappropriate anger, trouble managing anger, or transient paranoia or dissociation.
    • As with other mental disorders, there is no specific definitive test, like a blood test, to diagnose BPD. Therefore, practitioners conduct a mental-health interview that looks for the presence of the symptoms previously described and usually explore the person's history for any medical problem or other emotional problem that may show symptoms of the disorder.
    • Psychotherapy approaches that have been helpful in treating BPD include dialectical behavior therapy, cognitive behavioral therapy, interpersonal therapy, and psychoanalytic psychotherapy.
    • The use of psychiatric medications like antidepressants, mood stabilizers, and antipsychotics may be useful in addressing some of the symptoms of BPD but do not manage the illness in its entirety.
    • Partial hospitalization can help treat BPD by providing frequent supervision and assessment in a safe environment, while allowing the sufferer to go home each evening.
    • The presence of BPD tends to worsen the symptoms of other mental illnesses and increase the risk for self-mutilation, as well as for attempting or completing suicide.
    • People with BPD are at somewhat higher risk for engaging in violent behavior. That risk is further increased when the individual with BPD also is suffering from antisocial personality disorder, has a previous history of violent behavior, frequently uses sedative medications, or experiences several changes in their psychiatric medications.
    • While they symptoms of BPD tends to diminish over years for many people, how well or poorly people with BPD progress over time seems to be influenced by the severity of the symptoms, the individual's current personal relationships, whether or not the sufferer has a history of being abused as a child, as well as whether or not the individual receives appropriate treatment.
    • Steady employment or school status once symptoms of BPD subside (remit) tends to protect BPD sufferers from experiencing a future relapse.

    What is borderline personality disorder (BPD)?

    Borderline personality disorder (BPD) is a mental disorder that belongs to the group of mental illnesses called personality disorders. Like other personality disorders, it is characterized by a consistent pattern of thinking, feeling, and interacting with others and with the world that tends to cause significant problems for the sufferer. Specifically, BPD tends to be associated with a pattern of unstable ways of seeing oneself, feeling, behaving, and relating to others that markedly interferes with the individual's ability to function. Also, as with other personality disorders, the person is usually an adolescent or adult before they can be assessed as meeting full symptom criteria for BPD.

    Historically, BPD has been thought to be a set of symptoms that include both mood problems (neuroses) and distortions of reality (psychosis) and therefore was thought to be on the borderline between mood problems and schizophrenia. However, it is now understood that while the symptoms of BPD may straddle those symptom complexes, this illness is more closely related to other personality disorders in terms of how it may develop and occur within families. Contrary to what the medical community thought in the past, BPD is now understood to occur equally in men and women in general, while primarily in women in groups of people who are receiving mental-health treatment (treatment populations). The frequency with which this disorder occurs is also thought to be considerably higher than previously thought, affecting nearly 6% of adults over the course of a lifetime.

    What other disorders often occur with BPD?

    Men with BPD are more likely to also have a substance-use disorder. BPD is more likely to be associated with eating disorders symptoms in women. In adolescents, BPD tends to co-occur with more anxious and odd personality disorders like schizotypal and passive aggressive personality disorder, respectively. Adults who have antisocial personality disorder, formerly also colloquially called sociopaths, may be more likely to also have BPD. Interestingly, even people who have some symptoms (traits) of BPD but do not meet full diagnostic criteria for the disorder can experience both traits of BPD and narcissistic personality disorder.

    Although there has been some controversy as to whether or not BPD is truly its own disorder or a variation of bipolar disorder, research supports the theory that BPD, like virtually every medical or other mental-health disorder, can appear in nearly as many unique and complex ways as there are people who have it. In other words, some individuals with BPD will have that disorder alone, while others will have it in combination with bipolar or another mental disorder. Still others will appear to have BPD but really qualify for the diagnosis of bipolar disorder and visa versa.

    BPD is not recognized worldwide. It is most closely diagnosed as emotionally unstable personality disorder in the International Classification of Disease, or ICD-10. Although countries like China and India recognize mental disorders that have some symptoms in common with BPD, its existence is not formally recognized.

    What causes borderline personality disorder?

    Although there is no specific cause for BPD, like most other mental disorders, it is understood to be the result of a combination of biological vulnerabilities, ways of thinking, and social stressors (biopsychosocial model). Biologically, individuals with BPD are more likely to have abnormalities in the size of the hippocampus, in the size and functioning of the amygdala, and in the functioning of the frontal lobes, which are the areas of the brain that are understood to regulate emotions and integrate thoughts with emotions. Although some research asserts that people with BPD seem to have areas of the brain that are more and less active compared to individuals who do not have the disorder, other research contradicts that. Therefore, specific patterns of brain functioning, as they are currently studied and understood, seem unreliable predictors of BPD.

    While it is not thought to be genetic, it can somewhat run in families. Psychologically, BPD seems to make a person more vulnerable to difficulty managing their emotions, particularly impulsive aggression. Socially, this disorder predisposes sufferers to be more likely to excessively expect to be criticized or rejected and negatively personalize disinterest or inattention from others. Their social tendencies make for great difficulty in their relationships. In addition to these issues, people with BPD are more likely to have suffered from childhood abuse or neglectful parenting.

    What are the risk factors for borderline personality disorder?

    Adults who come from families of origin where divorce, neglect, sexual abuse, substance abuse, or death occurred are at higher risk of developing BPD. In children, the risk for developing this disorder appears to increase when they have a learning problem or certain temperaments. Adolescents who develop alcohol abuse or addiction are also apparently at higher risk of developing BPD compared to those who do not.

    What are borderline personality disorder symptoms and signs?

    As per the DSM (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Treatment Revision) definition, in order to qualify for the diagnosis of BPD, an individual must have at least five of the following symptoms:

    • Unstable self-image, in that they may drastically and rapidly change in the way they perceive their own likes, dislikes, strengths, weaknesses, goals, and intrinsic value as a person
    • Unstable relationships, in that individuals with this disorder rapidly, drastically, and often frequently change from seeing another person as nearly perfect (idealizing) to seeing the other person as being virtually worthless (devaluing)
    • Unstable emotions (affects), in that the sufferer experiences marked, rapid changes in feelings (for example, severe anger, joy, euphoria, anxiety, including panic attacks and depression) that are stress related, even if the stresses may be seen as minor or negligible to others
    • Desperate efforts to avoid being abandoned, whether the abandonment is real or imagined
    • Significant impulsivity, in that the person with BPD tends to act before thinking to the point that it is self-damaging (for example, sexual behaviors, spending habits, eating habits, driving behaviors, or in the use of substances)
    • Recurring suicidal behaviors, threats, or attempts
    • Chronic feelings of emptiness
    • Inappropriate, intense anger or difficulty managing their anger when it occurs
    • Transient, stress-related paranoia or severe dissociation (lapses in memory)

    How is borderline personality disorder diagnosed?

    There is no specific definitive test, like a blood test, that can accurately assess that a person has BPD. People who are concerned that they may suffer from BPD might explore the possibility by taking a self-test, either an online or printable test. To determine the presence of this disorder, practitioners conduct a mental-health interview that looks for the presence of the symptoms, also called diagnostic criteria, previously described. As with any mental-health assessment, the practitioner will usually work toward ruling out other mental disorders, including mood problems like depression, anxiety disorders including anxiety attacks or generalized anxiety, types of other personality disorders like narcissistic personality disorder, dependent personality disorder or histrionic personality disorder, drug-abuse problems as well as problems being in touch with reality, like schizophrenia or delusional disorder. Besides determining if the person suffers from BPD, the mental-health professional may assess that while some symptoms (traits) of the disorder are present, the person does not fully qualify for the diagnosis.

    The professional will also likely try to ensure that the individual is not suffering from a medical problem that may cause emotional symptoms. The mental-health professional will therefore often inquire about when the person has most recently had a physical examination, comprehensive blood testing, and any other tests that a medical professional deems necessary to ensure that the individual is not suffering from a medical condition instead of or in addition to emotional symptoms. Due to the use of a mental-health interview in making the diagnosis and the fact that this disorder can be quite resistant to treatment, it is of great importance that the practitioner know to conduct a thorough assessment. This is to assure that the person is not incorrectly assessed as having BPD when he or she does not.

    What is the treatment for borderline personality disorder?

    Different forms of psychotherapy have been found to effectively treat BPD. Dialectical behavior therapy (DBT) is an approach to psychotherapy in which the therapist specifically addresses four areas that tend to be particularly problematic for individuals with BPD: self-image, impulsive behaviors, mood instability, and problems in relating to others. To address those areas, treatment with DBT tries to build four major behavioral skill areas: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. Talk therapy that focuses on helping the person understand how their thoughts and behaviors affect each other (cognitive behavioral therapy or CBT) has also been found to be effective treatment for BPD. Other psychotherapy approaches that have been used to address BPD include interpersonal psychotherapy (IPT) and psychoanalytic therapy. IPT is an approach that focuses on how the person's symptoms are related to the problems that person has in relating to others. Psychoanalytic therapy, which seeks to help the individual understand and better manage his or her ways of defending against negative emotions, has been found to be effective in addressing BPD, especially when the therapist is more active or vocal than in traditional psychoanalytic treatment and when this approach is used in the context of current rather than past relationships.

    The use of psychiatric medications, like antidepressants (for example, fluoxetine [Prozac], sertraline [Zoloft], paroxetine [Paxil], citalopram [Celexa], escitalopram [Lexapro], venlafaxine [Effexor], duloxetine [Cymbalta], or trazodone [Desyrel]), mood stabilizers (for example, divalproex sodium [Depakote], carbamazepine [Tegretol], or lamotrigine [Lamictal]), or antipsychotics (for example, olanzapine [Zyprexa], risperidone [Risperdal], aripiprazole [Abilify], paliperidone [Invega], iloperidone [Fanapt], or asenapine [Saphris]) may be useful in addressing some of the symptoms of BPD but do not manage the illness in its entirety. On the positive side, some women who suffer from both BPD and bipolar disorder may experience a decrease in how irritable and angry they feel, as well as a decrease in how often and severely they become aggressive when treated with a mood stabilizer like Depakote. On the other hand, the use of medications in the treatment of symptoms in individuals with BPD may sometimes cause more harm than good. For example, while people with BPD may experience suicidal behaviors no more often than other individuals with a severe mental illness, they often receive more medications and therefore suffer from more side effects. Also, given how frequently many sufferers of BPD experience suicidal feelings, great care is taken to avoid the medications that can be dangerous in overdose.

    Learn more about: Prozac | Zoloft | Celexa | Lexapro | Effexor | Cymbalta | Desyrel | Depakote | Tegretol | Lamictal | Zyprexa | Risperdal | Abilify | Invega | Saphris

    Partial hospitalization is an intervention that involves the individual with mental illness being in a hospital-like treatment center during the day but returning home each evening. In addition to providing a safe environment and frequent monitoring by mental-health professionals, partial hospitalization programs allow for more frequent mental-health interventions like professional assessments, psychotherapy medication treatment, as well as development of a treatment plan for after discharge from the facility. While funding for a long-term stay in a partial hospitalization facility may be difficult, research shows that when it is provided using a psychoanalytic approach, it may help the person with BPD enjoy a decrease in the severity of anxiety and depression, the frequency of suicide attempts and full hospitalizations, as well as developing improved relationships with others. Contrary to earlier beliefs, BPD has been found to significantly improve in response to treatment with appropriate inpatient hospitalization. Loved ones of individuals with BPD might benefit from participation in a support group.

    What are borderline personality disorder complications?

    The presence of BPD can often worsen the course of another mental condition with which it occurs. For example, it tends to change the symptoms of posttraumatic stress disorder and to worsen depression.

    Individuals with BPD are at risk for self-mutilation, as well as for attempting or completing suicide. While cutting and other forms of self-harm, as well as suicidal behaviors seem to be associated with alleviating negative feelings, it is thought that self-mutilating behaviors are more an expression of anger, punishing oneself, distracting oneself, and eliciting more normal feelings. In contrast, suicide attempts are thought to be more often associated with feeling survivors will be better off for their death. People who engage in self-mutilation are more likely to commit suicide compared to those who do not self-mutilate.

    Although most individuals with a mental disorder do not engage in violent behavior, those who suffer from BPD have a somewhat increased risk for such behaviors. That risk is also increased for individuals who suffer from antisocial personality disorder, have previous history of violent behavior, frequent use of sedative medications, or experience several changes in their psychiatric medications in general.

    Complications of BPD also often involve families of the person with the disorder. For example, a parent with BPD is vulnerable to having depressive symptoms in their children.

    What is the prognosis of people with borderline personality disorder?

    As with any illness, an appropriate question about BPD is if it is curable. While improvement in any personality disorder is not synonymous with being cured, the symptoms of BPD do tend to diminish with time. How well or poorly people with BPD progress over time seems to be influenced by how severe the disorder is at the time that treatment starts, the state of the individual's current personal relationships, whether or not the sufferer has a history of being abused as a child, as well as whether or not the person receives appropriate treatment. Simultaneously suffering from depression, other emotional problems, or a low level of conscientiousness have been found to be associated with a greater likelihood of symptoms of BPD returning (relapse). Conversely, having steady employment or school status once symptoms of BPD subside (remit) tends to protect BPD sufferers from experiencing a future relapse.

    What is borderline personality disorder (BPD)?

    Borderline personality disorder (BPD) is a mental disorder that belongs to the group of mental illnesses called personality disorders. Like other personality disorders, it is characterized by a consistent pattern of thinking, feeling, and interacting with others and with the world that tends to cause significant problems for the sufferer. Specifically, BPD tends to be associated with a pattern of unstable ways of seeing oneself, feeling, behaving, and relating to others that markedly interferes with the individual's ability to function. Also, as with other personality disorders, the person is usually an adolescent or adult before they can be assessed as meeting full symptom criteria for BPD.

    Historically, BPD has been thought to be a set of symptoms that include both mood problems (neuroses) and distortions of reality (psychosis) and therefore was thought to be on the borderline between mood problems and schizophrenia. However, it is now understood that while the symptoms of BPD may straddle those symptom complexes, this illness is more closely related to other personality disorders in terms of how it may develop and occur within families. Contrary to what the medical community thought in the past, BPD is now understood to occur equally in men and women in general, while primarily in women in groups of people who are receiving mental-health treatment (treatment populations). The frequency with which this disorder occurs is also thought to be considerably higher than previously thought, affecting nearly 6% of adults over the course of a lifetime.

    What other disorders often occur with BPD?

    Men with BPD are more likely to also have a substance-use disorder. BPD is more likely to be associated with eating disorders symptoms in women. In adolescents, BPD tends to co-occur with more anxious and odd personality disorders like schizotypal and passive aggressive personality disorder, respectively. Adults who have antisocial personality disorder, formerly also colloquially called sociopaths, may be more likely to also have BPD. Interestingly, even people who have some symptoms (traits) of BPD but do not meet full diagnostic criteria for the disorder can experience both traits of BPD and narcissistic personality disorder.

    Although there has been some controversy as to whether or not BPD is truly its own disorder or a variation of bipolar disorder, research supports the theory that BPD, like virtually every medical or other mental-health disorder, can appear in nearly as many unique and complex ways as there are people who have it. In other words, some individuals with BPD will have that disorder alone, while others will have it in combination with bipolar or another mental disorder. Still others will appear to have BPD but really qualify for the diagnosis of bipolar disorder and visa versa.

    BPD is not recognized worldwide. It is most closely diagnosed as emotionally unstable personality disorder in the International Classification of Disease, or ICD-10. Although countries like China and India recognize mental disorders that have some symptoms in common with BPD, its existence is not formally recognized.

    What causes borderline personality disorder?

    Although there is no specific cause for BPD, like most other mental disorders, it is understood to be the result of a combination of biological vulnerabilities, ways of thinking, and social stressors (biopsychosocial model). Biologically, individuals with BPD are more likely to have abnormalities in the size of the hippocampus, in the size and functioning of the amygdala, and in the functioning of the frontal lobes, which are the areas of the brain that are understood to regulate emotions and integrate thoughts with emotions. Although some research asserts that people with BPD seem to have areas of the brain that are more and less active compared to individuals who do not have the disorder, other research contradicts that. Therefore, specific patterns of brain functioning, as they are currently studied and understood, seem unreliable predictors of BPD.

    While it is not thought to be genetic, it can somewhat run in families. Psychologically, BPD seems to make a person more vulnerable to difficulty managing their emotions, particularly impulsive aggression. Socially, this disorder predisposes sufferers to be more likely to excessively expect to be criticized or rejected and negatively personalize disinterest or inattention from others. Their social tendencies make for great difficulty in their relationships. In addition to these issues, people with BPD are more likely to have suffered from childhood abuse or neglectful parenting.

    What are the risk factors for borderline personality disorder?

    Adults who come from families of origin where divorce, neglect, sexual abuse, substance abuse, or death occurred are at higher risk of developing BPD. In children, the risk for developing this disorder appears to increase when they have a learning problem or certain temperaments. Adolescents who develop alcohol abuse or addiction are also apparently at higher risk of developing BPD compared to those who do not.

    What are borderline personality disorder symptoms and signs?

    As per the DSM (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Treatment Revision) definition, in order to qualify for the diagnosis of BPD, an individual must have at least five of the following symptoms:

    • Unstable self-image, in that they may drastically and rapidly change in the way they perceive their own likes, dislikes, strengths, weaknesses, goals, and intrinsic value as a person
    • Unstable relationships, in that individuals with this disorder rapidly, drastically, and often frequently change from seeing another person as nearly perfect (idealizing) to seeing the other person as being virtually worthless (devaluing)
    • Unstable emotions (affects), in that the sufferer experiences marked, rapid changes in feelings (for example, severe anger, joy, euphoria, anxiety, including panic attacks and depression) that are stress related, even if the stresses may be seen as minor or negligible to others
    • Desperate efforts to avoid being abandoned, whether the abandonment is real or imagined
    • Significant impulsivity, in that the person with BPD tends to act before thinking to the point that it is self-damaging (for example, sexual behaviors, spending habits, eating habits, driving behaviors, or in the use of substances)
    • Recurring suicidal behaviors, threats, or attempts
    • Chronic feelings of emptiness
    • Inappropriate, intense anger or difficulty managing their anger when it occurs
    • Transient, stress-related paranoia or severe dissociation (lapses in memory)

    What is the treatment for borderline personality disorder?

    Different forms of psychotherapy have been found to effectively treat BPD. Dialectical behavior therapy (DBT) is an approach to psychotherapy in which the therapist specifically addresses four areas that tend to be particularly problematic for individuals with BPD: self-image, impulsive behaviors, mood instability, and problems in relating to others. To address those areas, treatment with DBT tries to build four major behavioral skill areas: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. Talk therapy that focuses on helping the person understand how their thoughts and behaviors affect each other (cognitive behavioral therapy or CBT) has also been found to be effective treatment for BPD. Other psychotherapy approaches that have been used to address BPD include interpersonal psychotherapy (IPT) and psychoanalytic therapy. IPT is an approach that focuses on how the person's symptoms are related to the problems that person has in relating to others. Psychoanalytic therapy, which seeks to help the individual understand and better manage his or her ways of defending against negative emotions, has been found to be effective in addressing BPD, especially when the therapist is more active or vocal than in traditional psychoanalytic treatment and when this approach is used in the context of current rather than past relationships.

    The use of psychiatric medications, like antidepressants (for example, fluoxetine [Prozac], sertraline [Zoloft], paroxetine [Paxil], citalopram [Celexa], escitalopram [Lexapro], venlafaxine [Effexor], duloxetine [Cymbalta], or trazodone [Desyrel]), mood stabilizers (for example, divalproex sodium [Depakote], carbamazepine [Tegretol], or lamotrigine [Lamictal]), or antipsychotics (for example, olanzapine [Zyprexa], risperidone [Risperdal], aripiprazole [Abilify], paliperidone [Invega], iloperidone [Fanapt], or asenapine [Saphris]) may be useful in addressing some of the symptoms of BPD but do not manage the illness in its entirety. On the positive side, some women who suffer from both BPD and bipolar disorder may experience a decrease in how irritable and angry they feel, as well as a decrease in how often and severely they become aggressive when treated with a mood stabilizer like Depakote. On the other hand, the use of medications in the treatment of symptoms in individuals with BPD may sometimes cause more harm than good. For example, while people with BPD may experience suicidal behaviors no more often than other individuals with a severe mental illness, they often receive more medications and therefore suffer from more side effects. Also, given how frequently many sufferers of BPD experience suicidal feelings, great care is taken to avoid the medications that can be dangerous in overdose.

    Learn more about: Prozac | Zoloft | Celexa | Lexapro | Effexor | Cymbalta | Desyrel | Depakote | Tegretol | Lamictal | Zyprexa | Risperdal | Abilify | Invega | Saphris

    Partial hospitalization is an intervention that involves the individual with mental illness being in a hospital-like treatment center during the day but returning home each evening. In addition to providing a safe environment and frequent monitoring by mental-health professionals, partial hospitalization programs allow for more frequent mental-health interventions like professional assessments, psychotherapy medication treatment, as well as development of a treatment plan for after discharge from the facility. While funding for a long-term stay in a partial hospitalization facility may be difficult, research shows that when it is provided using a psychoanalytic approach, it may help the person with BPD enjoy a decrease in the severity of anxiety and depression, the frequency of suicide attempts and full hospitalizations, as well as developing improved relationships with others. Contrary to earlier beliefs, BPD has been found to significantly improve in response to treatment with appropriate inpatient hospitalization. Loved ones of individuals with BPD might benefit from participation in a support group.

    What are borderline personality disorder complications?

    The presence of BPD can often worsen the course of another mental condition with which it occurs. For example, it tends to change the symptoms of posttraumatic stress disorder and to worsen depression.

    Individuals with BPD are at risk for self-mutilation, as well as for attempting or completing suicide. While cutting and other forms of self-harm, as well as suicidal behaviors seem to be associated with alleviating negative feelings, it is thought that self-mutilating behaviors are more an expression of anger, punishing oneself, distracting oneself, and eliciting more normal feelings. In contrast, suicide attempts are thought to be more often associated with feeling survivors will be better off for their death. People who engage in self-mutilation are more likely to commit suicide compared to those who do not self-mutilate.

    Although most individuals with a mental disorder do not engage in violent behavior, those who suffer from BPD have a somewhat increased risk for such behaviors. That risk is also increased for individuals who suffer from antisocial personality disorder, have previous history of violent behavior, frequent use of sedative medications, or experience several changes in their psychiatric medications in general.

    Complications of BPD also often involve families of the person with the disorder. For example, a parent with BPD is vulnerable to having depressive symptoms in their children.

    What is the prognosis of people with borderline personality disorder?

    As with any illness, an appropriate question about BPD is if it is curable. While improvement in any personality disorder is not synonymous with being cured, the symptoms of BPD do tend to diminish with time. How well or poorly people with BPD progress over time seems to be influenced by how severe the disorder is at the time that treatment starts, the state of the individual's current personal relationships, whether or not the sufferer has a history of being abused as a child, as well as whether or not the person receives appropriate treatment. Simultaneously suffering from depression, other emotional problems, or a low level of conscientiousness have been found to be associated with a greater likelihood of symptoms of BPD returning (relapse). Conversely, having steady employment or school status once symptoms of BPD subside (remit) tends to protect BPD sufferers from experiencing a future relapse.

    Source: http://www.rxlist.com

    Men with BPD are more likely to also have a substance-use disorder. BPD is more likely to be associated with eating disorders symptoms in women. In adolescents, BPD tends to co-occur with more anxious and odd personality disorders like schizotypal and passive aggressive personality disorder, respectively. Adults who have antisocial personality disorder, formerly also colloquially called sociopaths, may be more likely to also have BPD. Interestingly, even people who have some symptoms (traits) of BPD but do not meet full diagnostic criteria for the disorder can experience both traits of BPD and narcissistic personality disorder.

    Although there has been some controversy as to whether or not BPD is truly its own disorder or a variation of bipolar disorder, research supports the theory that BPD, like virtually every medical or other mental-health disorder, can appear in nearly as many unique and complex ways as there are people who have it. In other words, some individuals with BPD will have that disorder alone, while others will have it in combination with bipolar or another mental disorder. Still others will appear to have BPD but really qualify for the diagnosis of bipolar disorder and visa versa.

    BPD is not recognized worldwide. It is most closely diagnosed as emotionally unstable personality disorder in the International Classification of Disease, or ICD-10. Although countries like China and India recognize mental disorders that have some symptoms in common with BPD, its existence is not formally recognized.

    Source: http://www.rxlist.com

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