Borderline Personality Disorder
Borderline personality disorder (BPD) involves difficulty regulating emotions, a strong fear of abandonment, and instability in relationships and self-image.
BPD is treatable, and outcomes for many people are good. It’s rooted in real neurobiological and developmental factors, not a character weakness.
What are the signs of BPD?
Emotions & sense of self
- Intense fear of real or perceived abandonment, and significant efforts to avoid it
- An unstable sense of self or identity
- Intense mood reactivity, with emotional shifts that can happen quickly
- Chronic feelings of emptiness
- Difficulty managing intense anger
Relationships & behaviour
- A pattern of intense, unstable relationships, often shifting between idealising and being disappointed in someone
- Impulsivity in areas that could be risky, such as spending, substance use or driving
- Recurring thoughts of self-harm or suicide, or self-harming behaviour, in some people with BPD
- In some cases, brief episodes of stress-related paranoia or dissociation
What underlies most of these experiences is a real difficulty regulating intense emotions, not a deliberate choice or a manipulative intent.
What contributes to BPD?
Biological factors
Genetics and individual differences in emotional sensitivity and regulation appear to play a role.
Early experiences
Invalidating, unstable or difficult early environments are commonly associated with BPD, though not everyone with BPD has this history, and not everyone with this history develops BPD.
Sensitivity meeting environment
A widely supported model suggests BPD often develops from the combination of an emotionally sensitive temperament and an environment that didn’t adequately support learning to manage that sensitivity.
How is BPD treated?
BPD is treatable, and outcomes for many people are good, particularly with structured, BPD-specific therapy.
Dialectical behaviour therapy (DBT)
Developed specifically for BPD, with strong evidence. DBT builds skills in emotional regulation, distress tolerance, interpersonal effectiveness and mindfulness.
Mentalisation-based therapy (MBT)
Helps build the capacity to understand your own and others’ mental states, which is often affected in BPD.
Schema therapy
Addresses long-standing patterns and beliefs that developed from earlier experiences.
Structured, longer-term treatment
BPD treatment is often longer-term than treatment for some other conditions. That’s a normal and expected part of the process, not a sign it isn’t working.
With appropriate treatment, many people with BPD improve substantially, and a significant proportion no longer meet diagnostic criteria after a number of years of treatment.
When should I see a psychologist about BPD?
It’s worth reaching out if you’ve noticed a pattern of intense emotional reactivity, unstable relationships, and fear of abandonment that has affected multiple areas of your life over time.
- Emotional shifts that feel intense and hard to manage
- A recurring pattern of intense, unstable relationships
- Fear of abandonment that drives a lot of your behaviour
- Impulsivity or self-harm during periods of distress. Seek support immediately if you’re having thoughts of suicide; see the crisis contacts above.
A GP can set you up with a Mental Health Care Plan under Medicare’s Better Access scheme, which covers a rebate for a set number of psychology sessions each year.
Matched with someone who's the right fit, not just whoever's free
Pair matches you with an AHPRA-registered psychologist based on your situation. The match considers clinical fit, practical things like session format and cost, and, if you want, identity-based preferences.
Get matched with a psychologistFrequently asked questions
Is BPD a life sentence, or can people recover?
People with BPD can and do experience significant, lasting improvement, particularly with structured treatment like DBT.
Is BPD the person’s fault, or their parents’ fault?
BPD is best understood as developing from a combination of biological sensitivity and environmental factors.
Are people with BPD manipulative?
No. This is a persistent but inaccurate stereotype. What can look like manipulation is usually intense fear of abandonment and difficulty regulating overwhelming emotions, not a deliberate strategy.
What’s the difference between BPD and just having intense emotions?
BPD specifically involves a persistent pattern, across relationships, self-image and behaviour, that causes significant distress or difficulty functioning.
Is DBT only for people with BPD?
DBT was originally developed for BPD and has the strongest evidence base there, but it’s also used effectively for other conditions involving emotional regulation difficulties.
Do I need a GP referral to see a psychologist about BPD?
No. A GP referral is only needed for a Medicare rebate through a Mental Health Care Plan.
Ready to find the right mental health support?
Answer a few questions and we’ll match you with the right clinician.
Find your match for free