Borderline personality disorder (BPD)?

What’s it like to live with BPD?

Your experience of living with BPD is unique to you, but this page describes some common experiences that you might recognise:

• Difficult feelings and behaviour towards yourself
• Difficult feelings and behaviour towards others
• Problems with drugs or alcohol
• BPD and other mental health problems
• Facing stigma about BPD

If you feel unable to keep yourself safe, it’s a mental health emergency. Get emergency advice.

Difficult feelings and behaviour towards yourself

How you might think or feel

• Lonely
• Overwhelmed by the strength of your emotions and how quickly they change
• Like there’s something inherently wrong with you, and that it’s your fault if bad things happen to you because you deserve them
• Like you’re a bad person, or not a real person at all
• That you don’t know what you want from life, or what you like or dislike
• Empty, numb or like you have no purpose
• Like your feelings are impossible to understand or describe
• Like you’re a child in an adult world 

How you might behave as a result

• Self-harming or attempting suicide
• Overspending or binge eating
• Using recreational drugs, alcohol or smoking to try to cope with your emotions
• Quitting just before achieving something, or avoiding activities where you think you might fail or be disappointed
• Often changing jobs, hobbies, goals or plans
• Keeping very busy so you’re never alone

Difficult feelings and behaviour towards others

How you might think or feel 

• That friends or partners will leave you forever if they’re angry or upset with you
• That people are judging or thinking badly about you
• Like no one understands you, or you’re not like other people and will never be able to understand them
• That people are either completely perfect and kind, or bad and hurtful, and there’s no middle ground (this is sometimes called ‘splitting’, or black-and-white thinking)
• Wanting to be close to others but also feeling scared of close relationships
• Like the world is a scary and dangerous place, and you want to run away and hide

How you might behave as a result

• Getting very angry or frustrated with people
• Struggling to trust people
• Having unrealistic expectations of people or contacting them very frequently
• Wanting to be close to people but worrying they’ll leave or reject you, and so avoiding or pushing them away
• Spending a lot of time thinking and worrying about things that other people say or do
• Asking for lots of reassurance or testing people’s commitment or opinion of you
• Distancing yourself from people or ending relationships with friends or partners because you think they might leave you
• Anxiously looking out for signs that people might reject you

See our page below on self-care for BPD for some ideas on how to cope with difficult feelings.

Problems with drugs or alcohol

Some people with BPD might be more likely to misuse drugs and alcohol as a way of trying to cope with the difficult emotions they experience.

You can find more information, including where to get support, on our pages on recreational drugs and alcohol. You can also find confidential advice about drugs and alcohol on the FRANK website.

BPD and other mental health problems

It’s common to experience other mental health problems and experiences alongside BPD, which could include:

• Anxiety and panic attacks
• Depression
• Eating problems
• Dissociative disorders
• Psychosis or hearing voices
• Bipolar disorder
• Post-traumatic stress disorder (PTSD)
• Sleep problems

Facing stigma about BPD

Because BPD is a complex diagnosis that not everyone understands well, you might find some people have a negative image of it, or have misconceptions about you.

This can be very upsetting and frustrating, especially if someone who feels this way is a friend, colleague, family member or a health care professional.

Some people, even health professionals, can view BPD as something which is untreatable or makes people ‘difficult’ to help. This is unfair and untrue. You may have experienced mistrust, judgement, or a lack of empathy from people in the past. If you’ve been treated in this way, it’s understandable you may be worried about seeking help or telling people about your diagnosis.

It’s important to remember that you aren’t alone, and you don’t have to put up with misconceptions. Here are some options for you to think about:

• Show people this information. This could help them better understand what your diagnosis means
• Get more involved in your treatment. Mind’s pages on seeking help for a mental health problem provide guidance on having your say in your treatment, making your voice heard, and overcoming barriers
• Know your rights. Mind’s pages on legal rights have more information, including how you can complain about your care
• Take action with Mind. See Mind’s campaigning page for details of the different ways you can get involved with helping us challenge stigma

What causes BPD?

There’s no clear reason why some people experience difficulties associated with BPD. Women are given this diagnosis more often than men – more research needs to be done to understand why this is. But it can affect people of all genders and backgrounds.

Researchers think that BPD is caused by a combination of factors, including:

• Stressful or traumatic life events
• Genetic factors

Stressful or traumatic life events

If you get a BPD diagnosis you’re more likely than most people to have had difficult or traumatic experiences growing up, such as:

• Often having felt afraid, upset, unsupported or invalidated
• Family difficulties or instability, such as living with a parent or carer who experienced an addiction
• Sexual, physical or emotional abuse or neglect
• Losing a parent

Difficult childhood experiences may cause you to develop particular coping strategies, or beliefs about yourself and other people. These can become less helpful in time and cause you distress. You might also be struggling with feelings of anger, anxiety and depression.

You might also experience BPD without having any history of traumatic or stressful life events. Or you might have had other types of difficult experiences.

If you already experience some of these difficulties, then experiencing stress or trauma as an adult could make things worse. Our pages on how to manage stress and post-traumatic stress disorder have some tips on how to cope.

Genetic factors

You’re more likely to get a diagnosis of BPD if someone in your close family also has one. This suggests that genetic factors could contribute to BPD. But we also know that the environment we grow up in and our early relationships can impact the way we think, feel and behave as adults. So it’s difficult for researchers to know exactly how much of a role genes play.

It’s possible that a combination of factors could be involved. Genetics might make you more vulnerable to developing BPD. Whereas stressful, difficult or traumatic life experiences could then trigger these vulnerabilities. More research is needed to understand this area.

Can children and young people be diagnosed with BPD?

It’s very hard to diagnose BPD in children and young people because you go through so many changes as you grow up. But you might be given the diagnosis as a teenager if your difficulties have lasted for long enough and BPD is the diagnosis that best matches what you’re experiencing.

You may also hear the term ‘emerging borderline personality disorder’. YoungMinds has more information about BPD and emerging BPD for young people.

Misdiagnosis of BPD

This page covers:

• Challenges with getting a BPD diagnosis
• What can I do if I disagree with my diagnosis

Challenges with getting a BPD diagnosis

There are many reasons why you may experience challenges with getting a BPD diagnosis, including get the wrong diagnosis. The symptoms of BPD are very broad, and some can be similar to or overlap with other mental health problems, such as:

• Bipolar disorder
• Complex post-traumatic stress disorder (C-PTSD)
• Depression
• Anxiety
• Psychosis

Unfortunately, there are lots of assumptions and misunderstandings around BPD. Not every doctor or health professional understands it. And there are lots of disagreements about how BPD should be described, diagnosed or treated. You may experience BPD and other mental health problems at the same time.

We also don’t all experience or express our pain in the same ways. So this can make it harder for someone to understand what’s going on for us, and which diagnosis or support best fit what we need.

Because of this, you might:

• Not get a diagnosis of BPD when you feel you should have one
• Get a diagnosis of a different mental health problem which you don’t agree with
• Get a BPD diagnosis when you feel you should have a different diagnosis
• Get a BPD diagnosis when you feel you shouldn’t have a diagnosis at all 

What can I do if I disagree with my diagnosis?

If you’re worried that your diagnosis doesn’t fit the way you feel, it’s important to discuss it with a mental health professional so you can make sure you’re getting the right support to help you.

See these pages on seeking help for a mental health problem for information on how to make sure your voice is heard, and what you can do if you’re not happy with your doctor.

What treatments can help?

This page covers:

• Talking therapies
• Therapeutic communities
• Medication
• How can I get treatment?

Talking therapies

Talking therapies are thought to be the most helpful treatment for BPD, although more research is needed into the types of treatments that are most effective.

The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in health care – suggests that the following kinds of talking treatments may be helpful:

• Dialectical behaviour therapy (DBT) – uses individual and group therapy to help you learn skills to cope with difficult emotions. So far, NICE has recommended this treatment for women with BPD who often self-harm, and it’s also thought to be helpful for other groups
• Mentalisation-based therapy (MBT) – aims to help you recognise and understand your and other people’s mental states, and to examine your thoughts about yourself and others. You can read more about MBT for DBT on the NHS website

NICE says that other types of talking therapy could potentially be helpful too, including:

• Cognitive behavioural therapy (CBT) – aims to help you understand how your thoughts and beliefs might affect your feelings and behaviour. See this page on CBT for more information
• Cognitive Analytic Therapy (CAT) – combines CBT’s practical methods with a focus on the relationship between you and your therapist. This can help you look at how you relate to people, including yourself, and what patterns have developed for you
• Other talking therapies – such as schema-focused cognitive therapy, psychodynamic therapy, interpersonal therapy or arts therapies. See these pages on talking therapies and arts and creative therapies for more information

Therapeutic communities

Therapeutic communities are specially designed programmes where you work with a group of other people experiencing mental health problems to support each other to recover. You might live together some or all the time, or meet up regularly.

Activities can include different types of individual or group therapy, as well as household chores and social activities. The Consortium for Therapeutic Communities provides a directory of therapeutic communities in the UK.

Medication

NICE doesn’t recommend using medication to treat the ongoing symptoms of BPD. This is because there aren’t any drugs that are known to be effective.

But we know that in practice doctors often do prescribe medication for people diagnosed with BPD. This could include antidepressants, antipsychotics or mood stabilisers.

You might also take this medication for other mental health problems you’re experiencing. Or you may be given medication to help you manage specific symptoms.

In a crisis situation, your doctor might prescribe you a sleeping pill or minor tranquilliser to help you feel calmer. But they shouldn’t prescribe these for longer than a week.

Your doctor should give you information about any drug you take. This information should be in a format that you can access and understand. They should also give you regular check-ups to review your medication. So if this isn’t happening and you’d like to talk about your medication, make an appointment to discuss it with your doctor.

Medication really helps some people but isn’t right for others. Before deciding to take any drug, it’s important to make sure you have all the facts you need to make an informed choice.

See these pages on things to consider before taking medication and your right to refuse medication for more information. Mind’s pages on coming off medication give guidance on how to come off medication safely.

How can I get treatment?

To get treatment on the NHS you should visit your GP, who can refer you to your local community mental health team (CMHT) for an assessment.

If you receive NHS treatment, it should be in line with NICE guidelines. These say that:

• Anyone with possible BPD should have a structured assessment with a specialist in mental health before being given a diagnosis
• You should have a say in the type of treatment you’re offered. If you’re not getting the type of treatment you think would most help you, it could help to talk to an advocate

You can read the full guidelines and additional recommendations for BPD on the NICE website.

Will I get the help I need in a crisis?

Unfortunately, you might find that services in your area aren’t always able to provide the best possible care to support you.

We know how frustrating and difficult it can be to cope with services that don’t provide the exact help you need, exactly when you need it. That’s why we’re campaigning to improve crisis care across the country.

Can I go private?

Waiting times for talking treatments on the NHS can be long. And specialist services aren’t always available on the NHS. Because of this, you may consider going private. Unfortunately, this can be expensive so may not be possible.

Some private therapists offer a sliding scale of payment though, depending on your circumstances. So it may be worth checking their website or contacting them to see if this is something they can do. See Mind’s page on private sector care for more information.

Where else can I get support?

Treatment for BPD can be very limited and may vary depending on your circumstances. If you’re struggling to access the support you need through the NHS, it might be worth looking into charities or other third sector organisations. For example:

• Your local Mind may be able to help or suggest other local services. See this page on third sector services for more information
• You could consider trying peer support. This could be through an online community, like Mind’s Side by Side. Or through a local support group

For advice on what to do when you’re struggling to access the support you need, see this page on facing barriers to seeking help.

Taking care of yourself

You might feel like every day is a struggle. But there are lots of things that could help.

If you feel unable to keep yourself safe, it’s a mental health emergency. Get emergency advice.

How can I help myself now?

If you’re feeling overwhelmed, it might help to focus on one feeling at a time. Here are some ideas that you could try to see if they work for you.

Different things work at different times for different people, so try to be kind to yourself if some things don’t work for you. Over time, you might develop your own tips to add to this list too.

If I’m feeling angry, frustrated or restless

You could:

• Rip up some paper
• Hit a pillow
• Do some exercise
• Listen to loud music
• Do a practical activity like gardening or woodwork

See our page on how to manage anger for more tips.

If I’m feeling depressed, sad or lonely

You could:

• Wrap up in a blanket and watch your favourite TV show
• Write all your negative feelings on a piece of paper and tear it up
• Listen to music that you find uplifting or soothing
• Write a comforting letter to the part of yourself that is feeling sad or alone
• Let yourself cry or sleep
• Cuddle a pet or a soft toy

See our page on self-care for depression for more tips.

If I’m feeling anxious, panicky or tense

You could:

• Make yourself a hot drink and drink it slowly, noticing the taste and smell, the shape of the mug and its weight in your hand
• Take 10 deep breaths, counting each one out loud
• Write down everything you can think of about where you are right now, such as the time, date, colour of the walls and the furniture in the room
• Take a warm bath or shower – this can help change your mood by creating a soothing atmosphere and a distracting physical sensation

See our page on self-care for anxiety and panic attacks for more tips.

If I’m feeling dissociative or spaced out 

You could:

• Chew a piece of ginger or chilli
• Clap your hands and notice the stinging sensation
• Drink a glass of ice-cold water

See our page on self-care for dissociative disorders for more tips.

If I want to self-harm

You could:

• Rub ice over where you want to hurt yourself
• Stick sellotape or a plaster on your skin and peel it off
• Take a cold bath or shower 

See our page on helping yourself cope with self-harm for more tips. 

Taking care of yourself

How can I help myself in the longer term? 

• Talk to someone
• Keep a mood diary
• Plan for difficult times
• Make a self-care box
• Try peer support
• Focus on what matters to you
• Look after your physical health
• Find specialist support for contributing factors

Talk to someone

It can be hard to reach out when you’re not feeling well, but it might help to share difficult thoughts. If you don’t feel you can talk to the people around you, you could try contacting a helpline.

For example, you can talk to Samaritans for free on 116 123 or jo@samaritans.org about anything that’s upsetting you. See this page on helplines and listening services for more information about different helplines.

Keep a mood diary

Recording your moods in a diary could help you spot patterns in what triggers difficult experiences for you. Or notice early signs when they’re beginning to happen.

Try noting down difficult thoughts or feelings. This might help get them out of your head and make them feel less overwhelming. You can then reflect on them when you feel calmer or talk about them with someone you trust.

You could also make a note of what’s going well. It’s really important to be kind to yourself and recognise difficult steps you’ve taken, or new things you’ve tried. These don’t need to be big things. They could be things like having a shower, going for a walk or sending someone a text. Or managing a difficult situation in a slightly different way.

Plan for difficult times

If you’re feeling less well you might not be able to tell people what help you want, so it could be helpful to plan ahead.

The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in healthcare – recommends that everyone with BPD has a crisis plan. This should include possible triggers, self-help strategies and details for getting support, and should be shared with you and your GP.

Make a self-care box

You could put together some things that might help you when you’re struggling – a bit like making a first aid kit for your mental health.

For example:

• Favourite books, films or music
• A stress ball or fiddle toy
• Helpful sayings or notes of encouragement
• Pictures or photos you find comforting
• A soft or weighted blanket
• Cosy slippers
• Something comforting to smell or taste, like a lavender bag or mints

Or you could make a digital self-care kit. You could save this on your phone so you can look at it anytime. You could save photos, music, videos, messages or sayings that you find helpful. Or notes to remind yourself how to manage difficult situations.

Try peer support groups

Peer support groups bring together people who’ve had similar experiences. Some people find this very helpful.

There are lots of ways to find peer support groups.

You could try Mind’s supportive online community, Side by Side.

Focus on what matters to you

Sometimes when we’re given a mental health diagnosis, it can feel like this defines us as a person. But this isn’t true.

Try to focus on the things that matter to you. Or things you value about your character, or which make you happy. This could be your values, interests, opinions or passions. It might help to write them down or say them out load. Some people find it helpful to express themselves creatively.

And if you don’t know yet what matters to you or what you value about yourself that’s ok too – take your time. It can sometimes be difficult to have a sense of what we enjoy and why we matter when we’re feeling low or unwell. Especially if we’ve been treated badly by others.

See our page on improving your self-esteem for more information. 

Look after your physical health

Looking after your physical health can make a difference to how you feel emotionally. For example, it can help to:

• Try to improve your sleep. Sleep can help give you the energy to cope with difficult feelings and experiences. See our pages on coping with sleep problems for more information
• Think about what you eat. Eating regularly and keeping your blood sugar stable can make a difference to your mood and energy levels. See Mind’s pages on food and mood and eating problems for more information
• Try to do some physical activity. Exercise can be really helpful for your mental wellbeing. See Mind’s pages on physical activity for more information
• Spend time outside. Spending time in green space can boost your wellbeing. See Mind’s pages on nature and mental health for more information
• Be careful with alcohol or drug use. While you might want to use drugs or alcohol to cope with difficult feelings, in the long run they can make you feel a lot worse and may prevent you from getting the support you need for your mental health. See our pages on recreational drugs, alcohol and addiction for more information on what to do if you’re struggling with drugs and alcohol use

Find specialist support for contributing factors 

If you’ve experienced other issues that have contributed to your problems, it could be helpful to explore the help out there for these too. For example:

• Abuse or bullying. If you’ve been abused in childhood, the National Association for People Abused in Childhood (NAPAC) is there to support you, and these pages on abuse and useful contacts for PTSD list many more organisations that could help
• Racism. Mind’s pages on racism and mental health have information about the impacts of racism, as well as options for support. This also includes information on racism within the mental health system. And advice on overcoming barriers to getting support
• Money problems. Mind’s pages on money and mental health have information about the links between money worries and mental health. This includes advice about managing your money when you’re unwell. And options for support with debt, benefits or other financial concerns

How can other people help?

This information is for friends and family who want to support someone with BPD.

If someone you care about is diagnosed with BPD you might sometimes find it hard to understand their feelings or behaviour, or to know how to help. But there are lots of positive things you can do to support them:

• Be patient
• Don’t judge
• Be calm and consistent
• Remind them of their positive traits
• Set clear boundaries
• Plan ahead
• Learn their triggers
• Provide distractions
• Learn more about BPD
• Help them seek treatment and support
• Take care of yourself 

Be patient

If your loved one is struggling to deal with their emotions, try not to get involved in an argument in the heat of the moment. It could be better to wait until you both feel calmer to talk things through. 

Don’t judge 

It can be difficult if you don’t understand why someone is feeling or behaving in a certain way. Especially if their reactions seem upsetting or unreasonable. But try to remember that you’re not in their head and there may be things going on for them that you don’t understand. Try to listen, and acknowledge their feelings, rather than judging their reactions.

Be calm and consistent

If your loved one is experiencing a lot of overwhelming emotions, this could help them feel more secure and supported and will help in moments of conflict. If you feel yourself becoming angry or upset, try taking some time alone or going for a walk if you can.

Remind them of their positive traits 

When someone you care about is finding it hard to believe anything good about themselves, it can be reassuring to hear all the positive things you see in them.

Set clear boundaries

Practising good boundaries and expectations can make a big difference. If your loved one is feeling insecure about being rejected or abandoned, or seems worried about being left alone, it can help to clarify what you can expect from each other and to communicate about this calmly and patiently if things become unclear.

Plan ahead

When the person you’re supporting is feeling well, ask them how you can help them best when things are difficult. See our pages on supporting someone who feels suicidal, and supporting someone who is self-harming for more information.

Learn their triggers 

Talk to your loved one and try to find out what sort of situations or conversations might trigger negative thoughts and emotions. Understanding their triggers could help you avoid difficult situations, and feel more prepared when they have strong reactions to certain things.

Provide distractions

Sometimes helping to distract someone from difficult feelings can be really useful. Try suggesting activities or tasks, such as watching a film or tidying up. Or you could start something and let them know they’re welcome to join in when they feel ready.

Learn more about BPD

BPD is a complicated diagnosis, and your loved one might sometimes have to deal with other people’s misconceptions on top of trying to manage their mental health problem. Educating yourself can also help you to challenge stigma. Our about BPD and experiences of BPD pages contain more information.

Help them seek treatment and support

See this page on supporting someone to seek help for more information about how to help someone get the support they need, including what you can do when someone doesn’t want help. And see this page on advocacy in mental health for guidance on how to help them find an advocate.

Take care of yourself

Looking after someone else can sometimes be difficult and stressful. It’s important to remember that your mental health is important too. See these pages on coping when supporting someone else, managing stress and improving your wellbeing for more information on how to look after yourself.

Useful contacts 

Borderline Arts

borderlinearts.org
Uses the arts to raise awareness of borderline personality disorder and reduce stigma.

The Consortium for Therapeutic Communities

therapeuticcommunities.org
Online directory of therapeutic communities across the UK.

FRANK

0300 123 6600
talktofrank.com
Confidential advice and information about drugs, their effects and the law.

Mind

Mind’s helplines provide information and support by phone and email.

Local Minds offer face-to-face services across England and Wales. These services include talking therapies, peer support and advocacy.

Side by Side is Mind’s supportive online community for anyone experiencing a mental health problem.

The National Association for People Abused in Childhood (NAPAC)

0808 801 0331
support@napac.org.uk
napac.org.uk
Supports adult survivors of any form of childhood abuse. Offers a helpline, email support and local services.

NHS UK

nhs.uk
Information about health problems and treatments, including details of local NHS services in England.

Papyrus HOPELINEUK 

0800 068 41 41
07860039967 (text)
pat@papyrus-uk.org
papyrus-uk.org
Confidential support for under-35s at risk of suicide and others who are concerned about them. Open 24 hours, 7 days a week.

Samaritans

116 123 (freephone)
jo@samaritans.org
Freepost SAMARITANS LETTERS
samaritans.org
Samaritans are open 24/7 for anyone who needs to talk. You can visit some Samaritans branches in person.

Shout

85258 (text SHOUT)
giveusashout.org
Confidential 24/7 text service offering support if you’re in crisis and need immediate help.