Borderline Personality Disorder: The Signs and Treatment

Also known as emotional intensity disorder or emotionally unstable personality disorder, BPD (borderline personality disorder) is a complex mental and psychiatric condition where an individual has difficulty experiencing emotions and is constantly in a state of turmoil. It encompasses a pattern of upheaval in emotions, self-image and interpersonal relationships. Those suffering from BPD in most cases are acutely impulsive and often demonstrate self-injurious and destructive behaviour such as suicidal attempts, cutting and engaging in risky sexual behaviours.  

In most cases, BPD occurs by the onset of early adulthood. Sufferers are usually very sensitive to their surroundings and circumstances with perceptions of an impending rejection or separation, external structure loss leading to intense changes in behaviour, cognition and self-image.

Signs/Symptoms of BPD:

Losing Touch with Reality or Suspicion

BPD sufferers usually struggle with suspicious thoughts or paranoia about the motives of others. Under extreme stress they end up with dissociation or feeling out of touch with reality. They feel spaced out and foggy or outside their own bodies.

Abandonment Fear

BPD leaves people with an intense fear of being left alone or abandoned. A simple event like a loved one going away or arriving late from work could trigger this deep fear resulting in frantic efforts to keep the loved one close. The sufferer can jealously track the movements of the loved one, start fights, cling or beg and sometimes physically block the loved one from leaving. Rather than keep the loved one, such behaviour drives them away.

Explosive Anger

BPD sufferers usually struggle with short temper and intense anger. Self-control is extremely hard after fuses are lit and the individual could be consumed wholly by rage, throw things and yell. The anger can be directed outwards or inwards as the individual becomes angry with himself/herself.

Unstable Relationships

Those with BPD usually have short-lived and intense relationships. They fall in love very fast in search of an individual who will complete them only to be disappointed equally fast. Relationships are either horrible or perfect and never between the two extremes.

Chronic Emptiness Feeling

BPD sufferers talk about their empty feeling as if there is a void or hole inside. Extreme cases involve the individual feeling like they are nothing; since this a very uncomfortable feeling the individual tries to fill the void with all sorts of things like overspending, sex, food or drugs but nothing brings the desired satisfaction.  

Unstable and Unclear Self-Image

Anyone with BPD has a very unstable self. Sometimes the individual feels great about themselves yet other times she/he might feel worthless or evil. The individual usually has no clue about who he/she is or what he/she really wants in life. Such an individual is always changing jobs, sexual identity, goals, values, religion, lovers and friends.


Individuals with BPD are always engaging in deliberate suicidal behaviour and self harm. They make suicidal threats, gestures, think about suicide or actually attempt suicide. Self-harm activities include any attempt to harm without the intent to commit suicide such as burning or cutting yourself.

Self-Destructive Impulsive Behaviours

Those with BPD are always engaging in high sensational harmful behaviours, particularly when they are upset. This includes binge eating, shoplifting, risky sexual behaviours, overdoing alcohol or drugs, driving recklessly or spending money one cannot afford.

Intense Emotional Swings

BPD is highly characterised by unstable moods and emotions. For instance, the individual feels happy one moment and despondent the next. Little things most people don’t care about or brush off lead to emotional tailspins. Intense mood swings result but pass quite fast unlike bipolar disorder or depressing emotional swings.

Treatment of BPD:

Once an individual has been identified as having BPD, there are a number of treatments available. They include:

Counselling – Counsellors work with the sufferer until a solution to the problem has been found and ways of coping with the problem arrived at.

Psychotherapy – Psychotherapy helps the patient to see things in a different light and another perspective. Better choices are then explored to effect positive change.

Emotional Focused Therapy – EFT as its commonly known helps individuals deal with difficult emotions. This allows BPD patients to feel stronger in the future if challenging emotions and emotional experiences result.

Mindfulness – This type of therapy helps the BPD sufferer to focus awareness and attention to reality or present moment and ensures stresses and anxieties have dissipated.

Cognitive Behavioural Therapy – CBT, as it’s commonly referred to, is widely known as the most effective approach in the treatment of BPD and other mental health complications effectively.

At Spectrum Health, adults and young people dealing with BPD are accorded the critical help they need. Our psychologists also possess the skills required for helping children, young people and adults who are experiencing other difficulties as well as the ability to conduct a wide range of psychological assessments. All of our Counsellors and Psychologists are fully qualified and are members of the Psychological Society of Ireland.