What is Borderline Personality Disorder

Borderline personality disorder is a type of personality disorder characterized by emotional instability, interpersonal conflicts, and self-identity confusion. Borderline personality disorder is mainly characterized by intense emotional fluctuations, fear of abandonment, impulsive behavior, self harm or suicidal tendencies, tense interpersonal relationships, blurred self-image, strong feelings of emptiness, difficulty in controlling anger, and temporary loss of sense of reality. This disease may be related to childhood trauma, genetic factors, abnormal brain function, family environment, social and psychological factors, etc. Patients require long-term psychological therapy combined with medication intervention, and early intervention can help improve prognosis.

1. Emotional instability

Borderline personality disorder patients have large fluctuations in emotions and rapid transitions, which may quickly shift from extreme pleasure to deep depression. This emotional instability is often triggered by small external stimuli, making it difficult for patients to self regulate. Typical manifestations include anger erupting and quickly turning into self blame, or a strong dependence on others followed by sudden estrangement. The deficiency of emotional regulation ability is considered one of the core features of this disease, which is related to overactive amygdala and insufficient function of prefrontal cortex.

2. Interpersonal Relationship Conflict

Patients have a black-and-white cognitive pattern towards interpersonal relationships, often quickly switching between idealizing and belittling others. The anxiety of being abandoned leads to excessive dependence or preemptive termination of relationships. In intimate relationships, behaviors such as control, suspicion, and testing the other party's loyalty often occur. This interpersonal pattern stems from early damage to attachment relationships, and psychotherapy needs to focus on improving patients' relationship cognition and interaction styles.

3. Self Identity Disorder

Borderline personality disorder patients generally have self-awareness confusion, manifested by frequent changes in core identity elements such as career goals, values, and sexual orientation. Often accompanied by chronic feelings of emptiness and existential anxiety, some patients alleviate this pain through substance abuse, overeating, or self harm. The difficulty of identity integration is related to the lack of stable mirror experiences during childhood, and the self-identity module in dialectical behavioral therapy provides targeted interventions for this.

4. Impulsive behavior

Patients often exhibit impulsive behaviors such as substance abuse, risky behavior, overeating, extravagant consumption, and reckless driving. Self injury behaviors such as wrist cutting and burns are more common during emotional breakdowns, with the aim of regulating pain rather than suicide. This type of behavior is associated with abnormal serotonin system function, and mood stabilizers and antidepressants are often used in medication to improve impulse control.

5. Cognitive distortion

Patients may experience transient loss of reality or paranoid thoughts under stress, but not to the extent of psychotic symptoms. Common cognitive distortions include catastrophizing thinking, mind reading errors, emotional reasoning, and so on. These symptoms usually have a short duration and are associated with acute stress reactions, requiring differential diagnosis from diseases such as schizophrenia. Patients with borderline personality disorder need to establish stable treatment relationships, and dialectical behavioral therapy and psychogenic basic therapy are empirically effective psychological intervention methods. Drug therapy mainly targets specific symptoms such as depression, anxiety, or impulsivity. Family members should learn about diseases, avoid excessive involvement or simple accusations, and establish clear boundaries. Patients can engage in self-management through mindfulness training, emotional diaries, and regular daily routines, gradually developing their emotional regulation abilities and adaptive coping strategies. The establishment of a social support system is crucial for rehabilitation, and participating in professional support groups can help reduce feelings of shame.