As the use of AI therapy chatbots grows, so do potential dangers
Can AI help close the mental health gap, or is it doing more harm than good?
Mental health disorders come in many forms and affect thoughts, emotions and behaviors in complex ways. Conditions like anxiety, depression and bipolar disorder are among the most frequently diagnosed in the United States, but borderline personality disorder, or BPD, is a less common mental health condition that still impacts millions of people.
In fact, some 1.4% of U.S. adults have BPD, according to the U.S. National Institute of Mental Health (NIMH). However, some research suggests the true prevalence may be much higher due to underdiagnosis and the stigma surrounding personality disorders.
Here’s what BPD is, what causes it, how it is treated and why there is hope.
What is borderline personality disorder? Symptoms of BPD?
Borderline personality disorder is a complex mental health condition “characterized by a persistent instability in mood, behavior and self-image,” explains Amanda Darnley, a clinical psychologist based in Philadelphia. People with BPD “feel things deeply and intensely,” she explains, which makes emotional regulation a significant challenge.
It can lead to a range of symptoms and unwanted outcomes, including unstable relationships, intense anger, chronic feelings of emptiness, stress-related paranoia or dissociation and self-destructive behaviors such as substance abuse, reckless driving or self-harm. “Sudden mood swings, fear of abandonment and impulsive behaviors are also common,” adds Jimmy Noorlander, LCSW, a clinical social worker at Deseret Counseling in Utah. “It’s also important to note that symptoms can vary in severity and may look different from person to person.”
BPD can severely impact day-to-day functioning and often places intense strain on personal relationships. For instance, someone with BPD might have an overwhelming reaction to something like a canceled plan and feel devastated, rejected and question the entire relationship.
Diagnosing BPD involves a comprehensive psychological evaluation by a licensed mental health professional. While such evaluations can happen at most any age, diagnosis typically occurs in individuals over the age of 18, since many symptoms can overlap with normal adolescent development.
What is the cause of borderline personality disorder?
While “the exact causes of BPD are multifactorial and not fully understood,” explains Amber McGregor, a doctor of education and the clinical director of 1st Priority Institute for Better Living in Colorado, “BPD is often linked to a combination of genetic predisposition, environmental factors and neurological differences in emotional regulation.”
For example, a highly sensitive child with a naturally reactive temperament may do well in a nurturing environment but could be at higher risk for BPD if raised in “invalidating environments, where emotions are criticized, ignored, ridiculed or even punished,” says Darnley. These kinds of environments can impair the development of healthy coping strategies. Childhood trauma or abuse is also commonly reported among people diagnosed with BPD.
Genetics play a significant role as well, as research shows that heritable factors account for about 40% to 60% of a person’s risk for developing BPD. Indeed, the NIMH notes that those with a close family member who has BPD may be at increased risk themselves.
Neurological differences may also contribute. “People with BPD may have functional changes in brain areas that control impulses and regulate emotions,” McGregor explains. However, she says that much is still unknown about how – or if – these differences directly influence symptoms.
How is borderline personality disorder treated?
There are proven, effective treatment options available to people with BPD. The cornerstone of BPD treatment is psychotherapy, particularly dialectical behavior therapy (DBT) as it’s a method specifically developed for BPD. “This treatment teaches strategies for regulating emotions, ways to tolerate distress and skills necessary for healthy relationships,” says Darnley.
Other therapies, such as cognitive behavioral therapy (CBT) and schema therapy, can also be helpful in addressing unhelpful thought patterns and unresolved childhood experiences, adds Noorlander.
While medication is not the primary treatment for BPD, a therapist may prescribe antidepressants, mood stabilizers or antipsychotics to help a patient manage symptoms like depression, anxiety or impulsivity.
Also important is having “a strong support system,” notes Noorlander, which includes family, friends and peer support groups helping individuals with BPD feel understood, connected and encouraged in their journey toward recovery.
“Living with borderline personality disorder can be incredibly challenging, but it’s important to know that recovery is not only possible – it’s common,” offers McGregor. “With the right treatment, support and self-compassion, many individuals with BPD go on to build healthy relationships, develop emotional stability and lead fulfilling, meaningful lives.”