Breaking the Stigma: How Can We Better Understand and Treat Borderline Personality Disorder?

Understanding Borderline Personality Disorder: Characteristics and Impact

Borderline Personality Disorder (BPD) is a complex and often misunderstood mental health condition that affects how a person thinks, feels, and relates to others. Those living with BPD often experience intense emotional fluctuations, unstable relationships, a fragile sense of self, and difficulty managing impulses.

Common characteristics of BPD may include:

• A deep fear of abandonment and strong efforts to avoid real or perceived rejection

• Intense, rapidly shifting emotions

• Unstable interpersonal relationships that alternate between idealization and devaluation

• Impulsive or self-destructive behaviors (e.g., self-harm, binge eating, substance use)

• Chronic feelings of emptiness

• Episodes of intense anger, anxiety, or sadness

• Difficulty trusting others, along with dissociation or feelings of unreality, especially under stress

The impact of BPD can be significant, affecting self-esteem, relationships, and day-to-day functioning. However, with appropriate support, individuals with BPD can build resilience, develop emotional regulation skills, and lead fulfilling lives.

"Borderline Personality Disorder can make you feel deeply alone—even in a room full of people. You’re not too much, and you’re not alone. Healing is possible, and connection is within reach."

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Effective Therapeutic Coping Skills for BPD

Treatment for BPD often involves a combination of evidence-based therapeutic approaches and practical coping strategies. Some of the most effective skills and supports include:

• Dialectical Behavior Therapy (DBT): DBT is a gold-standard treatment for BPD. It teaches key skills in four areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

• Mindfulness Practices: Learning to stay grounded in the present moment helps individuals become more aware of their thoughts and feelings without becoming overwhelmed by them. Click here, for an introduction to mindfulness activity.

• Emotion Regulation Techniques: These include identifying and naming emotions, increasing positive experiences, and reducing vulnerability to emotional extremes (such as through sleep, nutrition, and self-care).

• Distress Tolerance Skills: Strategies like grounding techniques, sensory-based coping (e.g., using ice or deep pressure), and "TIPP" skills (temperature, intense exercise, paced breathing) can help individuals manage acute emotional pain without engaging in harmful behaviors.

• Interpersonal Effectiveness Training: Helps individuals develop assertiveness, set boundaries, and maintain relationships in healthier, more stable ways.

• Cognitive Behavioral Therapy (CBT): Can be helpful in identifying and challenging unhelpful thought patterns that contribute to emotional instability and interpersonal conflict.

• Self-Compassion and Validation: Learning to treat oneself with kindness and understanding can reduce shame and support healing, especially when paired with guidance from a trauma-informed therapist. To help you explore mindfulness and self-compassion, click here.

• Creative Expression: Journaling, art, music, or movement can provide safe outlets for emotional processing.

• Routine and Structure: Having a predictable daily rhythm can reduce feelings of chaos and provide a greater sense of safety and control.

"For minds that feel chaotic and emotions that shift like waves, mindfulness offers a moment of stillness. With BPD, each breath is a step toward grounding, clarity, and self-compassion."

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Steps to Emotional Regulation

1. Breathing: Slow, intentional breathing is a powerful way to calm your body and mind. Taking deep breathes allows you to process more information and continue to follow the steps to emotionally regulate.

2. Identify the Emotion: Recognize what you're feeling and name the emotion (e.g., anger, sadness, fear). For help identifying your emotion(s), click here.

3. Understand the Emotion’s Source: Explore what triggered the emotion and whether it fits the situation. For help exploring and understanding your emotion(s) and where it comes from, click here.

4. Check the Facts: Ask yourself: Is this emotion based on facts or assumptions? Challenge distorted thoughts if needed. Click here for a simple worksheet on challenging negative thoughts.

5. Increase Awareness Without Judgment: Mindfully observe your emotions without reacting impulsively or criticizing yourself.

6. Choose a Healthy Response: Use skills like deep breathing, grounding, or taking a break to pause and respond rather than react.

7. Engage in Opposite Action (if appropriate): If the emotion isn’t serving you (e.g., fear keeping you stuck), act opposite to the urge (e.g., face the fear calmly).

8. Practice Self-Compassion: Validate your experience and remind yourself that emotions are human and manageable.

   
   
   
   

   Breathing is one of the most powerful and accessible tools we have to regulate our emotions and calm the nervous system. When we feel overwhelmed, anxious, or emotionally dysregulated, our breath often becomes shallow and rapid, signaling the body to stay in a state of stress. By slowing and deepening our breath, we activate the parasympathetic nervous system—our body’s natural calming response—helping us return to a grounded, balanced state. Conscious breathing creates space between feeling and reaction, allowing us to respond with clarity rather than impulse.

"Emotional dysregulation in BPD can feel overwhelming—like a storm you can’t escape. But with the right coping skills, like grounding, and mindfulness, calm is possible. Healing starts with one skill, one breath, one moment at a time."

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EMDR and Ego States Therapy in the Treatment of BPD

In addition to the above, Eye Movement Desensitization and Reprocessing (EMDR) and Ego States Therapy can be powerful tools in treating the trauma-related components often underlying BPD. EMDR is a structured therapy that helps individuals reprocess distressing memories and reduce the emotional intensity tied to them. For individuals with BPD—many of whom have histories of early attachment trauma, abuse, or neglect—EMDR can support healing by decreasing the emotional reactivity triggered by past experiences. For more information on EMDR therapy, see our blog here.

Ego States Therapy works by helping individuals identify and work with different "parts" of the self—often developed as protective responses to trauma or overwhelming emotions. These parts may hold intense emotions, unmet needs, or internal conflicts. By helping clients build awareness, compassion, and communication between these internal states, Ego States Therapy promotes self-integration and emotional regulation, which are critical in the treatment of BPD. For more information about Ego-States therapy, see our blog here.

"Healing the parts within: EMDR and Ego States Therapy help untangle trauma and bring harmony to the fragmented self in Borderline Personality Disorder. Recovery is possible, one step at a time."

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Healing from BPD is absolutely possible. With the right tools, therapeutic support, and self-compassion, individuals can build emotional resilience, strengthen relationships, and experience meaningful change.

If you or someone you care about is living with BPD, you are not alone—and support is available.

"No matter how heavy the struggle feels, there is hope—and help is within reach. You don’t have to face Borderline Personality Disorder alone. Healing begins with safe connections."

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Frequently Asked Questions about Borderline Personality Disorder

What is Borderline Personality Disorder?

BPD is a serious mental health condition marked by unstable moods, self-image, behavior, and relationships. It's classified in the DSM‑5 as one of the personality disorders.

What are the symptoms of BPD?

Typical signs include intense mood swings, fear of abandonment, chronic emptiness, impulsivity, dissociation under stress, and unstable interpersonal relationships characterized by idealization and devaluation. It's important to note that having a few characteristics of BPD does not necessarily mean you have BPD. Diagnosis of any personality disorder is complex and takes into account more than a checklist of self reported experiences and symptoms.

What causes BPD?

The condition often arises due to a combination of genetic predisposition, brain differences, and early life trauma or invalidating environments during childhood. If you want to explore causes in relation to yourself, in more depth, the book, "The Borderline Personality Disorder Workbook," by Daniel J Fox, is a great starting point.

How is BPD diagnosed?

 A diagnosis typically requires a clinical interview focusing on DSM‑5 criteria—such as emotional instability, identity disturbance, impulsivity, and fear of abandonment—and ruling out other overlapping conditions like bipolar disorder or PTSD. In British Columbia, diagnosis requires you to see a psychiatrist, psychologist and/or a licensed healthcare practitioner that specializes in assessment of personality disorders.

Is BPD the same as bipolar disorder?

No—while both involve mood changes, BPD moods are rapidly triggered by relationships or stress, whereas bipolar mood episodes are longer and driven by biological factors. Receiving proper assessment is beneficial for client's as treatment for these two disorders varies.

What treatments are effective?

Psychotherapy is the primary treatment, with Dialectical Behavior Therapy (DBT) being recommended frequently. Other effective options include Cognitive Behavioral Therapy (CBT), Transference-Focused Psychotherapy (TFP), EMDR, Ego States Therapy, and supportive therapy. Many clients report benefiting from a combination of a skills based therapy and a trauma specific therapy.

How common is BPD?

Around 1–2% of the general population are affected, and up to 20% of psychiatric inpatients may have BPD.

Can medication help?

There are no medications designed specifically for BPD. However, medication may be prescribed to address co-occurring symptoms like depression, anxiety, or mood instability. Talking to your healthcare provider and being referred to a psychiatrist are generally recommended to help understand and manage medications for the treatment of BPD.

Can people recover from BPD?

Yes! Research shows that around 50–70% of individuals experience significant symptom remission over five to ten years with appropriate treatment.

How can I support someone with BPD?

Suggestions include encouraging professional help, maintaining empathy, learning communication skills, and setting clear, loving boundaries. Peer support and mood tracking can also be beneficial. Receiving professional support can help you with the suggestions above.