​Borderline Personality Disorder

Borderline personality disorder (BPD) is a serious mental illness that causes unstable moods, behaviour, and relationships. This is a type of mental health problem where your attitudes, beliefs and behaviours cause you to have problems in your life. This disorder usually begins in early adulthood and sometimes gets better with age.

With borderline personality disorder, you have an intense fear of abandonment or instability, and you may have difficulty tolerating being alone. However, because of anger, impulsiveness and frequent mood swings, you push others away, even though you want to have loving and lasting relationships.

The exact causes of borderline personality disorder are unknown, although research suggests that it is likely to be caused by a combination of genetic, environmental and social factors. Adults with borderline personality disorder are considerably more likely to have been victims of violence, including rape and other crimes.


Common symptoms of BPD include:

  • Extreme reactions (such as panic, depression or rage) to normal situations

  • Unstable relationships with family and friends

  • Distorted self-image with sudden changes in feelings, opinions, values, or goals

  • Impulsive and dangerous behaviour such as spending sprees, unsafe sex, substance abuse, reckless driving etc.

  • Suicidal threats or self-harming behaviour

  • Intense and highly versatile moods

  • Problems controlling your temper

  • Paranoid thoughts about out of body experiences​


If you feel socially isolated and harbour feelings of anger, suspicion and detachment, seek help from your doctor working with the Mind and Brain Service Line​ at The Aga Khan University Hospital.​
Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here​ are some tips to help get you started.​
No single test can diagnose BPD, therefore it is often underdiagnosed or misdiagnosed, and also because the symptoms are common to other types of disorders. Your psychiatrist or psychologist will attempt to detect BPD on the basis of a detailed interview and a discussion about your symptoms.  You will be asked about personal and family medical histories, including any history of mental illnesses. This information will help your doctor to decide upon the best treatment.

In many cases, BPD co-exists with other mental illnesses, making it difficult to distinguish. This is especially true if you don't discuss all of your symptoms with your doctor in detail. In women, BPD is more likely to co-exist with major depression, anxiety disorders, or eating disorders. In men, BPD is more likely to co-exist with disorders such as substance abuse or antisocial personality disorder.

Other illnesses that often occur with BPD include diabetes, high blood pressure, chronic back pain and arthritis. These conditions are associated with obesity, which is a common side effect of the medications prescribed to treat BPD and other mental disorders.​
Psychotherapy is the main form of treatment for BPD. Therapy or counselling will involve talking to your doctor about your feelings and symptoms, and building rapport and trust over time. The most common type of psychotherapy that may be used to treat BPD is cognitive behavioural therapy (CBT). CBT can help you to identify and change your core beliefs and/or behaviours that may be causing an inaccurate perception of yourself and others and consequently creating problems in your interactions with others. CBT may help reduce a range of mood and anxiety symptoms and reduce the number of suicidal or self-harming behaviours.

Medication is generally not used to treat BPD but for some people, medications can help reduce symptoms such as anxiety, depression, or aggression. While medications do not cure BPD, some medications may be helpful in managing specific symptoms. Medications can cause different side effects in different people. If you have BPD, you should discus with your doctor about what to expect from a particular medication.​
The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.
 
The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.
 
The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​
Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​
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The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.