90+ Facts & Stats About Borderline Personality Disorder (from 56 sources)

While the prevalence of any personality disorder in the U.S. adult population is 9.1%, the prevalence of borderline personality disorder is 1.4%, based on diagnostic interview data.^[1]

Borderline Personality Disorder (BPD) is a mental health condition that displays symptoms such as intense mood swings, fear of rejection, and difficulty in maintaining successful relationships. But it’s also marked by misconceptions and a lack of understanding.

In this article, we feature all the facts about BPD that you need to know, such as its causes, symptoms, how to manage the condition correctly, and notable studies that have been conducted on it.

• The prevalence of borderline personality disorder could be as high as 5.9 percent. [The Recovery Village]^[2]
• The limited epidemiological data available on borderline personality disorder suggest that the prevalence of the disorder is between .2 and 1.8 percent in the general community, 15 percent among psychiatric inpatients, and 50 percent among psychiatric inpatients with a personality disorder diagnosis [Hospital and Community Psychiatry] ^[3]
• Borderline personality disorder causes significant impairment and distress and is associated with multiple medical and psychiatric co-morbidities. [National Library of Medicine]^[4]

Causes and risk factors of borderline personality disorder

• Borderline personality disorder (BPD) is likely to be caused by a combination of factors, such as genetics, environmental factors, childhood experiences, and brain structure differences. [NHS]^[1]
• Having a family member with the mental health condition increases one’s risk of being diagnosed with BPD. [JAMA Psychiatry]^[5]
• Many people with BPD have altered levels of serotonin, a neurotransmitter in the brain that is involved in mood regulation, aggression, and impulse control. For example, BPD is defined by many symptoms linked to serotonergic dysregulation, such as suicidal behaviors and lack of impulse control. [Acta Neuropsychiatrica]^[6]
• In many people with BPD, three parts of the brain are either smaller than expected or have unusual levels of activity: the amygdala, which regulates emotions; the hippocampus, which regulates behavior and self-control; and the orbitofrontal cortex, which is involved in planning and making decisions. [NHS]^[1]
• Problems with these parts of the brain may contribute to symptoms of BPD, such as fear of abandonment, unstable relationships, mood swings, impulsiveness, and self-image issues. [Mayo Clinic]^[7]
• The development of these parts of the brain is affected by one’s early upbringing, which may also play a role in the onset of BPD. [NHS]^[1]
• Factors that increase the risk of developing BPD include being a victim of emotional, physical or sexual abuse; being exposed to long-term fear or distress as a child; being neglected by one or both parents; growing up with another family member who had a serious mental health condition or substance abuse problem; and experiencing severe long-term stress. [National Library of Medicine]^[4]
• Over 71% of people with BPD have experienced a form of trauma. Childhood trauma or abuse can affect the development of trust, attachment, and emotional regulation in a person with BPD. It can also lead to shame, guilt, anger, and low self-worth. [Psych Central]^[8]
• BPD can harm many areas of a person’s life, such as their intimate relationships, jobs, school, social activities, and self-image. [Mayo Clinic]^[7]
• People with borderline personality disorder have a significantly higher rate of self-harming and suicidal behavior than members of the general population. [National Institute of Mental Health]^[9]
• Between 3% and 10% of people with BPD commit suicide, which is over 50 times the rate of suicide in the general population. [American Journal of Psychiatry]^[10]
• Self-harming is often triggered by fear of abandonment, rejection, or disappointment in a loved one. [Cleveland Clinic]^[11]
  

Symptoms and diagnostic criteria of borderline personality disorder

• People with borderline personality disorder may experience intense mood swings and experience uncertainty about how they perceive themselves. [National Institute of Mental Health]^[9]

• They may switch from loving and admiring someone to hating and despising them, often without a clear reason. This is known as “splitting.” [Very Well Mind]^[12]
• People with borderline personality disorder may view things in extremes, such as all good or all bad. This may cause them to act impulsively or recklessly. [National Institute of Mental Health]^[9]
• BPD is diagnosed based on a set of nine criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the official source of diagnostic information for psychiatric disorders. [Very Well Mind]^[13]
• To be diagnosed with BPD, a person must exhibit at least five of the nine criteria, and the symptoms must be pervasive, persistent, and cause significant distress or impairment in functioning. [Very Well Mind]^[13]
• The nine criteria for BPD are: chronic feelings of emptiness; emotional instability; frantic efforts to avoid abandonment; identity disturbance; impulsive behavior; inappropriate anger; unstable relationships; suicidal or self-harming behavior; and transient paranoia or dissociation. [Very Well Mind]^[13]
• People with BPD may engage in impulsive and risky behaviors, such as substance abuse, binge eating, reckless driving, or unsafe sex. These behaviors may be attempts to cope with negative emotions or to fill a sense of emptiness. [National Institute of Mental Health]^[9]
• People with BPD may experience transient episodes of paranoia or dissociation when under stress. Dissociation is a feeling of being detached from oneself or reality, such as feeling numb, unreal, or outside one’s body. [National Institute of Mental Health]^[9]

Co-occurring disorders and conditions of borderline personality disorder

• Borderline personality disorder often co-occurs with other mental health disorders, such as mood disorders, anxiety disorders, substance use disorders, eating disorders, and post-traumatic stress disorder (PTSD). [National Institute of Mental Health]^[9]
• Co-occurring disorders can make it more challenging to correctly diagnose and treat BPD, especially when the disorders share symptoms. [National Institute of Mental Health]^[9] For example, a person with BPD may also experience symptoms of major depression, bipolar disorder, panic disorder, or alcohol use disorder.
• The co-occurrence of BPD and other mental health disorders can also worsen the outcomes and prognosis of both conditions. [Recovery Ranch]^[14] For example, a person with BPD and substance use disorder may have more severe impulsivity, suicidal behavior, and interpersonal problems than a person with either condition alone.
• The prevalence of co-occurring disorders among people with BPD varies depending on the type of disorder. However, some studies have estimated that about 85% of people with BPD have at least one co-occurring disorder. [Brain Sciences]^[15]
• The most common co-occurring disorder among people with BPD is major depressive disorder (MDD): 83% of people with BPD meet the criteria for major depressive disorder. [Very Well Mind]^[16]
• Another common co-occurring disorder among people with BPD is bipolar disorder, which affects about 20% of people with BPD. [Medicina]^[17]
• Anxiety disorders also frequently occur with BPD, affecting about 60% of people with BPD. [Everyday Health]^[18]
• Substance use disorders are another common co-occurring condition among people with BPD, with approximately 78% of adults with BPD developing a substance abuse disorder at some point in their lives. [Borderline in the Act]^[19]
• Eating disorders are prevalent among people with BPD, affecting about 50% of people with BPD. [Very Well Mind]^[20]
• PTSD is commonly seen in 25% to 50% of people who have BPD. [Very Well Mind]^[21]
  Treatment options for borderline personality disorder
• Borderline personality disorder is mainly treated using psychotherapy, but medication and hospitalization may be included. [Mayo Clinic]^[22]
• Psychotherapy can help you learn skills to manage and cope with your condition. [Mayo Clinic]^[22] These include helping you to focus better and manage uncomfortable emotions.
• Types of psychotherapy that have been found to be effective for treating BPD include dialectical behavior therapy (DBT), schema-focused therapy, mentalization-based therapy (MBT), and systems training for emotional predictability and problem-solving (STEPPS). [Mayo Clinic]^[22]
• A study that compared schema therapy (ST) and dialectical behavior therapy (DBT) for borderline personality disorder found that both treatments were effective in reducing BPD symptoms and costs. [BMC Psychiatry]^[23]
• However, in the same study, schema therapy (ST) showed a higher retention rate and a greater improvement in global functioning, or one’s ability to cope with various life aspects. [BMC Psychiatry]^[23]
• Medication can help reduce BPD symptoms such as depression, anxiety, anger, impulsivity, or self-harm. [Mayo Clinic]^[22]
• Some medications that may be prescribed for BPD are antidepressants, antipsychotics, and mood stabilizers. [Mayo Clinic]^[22] 
• Self-care can also play a role in treatment. Some self-care strategies that may help are enrolling in support groups, sharing experiences and feelings, doing breathing exercises, and seeking help when needed. [Medical News Today]^[24]

Coping strategies and self-help for borderline personality disorder

• One way to cope with self-harm urges is to use distraction techniques, such as listening to music, watching a movie, playing a game, calling a friend, or doing something creative. [Barend Psychology]^[25] These activities shift the focus away from negative emotions and provide some relief.
• Another way to cope with the urge to self-harm is to use alternative methods that cause less harm, such as holding ice cubes, snapping a rubber band on the wrist, or squeezing a stress ball. [Healthline]^[26]
• People with BPD can cope with their emotions by using mindfulness techniques, such as deep breathing, meditation, or observing the present moment without judgment. [Very Well Mind]^[27]
• Mindfulness can help calm the nervous system, increase awareness of emotions and thoughts, and reduce reactivity and impulsivity. [Very Well Mind]^[27]
• Writing down feelings on paper or in a diary can be a helpful coping strategy for people with BPD. [Optimist Minds]^[28]  Writing can help people express and release emotions, gain insight and perspective, and track patterns and triggers over time.
• People with BPD can benefit from finding support from others who understand their condition and can offer empathy and encouragement. Support reduces feelings of isolation, loneliness, and shame, and increases feelings of belonging, acceptance, and hope. [Very Well Mind]^[29]
• People with BPD can cope with their impulsive behaviors by managing what’s known as the emotion mind,” which occurs when they close themselves off to feedback from others. [Borderline Personality Disorder]^[30] To deal with this, techniques such as paying attention to thoughts, noticing body sensations, and pausing before taking action can help.
• People with BPD can cope with their relationship problems by using interpersonal effectiveness skills, such as expressing their needs and feelings clearly and respectfully, listening actively, setting healthy boundaries and limits, negotiating compromises and solutions, and validating others’ perspectives and emotions. [Very Well Mind]^[31]
• To better manage negative thoughts and feelings, cognitive restructuring techniques, such as identifying and challenging distorted thoughts (e.g., black-and-white thinking), replacing negative thoughts with more balanced and realistic ones, and using positive affirmations and self-compassion statements are beneficial. [Healthline]^[32]

The impact of BPD on relationships

• People with BPD may have a distorted and unstable self-image or sense of self. [National Institute of Mental Health]^[9]
• They may act impulsively and dangerously, such as by engaging in spending sprees, unsafe sex, substance abuse, reckless driving, or binge eating. These behaviors can harm themselves and others, and damage their relationships, jobs, school, or social activities. [National Institute of Mental Health]^[9]

• People with BPD may have a fear of abandonment or rejection, which can make them clingy or needy in relationships. [Very Well Mind]^[33]
• They may also tend to idealize or devalue people in their lives, which can cause instability and conflict in their relationships. [Medical News Today]^[34]
• People with BPD may have difficulty trusting others and communicating their needs and feelings effectively. [Medical News Today]^[34]
• Trouble setting boundaries and respecting those of others can also be a problem because they see others’ boundaries as rejection. [My Side of the Couch]^[35] This can lead to misunderstandings, arguments, or resentment.
• People with BPD may experience intense anger or problems controlling anger. They may lash out at others verbally or physically, or act passive-aggressively. This can hurt their relationships and social reputation, especially when combined with mood swings. [Mayo Clinic]^[7]
• People with BPD may experience dissociation, such as feeling cut off from themselves, observing themselves from outside their body, or feeling unreal. [National Institute of Mental Health]^[9]
• They may face stigma and discrimination from others who do not understand their condition or blame them for their symptoms. [Rethink]^[36] This can cause them to internalize negative messages about themselves and feel hopeless or worthless.

The stigma and misconceptions of borderline personality disorder

• Borderline personality disorder is a mental illness that is frequently misunderstood, misdiagnosed, and stigmatized. People with BPD may face stereotypes that they are dramatic, manipulative, and attention-seeking, which can affect their treatment and well-being. [Very Well Mind]^[37]
• BPD is not the same condition as bipolar disorder or antisocial personality disorder, although they may share some symptoms. [Clearview Treatment]^[38] BPD is characterized by a pervasive pattern of instability in mood, behavior, self-image, and interpersonal functioning. Bipolar disorder is characterized by episodes of mania and depression that usually last for weeks or months. An antisocial personality disorder is characterized by a disregard for the rights of others and a lack of remorse or empathy.
• BPD is not a lifelong sentence or a fixed identity. People with BPD can change and grow over time with treatment and support. [Help Guide]^[39]
• Many people with BPD experience a reduction in their symptoms as they age or engage in therapy. [Very Well Mind]^[40]
• Some people with BPD may no longer meet the criteria for the diagnosis after several years of recovery. [Canadian Journal of Psychiatry]^[41]
• BPD is not a reason to give up on yourself or your dreams. People with BPD can achieve their potential and live fulfilling and meaningful lives. [Sane]^[42]
• One person with BPD said that receiving the diagnosis caused them to feel a million different emotions simultaneously, such as relief, terror, and confusion. [National Alliance on Mental Illness]^[43] They also struggled to find adequate mental health services in their community.
• Another person with BPD said that they felt like their diagnosis was used against them by others who accused them of using it as an excuse for their bad behavior. [National Alliance on Mental Illness]^[44] They also felt like they had no support system and no hope for recovery.
• A third person with BPD said that the disorder impacts their life in every way, every single day. [Rethink]^[36] They described BPD as a disorder of instability in emotions, thought patterns, beliefs, behaviors, interpersonal relationships and sense of self. But, they also said that recovery is possible with the right treatment and support.
• A fourth person with BPD said that they felt overwhelmed by, and struggled to cope with, their intense emotions. [New York Presbyterian]^[45] They found help through dialectical behavior therapy (DBT) and medication.
• A fifth person with BPD said that they struggle every day with symptoms such as suicide ideation, and it hasn’t helped them to be surrounded by loved ones who don’t provide support. Getting help from a licensed trauma therapist and following self-care practices, such as taking care of themselves, was beneficial. [Emotions Matter]^[46]
• A sixth person with BPD said they struggled with BPD and co-occurring conditions such as eating disorders, alcohol abuse, and suicide attempts. It was only after committing to talk therapy and medication that they started to feel more in control of their condition. [Lenco Lab]^[47]

Research and future directions of borderline personality disorder

• BPD is associated with an increased risk of psychiatric disorders, somatic illnesses, and adverse behaviors, such as substance use, criminality, and suicide. [Nature]^[48]
• BPD may have a shared genetic etiology with other mental health conditions, such as trauma. [Nature]^[48]
• A recent review suggested that circadian rhythm disturbance is a common feature of BPD that may worsen symptoms and impair functioning. [Current Psychiatry Reports]^[49] 
• A study found that BPD is associated with reduced volume in several brain regions involved in emotion regulation, social cognition, and impulse control. [Journal of Psychiatry & Neuroscience]^[50] 
• The above study also suggested that environmental factors, such as childhood trauma or stress may influence these brain alterations. [Journal of Psychiatry & Neuroscience]^[50] 
• This research also suggested that this connectivity pattern may be related to emotional dysregulation and impulsivity in BPD. [Nature]^[51]  
• Some core symptoms of BPD include emotional dysregulation, impulsivity, and interpersonal hypersensitivity.

• Although these heartbeat fluctuations are not detectable, they can indicate health problems, such as mental health conditions such as depression and anxiety. [My Cleveland Clinic]^[53] 
• The same study supports the idea that mistrust and negativity bias can be observed in the social interactions of people with BPD. [Frontiers]^[56]
• Research has found that rejection during childhood, specifically emotional abuse and neglect, is linked to rejection sensitivity which is associated with BPD. [British Journal of Clinical Psychology]^[54] 
• BPD is associated with impaired theory of mind, the ability to infer the mental states of others. In a study, BPD patients significantly underperformed in overall theory of mind and mental state reasoning when compared to people who didn’t have BPD.  [Psychiatry Research]^[55] 
• A study that investigated whether people with BPD expected negativity in their interactions found that their expectations of selfishness from others outweighed the expectations of selfishness in the group of people without BPD. [Frontiers]^[56] 
• A recent study found that BPD is associated with altered functional connectivity between the amygdala and the prefrontal cortex, two brain regions involved in emotional processing and regulation. [Nature]^[51]  

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Eric Van Buskirk

Van Buskirk has a BS in Psychology from Skidmore, 1988. His Master of Science is from Boston University, 1997.

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