What is BPD?
Living With Big Emotions Has a Name
Important note:
This page is educational and not a substitute for professional evaluation. If you or someone you love is in immediate danger or at risk of self-harm, seek urgent help in your local area right away.
Borderline personality disorder (BPD) is a mental health diagnosis that describes patterns of intense emotions and behaviors employed to deal with them—and with the right skills and support, those patterns can change.
BPD affects how a person experiences and manages emotions. People with BPD often feel emotions very intensely, very quickly, and for more extended periods of time than others. Once emotions are triggered, it can be difficult to calm down and return to a sense of balance. Intense emotions may lead to:
- Rapid shifts in mood
- Fear of abandonment
- Difficulty trusting others
- Behaviors aimed at reducing emotional pain in the moment
Reframing BPD through the lens of emotion dysregulation changes the story from blame to clarity, and from hopelessness to practical pathways for change.
What Causes BPD?
People often want a simple answer to what causes borderline personality disorder (BPD). However, there is no single pathway, no single factor, and no single person or system behind it—BPD’s causes are complex, and can be best understood through a transactional model between inborn emotional vulnerabilities and environmental factors.
With over 200 possible combinations of symptoms, both BPD’s presentation and its causes are different from person to person. For some, an emotionally sensitive temperament may play a prominent role in the development of BPD. For others, environmental stressors or invalidation may contribute more. Most often, it is the interaction between these elements—not any one factor alone—that increases the risk of developing BPD.
What about Diagnosis?
BPD is diagnosed through careful clinical evaluation, not a single test or quick checklist, based on patterns that persist over time.
A trained mental health professional looks at things like:
- How strongly emotions are felt
- How difficult it is to calm down once emotions are triggered
- How emotions affect daily life, safety, and relationships
- The level of distress these patterns cause over time
Diagnostic criteria can feel confusing, stigmatizing, or incomplete. We see diagnosis as a tool for understanding and treatment fit, not a label that defines a person. A focus on the underlying patterns that shape people’s experiences—particularly severe and chronic emotion dysregulation, and how it affects relationships, behavior, thinking, and sense of self—can be less stigmatizing and lead to more effective treatment.
People often carry multiple diagnoses because symptom patterns overlap.
Common co-occurring conditions include:
- Depression
- Anxiety disorders
- PTSD or Complex PTSD
- Eating disorders
- Substance use disorders
Often, these diagnoses reflect interacting patterns linked to chronic emotion dysregulation.
Does Treatment Work?
The short answer is, yes!
Recent long-term studies consistently show that:
- Most individuals with BPD experience substantial improvement over time
- Remission (i.e., sustained periods without meeting full diagnostic criteria) is common, with long-term studies reporting rates as high as 85–93% over 10 years
- Meta-analyses (compilations of the results of multiple studies) indicate 50–70% remission rates, along with marked reductions in symptom severity and functional impairment
These findings directly challenge outdated beliefs that BPD is inherently chronic or untreatable. Recovery often means:
- The person learns to manage emotional instability.
- Self-harming or impulsive behaviors are reduced or eliminated.
- Interpersonal relationships and daily functioning improve.
- Life satisfaction and identity stability increase.
Evidence-based therapies that help with BPD are:
- Dialectical Behavior Therapy (DBT)
- Mentalization Based Therapy (MBT)
- Schema Based Therapy