What BPD Is
When people ask what Borderline Personality Disorder is, to me there are two answers. The first is answered by how it affects someone's life and the second is the textbook answer that you can get out of the big book o’ diagnoses. Aka, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).1
So I'll give you the easy-to-understand answer first. My version instead of the textbook’s, and in my words. As I see it, BPD is a way of relating to others that isn’t effective in a very specific way.1,6,9 The person really wants to connect and deeply fears being abandoned by the people they love. People experiencing BPD feel emotional pain that can even feel intensely physical at times. Their moods can shift quickly with what seems like little reason to outsiders.1,6,9 Sometimes, the pain gets so bad that it makes them willing to die in order to stop the pain. The goal of the person with BPD is often to bring others closer or keep themselves from being hurt. However, their actions often have the opposite effect. Instead, of bringing their favorite person closer, it can unstable relationships across the board, and even job loss if the BPD symptoms are strong enough.1,6,9,14
Now for the textbook answer. The DSM-5-TR describes Borderline Personality Disorder as, “a pervasive pattern of instability in interpersonal relationships, self-image, and emotions, along with marked impulsivity”. The pattern begins by early adulthood, happens in many different situations, and is diagnosed when at least 5 of 9 criteria for BPD are present.1
BPD Statistics
Now for the BPD statistics. BPD is estimated to affect somewhere between 1.6% to 5.9% of the general population.1 It's diagnosed more often in women than in men.1,9 With clinics diagnosing women with it 75% of the time and men only 25% of the time, while the general population has rates of the disorder at a roughly equal rate.1,6,9 This is something that I see in my therapy practice as well. When clients come in saying they have a personality disorder (PD), usually those who have been previously diagnosed with BPD are women. The men who come to us are more likely to be diagnosed NPD. However, after giving these clients the screening test and interview to diagnose, we see that the rate of the BPD in our therapy clients is closer to the rate in the general population, with men and women having it in nearly equal numbers. That is because with similar symptoms, therapists tend to look to Narcissistic Personality Disorder first for male clients, and Borderline first for female clients.9 So it is possible that the higher rates of BPD among women is poor diagnoses.6,9 BPD is also increasing in the population across time.6,9 And studies show that it is more common in younger people than in older people.6,9
Stigma and Understanding
Even though BPD is pretty common, it's often misunderstood and stigmatized.6,9,13 Many therapists do not routinely diagnose it or treat it.6,9,13 And clients often do not want to hear that they have it because of the stigma around the issue in the U.S..2,6,7,9,13 Thankfully, the stigma around "being borderline" is reducing thanks to things like content creators on social media.13 These forums "facilitate open discussions about mental illness, contribute to public awareness, and thus participate in reducing the stigma surrounding these disorders".13 The biggest issue with these spaces, however, is that it can also spread misinformation around BPD.13
Understanding what BPD actually is helps the people affected by it realize that it is manageable, and even treatable.3,9,13 It helps friends and loved ones of people affected by BPD understand their person, and how to not make things worse if the person is in the middle of a BPD crisis.13
Part of why I work with BPD is that I have known people with these symptoms my entire life. I have had friends, and at least one family member, who either had BPD or had many of the traits. Because of that, BPD does not feel mysterious or frightening to me. I know what it can look like in real relationships. When I see the pattern in therapy, my reaction is not, "This person is too much," or, "This is hopeless." My reaction is, "I am seeing some symptoms here. Let me slow down, assess carefully, and figure out what kind of support this person actually needs." That matters because people with BPD are often highly sensitive to rejection, fear, and disconnection. How we talk to them matters. The goal is not to judge the sensitivity. The goal is to understand it well enough to work with it.
Symptoms of BPD
People with BPD have several symptoms that can affect their lives on a regular basis.1,6,9,13 The most obvious of these is emotional instability, extremely intense emotions that can swing rapidly from positive to negative and back again.1,6,9,13 These shifts in mood may seem out of the blue even to the person experiencing them. They can be particularly confusing to those around them. These mood changes can include feelings of intense excitement, irritability, anxiety, rage, dysphoria, and emptiness, all within a short period.1,13
Another common sign of Borderline Personality Disorder is impulsive behavior.1,6,9,13 This can manifest in many ways. Some examples are reckless driving, substance abuse, binge eating, or impulsive spending.1,6 These behaviors are often a way to numb emotional pain or to fill a sense of emptiness.9,13 However, they can cause significant personal and financial consequences, heightening to the person’s upset.6,9
Interpersonal relationships are often very challenging for those with BPD.1,6,9,13 They may idealize someone one moment and then suddenly believe the person doesn’t care enough or is hurtful. This pattern of instability in relationships is often referred to as "splitting".1 Additionally, people with BPD may have intense fears of abandonment, which can lead to frantic efforts to avoid real or imagined separation or rejection.1,13 This fear can cause clingy or unpredictable behavior that strains relationships.9,13
Daily Life and Relationships
The impact of BPD on daily life can be profound and far-reaching.6,9 People with BPD often struggle with maintaining a consistent routine and fulfilling responsibilities at work or school. The emotional instability and impulsive behaviors that can come with BPD may lead to frequent job changes, academic difficulties, and strained relationships with colleagues and peers. This instability can create a cycle of failure and low self-esteem, further aggrivating the symptoms of BPD.9
Relationships are particularly affected by BPD.9 The intense fear of abandonment can lead to clinginess, possessiveness, and frequent arguments. The tendency to see people in black-and-white terms (idealizing them one moment and devaluing them the next) can make it difficult to maintain stable and healthy relationships.9 Romantic relationships can be turbulent, with frequent breakups and make ups. Friends and family members may also struggle to understand what they see as erratic behavior, leading to feelings of frustration and helplessness.
Daily life for someone with BPD can also involve significant internal turmoil.5,9 Chronic feelings of emptiness and identity disturbance can lead to a lack of direction and purpose. Self-harming behaviors and suicidal ideation are unfortunately common among people with BPD, posing severe risks to their health and well-being.6,9 Managing these symptoms requires a comprehensive and compassionate approach, including professional treatment and strong support systems.9,13
Myths About BPD
There are many myths and misconceptions about BPD that contribute to stigma and misunderstanding.12,13 One common myth is that people with BPD are manipulative or attention-seeking.9,13 In reality, their behavior often comes from intense emotional pain, trauma, fear of abandonment, and attempts to cope with overwhelming distress.8,9,13 Understanding this can help us have more empathy and reduce judgment.12,13
I remember back in my undergrad days when we were taught that personality disorders like BPD were untreatable. We know now that this is not true.3,9 BPD traits and symptoms can change over time, and many people improve with appropriate treatment and support.3,9 Therapies such as DBT can help people manage symptoms, regulate their emotions, and improve their quality of life.8,11,13
It is also a misconception that BPD only affects women. BPD is diagnosed more often in women in clinical settings, but community studies show the gender split may be more balanced than people used to think.6,9,10 Men with BPD may be underdiagnosed or misdiagnosed because of gender bias and differences in how symptoms show up, such as more impulsivity, aggression, or substance use.6,9 Recognizing that BPD can affect people of any gender is important for accurate diagnosis and treatment.6,9
References
1. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
2. Borderline Personality Disorder Resource Center. (n.d.). Borderline personality disorder resource center. Retrieved August 31, 2026, from https://www.bpdresourcecenter.org
3. Bornovalova, M. A., Hicks, B. M., Iacono, W. G., & McGue, M. (2009). Stability, change, and heritability of borderline personality disorder traits from adolescence to adulthood: A longitudinal twin study. Development and Psychopathology, 21(4), 1335–1353. https://doi.org/10.1017/S0954579409990186
4. First, M. B., Williams, J. B. W., Benjamin, L. S., & Spitzer, R. L. (2016). Structured clinical interview for DSM-5 personality disorders (SCID-5-PD). American Psychiatric Association Publishing.
5. Gunderson, J. G., Zanarini, M. C., Choi-Kain, L. W., Mitchell, K. S., Jang, K. L., & Hudson, J. I. (2011). Family study of borderline personality disorder and its sectors of psychopathology. Archives of General Psychiatry, 68(7), 753–762. https://doi.org/10.1001/archgenpsychiatry.2011.65
6. Loya, J. M., Wagner, A., Pittman, B., & Davis, M. T. (2024). Differences in diagnostic rules used to determine borderline personality disorder impact prevalence and associations with clinically relevant variables: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Personality Disorders: Theory, Research, and Treatment, 15(1), 60–73. https://doi.org/10.1037/per0000643
7. National Alliance on Mental Illness. (n.d.). Borderline personality disorder. Retrieved August 31, 2026, from https://www.nami.org/
8. Porter, C., Palmier-Claus, J., Branitsky, A., Mansell, W., Warwick, H., & Varese, F. (2020). Childhood adversity and borderline personality disorder: A meta-analysis. Acta Psychiatrica Scandinavica, 141(1), 6–20. https://doi.org/10.1111/acps.13118
9. Ramos-Suárez, I., Guerrero-Jiménez, M., Cervilla, J. A., & Gutiérrez, B. (2026). Epidemiology of borderline personality disorder in the general population: Prevalence, sociodemographic factors, and comorbidities: A systematic review and meta-analysis. Journal of Affective Disorders, 394, 120482. https://doi.org/10.1016/j.jad.2025.120482
10. Skoglund, C., Tiger, A., Rück, C., Petrovic, P., Asherson, P., Hellner, C., Mataix-Cols, D., & Kuja-Halkola, R. (2021). Familial risk and heritability of diagnosed borderline personality disorder: A register study of the Swedish population. Molecular Psychiatry, 26, 999–1008. https://doi.org/10.1038/s41380-019-0442-0
11. Stepp, S. D., Whalen, D. J., Pilkonis, P. A., Hipwell, A. E., & Levine, M. D. (2012). Children of mothers with borderline personality disorder: Identifying parenting behaviors as potential targets for intervention. Personality Disorders: Theory, Research, and Treatment, 3(1), 76–91. https://doi.org/10.1037/a0023081
12. Sánchez Rodríguez, I., Bianchi, J., Pinelli, F., Panizza, F., Ricciardi, E., Pietrini, P., & Petrocchi, M. (2026). Understanding mental health discourse on Reddit with transformers and explainability. Scientific Reports, 16, 6796. https://doi.org/10.1038/s41598-026-35918-3
13. Thériault, C., Cailhol, L., Poirier, S., Bérubé, F.-A., Ouellet, E., David, P., & Hudon, A. (2026). Le trouble de la personnalité limite à l’ère de TikTok: Exploration qualitative des discours d’internautes [Borderline personality disorder in the age of TikTok: A qualitative exploration of internet users’ comments]. The Canadian Journal of Psychiatry, 71(4), 307–316. https://doi.org/10.1177/07067437251411023
14. World Health Organization. (2025). ICD-11 for mortality and morbidity statistics (2025-01): Emotionally unstable personality disorder. https://icd.who.int/browse/2025-01/mms/en
