What happens to people who have borderline personality disorder?

The course of this illness is variable and often prolonged. It is more common in women, and usually surfaces during the teen years or young adulthood, with the first serious symptoms often appearing at the time of a significant change or separation. All people with this disorder experience upheaval, chaos and pain. Sometimes the illness can be managed with outpatient treatment. Some people require periodic brief hospitalizations when symptoms are intense. Other people require longer inpatient treatment to provide safety while they are learning healthier patterns of behavior. Most people make a reasonable work and social adjustment.
Dr. Marni Feuerman, LCSW, MFT
Marriage & Family Therapy

The first signs of borderline personality disorder usually appear by late childhood. The most common early signs are impulsive and reckless behavior. The disorder often fully develops in the late teens to early twenties. The risk of suicide associated with borderline personality disorder is greatest in the young adult years and gradually decreases with age. In the adult years, the disorder causes intense emotions, impulsive behaviors, and unstable relationships. Uncontrolled emotions and fear of being abandoned often lead to job losses, failed marriages, and uncompleted education.

Treatment can be very challenging. People with borderline personality disorder frequently have difficult relationships with their doctors. They often see others as either "good" or "bad." A shift from one view to the other, called splitting, can occur suddenly in any relationship for minor reasons.  These changes in feeling often are a source of tension between a person with borderline personality disorder and doctors. Splitting is also a common source of tension in relationships with friends and family members

Severe symptoms such as self-destructive and suicidal behavior, irrational thinking, and emotional problems related to relationships may improve as you begin treatment. Some symptoms may last longer, such as feelings of anger or emptiness or abandonment, suspiciousness, and difficulty tolerating being alone. .  Often other disorders occur along with borderline personality disorder as well and also need treatment (for example, depression or substance abuse).

The majority of those with this disorder gain more stable emotions, relationships, and employment during their 30s or 40s. Many people who get treatment for borderline personality disorder do decrease destructive behaviors, often within the first year of treatment.  According to the research, around half of those diagnosed with borderline personality disorder no longer have many of the behaviors associated with the disorder after about 10 years of treatment.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.