Borderline Personality Disorder

Borderline personality disorder (BPD) (called emotionally unstable personality disorder, borderline type in the ICD-10) is a personality disorder marked by a prolonged disturbance of personality function, characterized by unusual variability and depth of moods. These moods may secondarily affect cognition and interpersonal relations.

The disorder typically involves an unusual degree of instability in mood and black-and-white thinking, or splitting. BPD often manifests itself in idealization and devaluation episodes and chaotic and unstable interpersonal relationships, issues with self-image, identity, and behavior; as well as a disturbance in the individual's sense of self. In extreme cases, this disturbance in the sense of self can lead to periods of dissociation. It is only recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in individuals over the age of 18; however, symptoms necessary to establish the disorder can also be found in adolescents.

Splitting in BPD includes a switch between idealizing and demonizing others (absolute good or love versus absolute evil or hate with no middle term). This, combined with mood disturbances, can undermine relationships with family, friends, and co-workers. BPD disturbances may also include harm to oneself. Without treatment, symptoms may worsen, leading (in extreme cases) to suicide attempts.

There is an ongoing debate among clinicians and patients worldwide about terminology and the use of the word borderline, and some have suggested that this disorder should be renamed. The ICD-10 manual has an alternative definition and terminology to this disorder, called Emotionally unstable personality disorder. There is related concern that the diagnosis of BPD stigmatizes people and supports discriminatory practices.