I want to talk about a disorder known as Borderline Personality Disorder. Borderline Personality Disorder is marked by a pattern of instability. It touches relationships, emotions, moods, thoughts, and behavior. It is a disorder where a person struggles to regulate what is happening inside them. They struggle to regulate feelings. They struggle to regulate thoughts. They struggle to regulate moods. And because what is happening inside is unstable, what happens outside also becomes unstable—especially in relationships and behavior.
One of the biggest characteristics of this disorder is unstable relationships. People with borderline personality disorder often struggle to maintain close personal relationships in a steady way. It can look like a person’s feelings about others swing from one extreme to another. They can love you intensely. They can admire you excessively. They can attach to you deeply. But when they feel hurt or threatened, they may also hate intensely. They may reject you strongly. They may turn cold suddenly. And the person around them may feel confused because the change is sharp and dramatic.
This instability is not just about other people. It is also about the person’s inner world. Many people with borderline personality disorder carry insecurity. They feel uncertain about themselves, uncertain about others, and uncertain about whether relationships are safe. Insecurity becomes a foundation that affects how they relate to friends, family, and partners. And when insecurity is strong, relationships become difficult to maintain.
Another serious point I want to mention is suicidal risk. Many mental disorders come with suicidal thoughts and attempts—we have talked about depression and bipolar disorder, and how suicide can be part of those conditions. But in borderline personality disorder, the risk can be especially high. This is something caregivers and family members must take seriously. A person may talk about self-harm. A person may attempt suicide. A person may behave in ways that show they are in emotional pain that feels unbearable. When this happens, it should never be ignored or treated as drama. It is serious.
Mood swings are also part of this disorder. The person’s mood can shift quickly. And these mood swings are not always the same as what we see in other disorders. The changes can feel sudden, intense, and emotionally overwhelming. And alongside mood swings, a person may experience seasons where other problems rise and fall. There may be periods where depression becomes strong. Other times anxiety becomes strong. Other times substance use becomes part of the struggle. Other times the person feels the urge to harm themselves. It can feel like waves—different seasons, different storms, and the person may struggle to feel stable for long.
When we come to symptoms, there are some key patterns that stand out. One common symptom is fear of being abandoned. People with borderline personality disorder often live with a deep fear that family members will leave them, friends will leave them, or a partner will leave them. This fear can become so strong that it controls their behavior. They may cling, they may test people, they may become suspicious, or they may react intensely to small signs of distance. And that fear of abandonment is closely tied to the unstable relationships. When someone is always afraid of being left, they may behave in ways that push others away, even though what they truly want is to be loved and secure.
Another symptom is distorted self-image. This means the person struggles with how they see themselves. Their identity may feel unstable. One moment they may feel confident, and another moment they may feel worthless. One moment they may feel strong, and another moment they may feel like nothing. This unstable self-image contributes to unstable emotions and unstable choices.
Impulsive behavior is also common. Impulsivity means acting without thinking about consequences. It is like crossing the road without checking whether cars are coming. It is doing something quickly without stopping to evaluate danger or outcome. This impulsivity can show up in risky behaviors and reckless actions.
There is also a chronic feeling of boredom and emptiness. Some people describe it as feeling empty inside, like something is missing and they cannot explain what it is. It is not a small feeling. It is a chronic feeling—something that returns again and again. This emptiness can become one of the reasons they seek intense emotions, intense relationships, or impulsive activities—because calmness feels empty to them.
Another symptom is difficulty controlling anger. People may react with intense anger, and later—when they calm down—they may feel guilty or ashamed. Because the person struggles to regulate emotions, they may say or do things in the heat of the moment, and then when they “come back to themselves,” they feel regret. They may hate what they did, but during the emotional storm, they felt unable to control it.
There can also be moments where a person feels disconnected—disconnected from their thoughts, disconnected from their identity, as if they are not fully grounded in themselves. This disconnection can make the person’s life feel confusing, like they are not stable within their own mind.
When it comes to causes, I want to speak from the way we have been describing mental disorders throughout this book—these conditions begin in the brain. Borderline personality disorder is connected to brain functioning, especially the struggle to regulate emotions, moods, and thoughts. One possible cause is genetics, meaning it can be inherited. Some people may be born with a vulnerability that makes them more likely to develop this disorder.
Another major cause is trauma, especially early trauma. Abuse can contribute—physical abuse, sexual abuse, and other forms of mistreatment. Neglect is also a major factor. When children are neglected while young, it can affect how they develop emotionally and how they learn to trust. Separation can also contribute. When children are separated from parents, or when families break apart, it can create emotional wounds that shape how a person relates to others later in life. And these painful experiences are not limited to childhood. Trauma can also happen in adulthood. Relationship breakdowns, ongoing emotional neglect, and painful life events can contribute. The main idea remains this: the person struggles with emotional regulation. They struggle to regulate thoughts. They struggle to regulate moods. That struggle becomes the center of the disorder.
When it comes to treatment, I want to be clear in the way I have been clear before. Treatment here focuses on managing symptoms. Medication is often used to treat symptoms that come with the disorder—like severe mood swings, anxiety, depression, or other distress. But the disorder itself is managed over time. Alongside medication, talk therapy—psychotherapy—is important. A person needs support in learning how to understand emotions, how to respond, and how to build healthier patterns. Peer support and family support are also encouraged, because people do not heal well in isolation. If your friend has this disorder, if your family member has it, support matters. And that is why I keep repeating the purpose of this book. We are learning so we can respond well. We are learning so we do not stigmatize. We are learning so we can help people seek support early and manage these conditions with hope.
One of the biggest characteristics of this disorder is unstable relationships. People with borderline personality disorder often struggle to maintain close personal relationships in a steady way. It can look like a person’s feelings about others swing from one extreme to another. They can love you intensely. They can admire you excessively. They can attach to you deeply. But when they feel hurt or threatened, they may also hate intensely. They may reject you strongly. They may turn cold suddenly. And the person around them may feel confused because the change is sharp and dramatic.
This instability is not just about other people. It is also about the person’s inner world. Many people with borderline personality disorder carry insecurity. They feel uncertain about themselves, uncertain about others, and uncertain about whether relationships are safe. Insecurity becomes a foundation that affects how they relate to friends, family, and partners. And when insecurity is strong, relationships become difficult to maintain.
Another serious point I want to mention is suicidal risk. Many mental disorders come with suicidal thoughts and attempts—we have talked about depression and bipolar disorder, and how suicide can be part of those conditions. But in borderline personality disorder, the risk can be especially high. This is something caregivers and family members must take seriously. A person may talk about self-harm. A person may attempt suicide. A person may behave in ways that show they are in emotional pain that feels unbearable. When this happens, it should never be ignored or treated as drama. It is serious.
Mood swings are also part of this disorder. The person’s mood can shift quickly. And these mood swings are not always the same as what we see in other disorders. The changes can feel sudden, intense, and emotionally overwhelming. And alongside mood swings, a person may experience seasons where other problems rise and fall. There may be periods where depression becomes strong. Other times anxiety becomes strong. Other times substance use becomes part of the struggle. Other times the person feels the urge to harm themselves. It can feel like waves—different seasons, different storms, and the person may struggle to feel stable for long.
When we come to symptoms, there are some key patterns that stand out. One common symptom is fear of being abandoned. People with borderline personality disorder often live with a deep fear that family members will leave them, friends will leave them, or a partner will leave them. This fear can become so strong that it controls their behavior. They may cling, they may test people, they may become suspicious, or they may react intensely to small signs of distance. And that fear of abandonment is closely tied to the unstable relationships. When someone is always afraid of being left, they may behave in ways that push others away, even though what they truly want is to be loved and secure.
Another symptom is distorted self-image. This means the person struggles with how they see themselves. Their identity may feel unstable. One moment they may feel confident, and another moment they may feel worthless. One moment they may feel strong, and another moment they may feel like nothing. This unstable self-image contributes to unstable emotions and unstable choices.
Impulsive behavior is also common. Impulsivity means acting without thinking about consequences. It is like crossing the road without checking whether cars are coming. It is doing something quickly without stopping to evaluate danger or outcome. This impulsivity can show up in risky behaviors and reckless actions.
There is also a chronic feeling of boredom and emptiness. Some people describe it as feeling empty inside, like something is missing and they cannot explain what it is. It is not a small feeling. It is a chronic feeling—something that returns again and again. This emptiness can become one of the reasons they seek intense emotions, intense relationships, or impulsive activities—because calmness feels empty to them.
Another symptom is difficulty controlling anger. People may react with intense anger, and later—when they calm down—they may feel guilty or ashamed. Because the person struggles to regulate emotions, they may say or do things in the heat of the moment, and then when they “come back to themselves,” they feel regret. They may hate what they did, but during the emotional storm, they felt unable to control it.
There can also be moments where a person feels disconnected—disconnected from their thoughts, disconnected from their identity, as if they are not fully grounded in themselves. This disconnection can make the person’s life feel confusing, like they are not stable within their own mind.
When it comes to causes, I want to speak from the way we have been describing mental disorders throughout this book—these conditions begin in the brain. Borderline personality disorder is connected to brain functioning, especially the struggle to regulate emotions, moods, and thoughts. One possible cause is genetics, meaning it can be inherited. Some people may be born with a vulnerability that makes them more likely to develop this disorder.
Another major cause is trauma, especially early trauma. Abuse can contribute—physical abuse, sexual abuse, and other forms of mistreatment. Neglect is also a major factor. When children are neglected while young, it can affect how they develop emotionally and how they learn to trust. Separation can also contribute. When children are separated from parents, or when families break apart, it can create emotional wounds that shape how a person relates to others later in life. And these painful experiences are not limited to childhood. Trauma can also happen in adulthood. Relationship breakdowns, ongoing emotional neglect, and painful life events can contribute. The main idea remains this: the person struggles with emotional regulation. They struggle to regulate thoughts. They struggle to regulate moods. That struggle becomes the center of the disorder.
When it comes to treatment, I want to be clear in the way I have been clear before. Treatment here focuses on managing symptoms. Medication is often used to treat symptoms that come with the disorder—like severe mood swings, anxiety, depression, or other distress. But the disorder itself is managed over time. Alongside medication, talk therapy—psychotherapy—is important. A person needs support in learning how to understand emotions, how to respond, and how to build healthier patterns. Peer support and family support are also encouraged, because people do not heal well in isolation. If your friend has this disorder, if your family member has it, support matters. And that is why I keep repeating the purpose of this book. We are learning so we can respond well. We are learning so we do not stigmatize. We are learning so we can help people seek support early and manage these conditions with hope.
