Four Primary Forms of Borderline Personality Disorder.

Does This Fit You or Someone You Love?

Do sudden; out of proportion emotions seem to run your life, or that of the ones you love? Do you feel disdain and anger toward someone whom you love and respect, leaving you confused as to how you can feel that way? Does reading negative words trigger fits of rage? Read on, you may have Borderline Personality Disorder. There is hope though, through therapies and support, a person with Borderline Personality Disorder can live a normal life.

Emotions and Reactions

Do you or someone in your life seem out of control? One minute they are sweet and kind, and then as if something overcame them, they are angry and saying things they would not say when in the kind mode. Perhaps this person seems like they have two different personalities but yet, they are the same person. Perhaps this person is you. You cannot understand why you can read a negative word and get so angry, unrealistically so. Or why you get so angry and out of sorts over every day negative situations. You may think you have an anger problem, but yet you feel so empty and lost, how could you have an anger problem and feel so lost? Maybe you get angry and then do not care about it, you try to go on with life while those that you just fought with are reeling with pain and shock at your reaction. You may not know why you are like this but feel something needs to change. You may learn you have Borderline Personality Disorder.

Borderline Personality Disorder (BPD) is a mental disorder that is relatively new in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision or DSM-IV-TR. The diagnosis of BPD involves history of symptoms and exclusion of other mental and physical health disorders.


Common Symptoms Prior to Diagnosis
  • Difficulty keeping emotions and thoughts regular
  • Impulsivity
  • Reckless behavior
  • Unstable relationships, worse with those they love
  • They can also have depression, anxiety, suicidal thoughts

Though these basic symptoms may lead a person for diagnosis and treatment, it is only the beginning of the official diagnosis. There are four types or levels of Borderline Personality Disorder.

The Four Main Types

Here are the four types of borderline personality disorder and their symptoms. It is important to keep in mind that these symptoms are not temporary as one would expect after a romantic break-up or a fight with a friend, but these are lasting symptoms. These symptoms you can depend on reoccurring on a regular basis, oftentimes without warning.

Discouraged Borderline:

  • Clingy
  • Dependent on others
  • Moody and somber, quiet, wallflower
  • Follows the popular crowd
  • Follows the crowd most likely to get attention, good or bad
  • Angry inside at those she/he loves the most
  • Tendency to explode with angry emotions
  • Violence to self, mutilation
  • Suicide threats, thoughts and completed

Impulsive Borderline:

  • Thrill seekers
  • Easily bored
  • Always seeking attention
  • Unpredictable
  • Life of the party
  • Overly flirtatious
  • Tendency to get themselves in trouble

Petulant Borderline:

  • Irritable
  • Impatient
  • Unpredictable
  • Defiant
  • Stubborn
  • Explosive anger
  • Needy, clingy then distant and cold

Self-Destructive Borderline:

  • Impulsive
  • Self mutilating
  • Self-hatred,
  • Engaging in dangerous sexual relationships
  • Other behaviors such as cutting because of self hate

People with borderline personality disorder are charismatic and usually the life of the party. They are also known as the one who can be relied on to start an argument and then return to their normal self as if nothing happened.

The Quiet, Discouraged One

Pictures Are Used With Permission by Sarah Cluck | Source

Other Symptoms That Can Be Seen at All Levels

  • Extreme reactions to thoughts of abandonment, whether it is threatened or not
  • Panic
  • Rage
  • Frantic behavior
  • A person with BPD has rough relationships with family and friends, especially those they love the most. It is almost as if the emotion of love itself can trigger the anger of the BPD. They can be clingy, excessively so to a person then devaluating the same person on the same day. They may have feelings of hatred and disdain for the same person or persons that they were clinging to earlier. They may suddenly and extremely dislike a friend or family member, latch onto others as family, disregarding whom they associated with as family before
  • They may also have a distorted sense of self from grand illusions of self importance to self hatred. A warning sign of an “attack” of anger is when there has been a quick change in life direction, such as dropping out of school, quitting a job they seemed to love. They bore easily and are easily distracted by self desire. They may exhibit intense and highly changeable moods lasting a few hours to day, or months in untreated cases.
  • They may comment on the feeling of observing oneself from outside their body, disassociating themselves and have paranoid thoughts.

Word of Note

80% of people with borderline personality disorder have suicidal thoughts with 4-9% commit suicide. This is a pretty high number so if you love someone with BPD, keep this in mind and alert the proper authorities if you are worried. It may be their therapist, family doctor, suicide hotline or police.

Age of onset is usually adolescent with possibly some signs in early childhood. Not all people will be hospitalized for treatment and some may be able to move past the symptoms and live normal lives, with proper treatment.

Difference in Gender

Men tend to show signs of Anti-Social Personality Disorder to go along with the Borderline personality disorder

Women tend to be depressed, have anxiety disorders and eating disorders

Common Health Conditions in Conjunction With BPD

  • Arthritis
  • Fibromyalgia
  • Back pain
  • High blood pressure

Borderline Personality disorder is a relatively new disorder and is still being studied, but there are schools of thought that think it may be inherited traits that blend with brain hormone imbalance, causing the disorder.

Possible Cultural Causes

Culturally, it is thought that unstable relationships within the family, coupled with rape or molestation can trigger borderline personality disorder in those that have the inherited personality traits such as controlling behavior, impulsivity, and inflated views of oneself.

Important to Keep in Mind

By themselves, these personality traits may be irritating but not considered a disorder, but when all elements come together, an adolescent may have borderline personality disorder triggered.


There is not one test to detect this disorder but one thing that is common among those with borderline personality disorder is that there is an overreaction to adverse or tense sounding written words. They react to harsh written words worse and with more aggression than a typical angry person. The reaction to unpleasant words can give the psychiatrist a peek into the severity of the disorder.

Brain imaging has shown some hope in detecting BPD. It has been noticed that those with BPD have less activity in the area of the brain that controls emotions when presented with harsh written words or other unpleasant stimuli, showing a degree of inability to understand how to appropriately handle a situation but over reacting in such situations as negative work environment, an argument or any other perceived negative situation.

These findings may be the key to explaining the instability in emotions.

Treatment Methods

Psychotherapy, or counseling sessions are the first step in treating BPD. Some medications may be added at this time if the depression or anxiety is too prevalent. It is thought that once the depression and anxiety are under control then treatment for the bpd can be more effective.

CBT or Cognitive Behavioral Therapy

The therapist works with the person to teach them to understand what triggers their aggression and help them learn to control their temper. They are also taught self-help in controlling impulsive behavior and how to handle their emotions when they are getting out of control

DBT or Dialectical Behavior Therapy

The person is taught to take stalk of their situation, look around and watch for triggers so that they can be better prepared to stay under control. Avoiding some situations may be necessary as the person gains control over time and can handle stress better. The person is taught methods to control their emotions, aid in not becoming overwhelmed and overreacting and reduces self-destructive behavior.

SFT or Schema-Focused Therapy

Therapy aimed at changing the way a person sees themselves. By working with the person’s self image the person can see themselves in a more normal way, neither over the top or egotistical appearing nor self loathing

STEPPS or Systems Training for Emotional Predictability and Problem Solving.

Therapy is provided one on one and in group settings using the STEPPS program. This is a relatively short program, usually lasting 20 sessions, 2 hours long each time and can be led by a social worker. Through this system, patients are taught to plan ahead how they will react to a situation, to practice emotional responses and be prepared. By having this type of therapy in a group setting the patients can learn how others react and respond to various negative stimuli in a secure and safe setting.

Alternative Options

There are no approved medications for BPD but when anxiety and depression may be treated separately from BPD. Omega 3 fatty acids have been shown to calm the emotional responses of women in particular in some studies.

Family and Friends Can Help

Family and friends need to be mindful of the fact that aggressive episodes will happen. They are not necessarily personal. The verbal attack may be because of an outside stressor that the person is having difficulty internalizing and working through correctly. The patient/person may have just had a sad experience and then see a negative email and lash out at their sibling or favorite parent, for example. With patience and making sure that the patient goes to therapy sessions and takes their medication on time, these hard times can become less frequent. It is extremely important that the family or friends alert authorities or therapist if the patient is talking about harming themselves or others.

If you believe you may have BPD, get in touch with your physician or local mental health care center. The earlier the treatment begins the better. There is hope, with proper treatment; the majority of patients learn to lead normal, fulfilling and happy lives. If you are feeling suicidal, call 911 or a suicide hotline immediately.


Although it seems that having someone in your life with Borderline Personality Disorder or having it yourself seems very bleak and hard, with therapy and patience, everyone can live normal lives and be happy. Even in the worst of times, there will be times when the person suffering has good times and can laugh and be joyful. Enjoy these times and look forward to many more of them in the future. It can happen.