Symptoms of borderline personality disorder usually begin by early adulthood. They include unstable relationships, difficulty managing emotions, emotional instability, trouble with impulse control or impulsive behavior, and trouble controlling anger. You might also struggle with suicidal or self-destructive thoughts, feelings, and behaviors.

According to the current version of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5—a reference commonly used by mental health professionals in the US—borderline personality disorder can cause intense episodes of:

Borderline personality is also often associated with a profound fear of abandonment, making it hard for you to be alone; yet at the same time, your anger, mood swings, and impulsive behavior can make things worse by driving others away. Borderline personality disorder is also often associated with an uncertain sense of who you really are.

Not everyone with borderline personality disorder experiences every symptom. Some individuals report having only a few, while others indicate having many. Likewise, symptoms of borderline personality disorder can vary a lot between individuals. Differentiating borderline personality disorder from bipolar disorder—or recognizing that both are present—is a crucial step.

While its origins are not fully known, experts believe borderline personality disorder reflects a combination of an inborn predisposition, and the impact of adverse or even traumatic early life experiences that complicate finding attachments that are experienced as safe, secure and understanding.

Borderline personality disorder is a serious disorder on its own, but it is also often found to co-occur with other mental disorders. In these situations, borderline personality disorder complicates treatment of co-occurring disorders, like depression, anxiety disorders and others, often leading to what are referred to as “treatment-resistant” disorders.

At the Austen Riggs Center, we have successfully helped many patients with borderline personality disorder. In fact, we are known as the place “where treatment-resistant patients become people taking charge of their lives.”

Experts agree that the mainstay of treatment for borderline personality disorder is psychotherapy. Medications may help, especially with co-occurring disorders, but they are rarely enough. Effective treatment that focuses on helping you learn to handle sometimes overwhelming emotions and form more stable relationships with others takes time. With the right treatment, most people struggling with borderline personality disorder make gains and live fuller, richer lives.

At Riggs, the whole person is the focus of the treatment, not simply discrete symptoms. We work with you as a person with your own unique life story and your own problems and strengths.

Our treatment approach centers on intensive psychodynamic psychotherapy four times a week with a doctoral-level therapist, exploring your lived experiences to identify patterns and the potential impact of losses or other adverse experiences that may be outside your awareness but that influence your decision making. Through this deeper self-understanding, you can be freer to make better choices.

To augment regular psychotherapy sessions, medication might be part of the treatment for borderline personality disorder at Riggs. We have been trailblazers in developing what we call psychodynamic psychopharmacology, a way of using medications for their biochemical benefit, while also carefully attending to the impact of their meanings to the patient and to the doctor.

Family is often part of the social context in which symptoms of borderline personality disorder may emerge. So an important part of every treatment at Riggs is family evaluation—with family treatment offered when indicated.

In addition to therapy and medications, our open setting with its Therapeutic Community Program mobilizes the powerful potential of social learning through interactions with peers—a profound opportunity to learn about aspects of ourselves that we cannot see but that others can help us see and address. Within the Therapeutic Community Program, we also teach skills to help manage intense and sometimes overwhelming feelings that are part of borderline personality disorder and that may also emerge during the challenging work of psychotherapy.

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