If you have been diagnosed with borderline personality disorder (BPD), there’s more than one way you might feel about it. It’s possible that getting diagnosed was the first time you’d ever heard of BPD. Or perhaps you learned about it on your own and brought it up to your therapist or doctor. The diagnosis might make sense to you, give you language to describe your difficulties, and affirm your experiences. Conversely, the diagnosis might feel unclear, wrong, or worse. Whether the diagnosis feels helpful or confusing, it is natural to wonder where to go from here.

Searching for information online can be overwhelming. Researchers, clinicians and the general public have a long history of misunderstanding BPD. This has led to the proliferation of sources – even some self-help books and academic articles – that present misleading or stigmatising information about the disorder. Yet learning more about your condition is critical for self-understanding, healing and growth.

In this Guide, we’ll give you reliable, evidence-based information to help you understand what the BPD diagnosis means and how to move forward – whether you got your diagnosis recently or years ago. If you have not been diagnosed but wonder if you might have BPD, you may find this information useful too.

What ‘borderline personality disorder’ actually means

Each of us has a personality, or a unique way that we think about, perceive and relate to other people and ourselves. The term ‘personality disorder’ reflects that people with BPD have personality patterns – certain characteristic ways of thinking and feeling – that can interfere with the ability to build and maintain healthy relationships, both with themselves and with others.

This does not mean that your personality is ‘broken’ if you have BPD, or that you don’t have positive qualities. Each person with BPD has their own personality strengths. We have worked with people who are hilarious, creative, caring, bright. At the same time, they have certain patterns of difficulties in how they relate to themselves and others. Many people have these difficulties sometimes. It’s when they become impairing, and present over time and in different situations, that we call these patterns a personality disorder.

As you might have experienced for yourself, people with BPD often struggle with:

• an underdeveloped or unstable sense of self;
• instability in goals or values;
• hypersensitivity to feeling criticised, rejected or abandoned;
• intense, unstable relationships marked by conflict, mistrust and fears of being abandoned by others.

BPD is sometimes considered a disorder of ‘stable instability’. This looks different for each person but, generally, people with BPD commonly fluctuate between viewing themselves and others in black-and-white ways – as all good or all bad. They often struggle with self-hatred or difficulty defining themselves, as well as chronic feelings of emptiness. Difficulties with managing emotions are often linked to interactions with others: feeling abandoned or rejected leads to intense negative emotions such as sadness, anxiety or anger. These emotions can be so intense that they motivate dysregulated behaviours, including self-harm and impulsive acts such as drug use, shoplifting or reckless driving. The symptoms themselves can fluctuate over time, and there might be periods when symptoms are worse, including times of significant stress.

The term ‘borderline’ itself is not very helpful for understanding the condition. It originally referred to the idea that the problems of BPD exist between, or at the border of, ‘psychosis’ and ‘neurosis’ – an idea rooted in early psychoanalytic concepts. This understanding of the disorder does not reflect the majority of current research on BPD or people’s personal experiences with it, but the term ‘borderline’ has lived on.

It can take years to get a BPD diagnosis. Although increasing awareness has allowed some to receive it as early as adolescence, others are diagnosed in their 40s or beyond. If you were previously misdiagnosed with a different condition, you are not alone. BPD is often misdiagnosed as bipolar disorder, despite important differences between the two. For example, people with BPD experience intense mood shifts (as do those with bipolar disorder), but they are typically caused by interpersonal events such as feeling rejected, criticised or abandoned, and they usually last no more than a few hours. Another common misdiagnosis is post-traumatic stress disorder (PTSD) or complex PTSD. In comparison with these conditions, people with BPD tend to experience a greater fear of abandonment and difficulties with suicidal behaviour.

Further complicating diagnosis, people with BPD often meet the criteria for more than one psychological disorder. For example, they might experience major depressive disorder, an anxiety disorder, ADHD, obsessive-compulsive disorder, or others. A doctor may see a person’s problems through the lens of another disorder and miss that BPD is also present.

BPD is thought to arise from interactions between an emotionally vulnerable temperament – which is largely genetically inherited – and early life experiences. It is common for people with BPD to have experienced abuse or neglect during childhood, though that is not required for diagnosis. The early life factors are often more subtle experiences of invalidation that can arise from a mismatch between a family context and a child’s needs.

The first steps toward feeling better

This is a highly complex and frequently misunderstood disorder. Hopefully, a diagnosis brings some comfort and helps to validate your experience. But if you find the label stifling, know that a diagnosis is what you make it. Consider the BPD diagnosis – and this Guide – as first steps toward feeling better, offering language that you can use to open the door to new treatments and lasting coping strategies. Psychotherapy is standard for the treatment for BPD, but the information and tools for self-care that we’ll describe can be used as a supplement.

There is great reason for hope following a BPD diagnosis. With a combination of treatment, perseverance and time, recovery is absolutely possible. We have personally seen people with this condition make tremendous strides, and we hope the following guidance will help you make your own.

Pause and practise self-compassion

As you take in all the information we’re presenting, you might be feeling the urge to start frantically Googling. Or maybe you just want to stop thinking about the term ‘borderline personality disorder’ for the foreseeable future. Let this be an opportunity to press pause and just consider what that term brings up in you. Does it make you feel relieved? Understood? Do you feel defensive, or confused? What associations come up in your mind? Diagnostic labels can be useful, offering a framework for understanding yourself and the experiences you share with others. But they can also feel constricting, or like an oversimplification. Describe to yourself how you feel.

Then, use this moment to practise some kindness to yourself. People with BPD often struggle with self-compassion. This might stem from chronic invalidation, black-and-white thinking (viewing yourself as all good or all bad), a lack of stable models of compassion while growing up, or other causes. The difficulty with self-compassion can, in turn, worsen feelings of shame and low self-esteem, making recovery seem inapproachable. Simply ‘being kind to yourself’ might seem easier said than done. But research suggests that there are many small ways to cultivate self-compassion and thereby support recovery down the line. Pausing to appreciate the effort you’re putting in to learn about BPD and treatment can help you avoid fatigue and feel better about the process.

Before we continue, you might wish to try out this ‘Five Breaths’ exercise, which can help you pause and practise self-compassion:

Relax your shoulders, unclench your jaw. Take a moment to tune in to your five senses: this might mean noticing where your feet connect to the ground, the feeling of a chair pressed against your back, or any particular sounds or smells present around you.

Then, going at your own pace, take a series of breaths:

First breath

Take a deep breath and release it slowly.

Second breath

Inhale again and, as you exhale, express your gratitude. For example:

‘I am grateful for my body.’
‘I am grateful for the sun on my skin.’
‘I am grateful for my pet.’

Third breath

Take another breath in, and exhale. Focus on one thing that you want to be today. For example:

‘Today I will be calm.’
‘Today I will be patient.’
‘Today I will let go of judgment.’

Fourth breath

Inhale again and, as you exhale, say aloud a thought that represents your ideal self. Who are you, and who do you want to be? For example:

‘I am a kind human being who wants to help others.’
‘I am a mindful person, and I want to live in the moment.’
‘I am a loving individual who tries to do the right thing.’

Fifth breath

Take a deep breath in and out to finish.

Seek out (or continue) treatment for BPD

Psychotherapy is the primary form of treatment for BPD. Although medications may be useful for difficulties that people often have alongside BPD, such as depression, they do not treat BPD itself. Helpfully, there are a number of specialised psychotherapies for treating this condition. One of these is dialectical behaviour therapy (DBT), a skills-based, intensive treatment that focuses on improving mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. Another specialised approach is mentalisation-based therapy (MBT), which focuses on helping patients consider how they are thinking and feeling about themselves and others, with the goal of remaining curious and tolerant of complexity.

Both of these treatments are effective for BPD, though they can be difficult to access due to cost and availability. Other treatments, including an approach called good psychiatric management (GPM), were designed with access in mind. GPM is generally less intensive (less time is required each week) and does not require clinicians to have highly specialised training. It is a commonsense treatment that focuses on hypersensitivity in interpersonal contexts, learning about the condition, and building a life outside of treatment.

Many therapists list BPD or personality disorders as a specialty of theirs but do not list the particular treatments they use. When seeking a therapist, it is often useful to search for the mention of specific treatments, or to ask your current medical or mental health care provider for referrals to clinicians who offer them.

Fortunately, many of the elements of BPD-focused treatments are present in general psychotherapy, and there is no evidence that receiving a therapeutic treatment not designed for BPD is harmful. Although we recommend seeking BPD-specific care, receiving some kind of psychotherapy is important, even if one of the types mentioned above is not currently available to you.

If you’re just starting treatment, you might see improvement in BPD symptoms in as little as 10 sessions. However, therapy for BPD usually lasts for a year or longer. Often, the frequency of therapy sessions decreases over time.

The amount of time you spend in therapy may depend partly on your goals, and you should set these in collaboration with your therapist. Your goals might relate to your emotional experience: for example, perhaps you would like to feel better about yourself, or learn coping strategies for painful emotions. You may also have behavioural goals, such as reducing self-harm or impulsive behaviours. Other goals could be more functional, such as holding stable employment or pursuing educational advancement.

Actively engage with your treatment

Therapy can be an emotionally challenging and time-consuming process, but it will be helpful only if you fully commit to it. Treatments for BPD in particular rely on your active participation. So it’s useful to approach therapy with an open mind and a willingness to try new things. Some treatments have very specific guidelines or structures, but you still have significant agency and choice within the treatment process. Work together with your therapist to agree on your treatment goals, monitor progress, and negotiate instances of disagreement or conflict.

Additionally, you have a right to information. You should feel empowered to ask your therapist or physician about your diagnosis, including how they think it explains your problems and what to expect in terms of treatment and recovery. It’s also important to ask your care providers about their experience treating BPD, and to request referrals to a therapist, psychiatrist or treatment programme if your provider is not trained to treat BPD, or if you do not feel that your treatment is working.

Use self-help strategies

While professional help is important for navigating the ups and downs of BPD, there are many beneficial things you can do in addition to formal treatments. Self-help strategies – including self-reflection, learning more about BPD (like you’re doing right now), and even daily habits such as getting exercise and eating well – are associated with better social and occupational outcomes for people with BPD. Finding the right professional treatment can take time. In the meantime, or in between treatment sessions, there are steps you can take on your own to start improving your mental health.

Try journaling

People with BPD are often highly self-critical, and this can drive problematic behaviours, including self-harm. There is evidence that regular (daily or weekly) writing in a journal about positive aspects of yourself can be helpful in both the short and long term. For example, you might write about one kind thing that you did recently, or one thing that you like about yourself (or that others like about you). Some other prompts, which could be useful for reflection and for understanding your response to the diagnosis, include:

a) How did you feel when you first heard the term ‘borderline personality disorder’, and how are you feeling now?
b) What do you think about when you hear ‘recovery’?
c) Picture yourself in 10 years: what are your hopes for this version of you?

Seek psychoeducation

Psychoeducation means learning more about the disorder from trustworthy sources, and it is a part of most major treatments for BPD. Generally, it’s a good idea to find sources that have been vetted by people with BPD or by BPD-focused advocacy organisations. We’ll share some specific resources in the Links & Books section at the end of this Guide. As you learn from these sources, reflect on how the information presented might help you understand your own story better.

Build a mindfulness practice

Mindfulness takes many forms, including but not limited to meditation. The ‘Five Breaths’ exercise described above is one example. Mindfulness refers broadly to the practice of noticing thoughts and feelings as they come up, without judgment. As one of the core elements of DBT, mindfulness is associated with benefits ranging from better sleep to relief from anxiety and depression. It is a particularly helpful tool for counteracting challenges such as black-and-white thinking and intense mood swings. While mindfulness alone may not make negative feelings go away entirely, it helps to create distance between a trigger – such as a perceived rejection, or a particularly strong negative thought – and your reaction. By widening the gap between trigger and response, mindfulness provides you with time to bring in additional tools, such as the distress-tolerance skills taught in DBT or simply something positively distracting.

If you’re looking for a place to start, there are plenty of quick, low-effort ways to incorporate mindfulness into your daily routine. Mindfulness exercises can feel difficult at first, but become easier with consistent practice. Sometimes it takes trial and error to find the practices that work best for you. Try to adopt a willing, open mind as you explore them.

One simple practice is getting outside and paying attention to your five senses. Go on a walk (in nature, if possible), and count five things you see or hear. Similarly, you could focus on your senses as you do something as routine as washing the dishes. What does the soap smell like? How does the water sound? How does it feel as it washes over your hands?

The BPD-focused organisation Emotions Matter provides a list of resources that include tools and apps for practising mindfulness.

Connect with social support

Think about current sources of support in your life. Are there particular friends, family members, teachers, religious leaders or other people who might be helpful to you as you navigate having this diagnosis? Now is a good time to cultivate supportive relationships with these individuals, to consider how you might want to talk with them about your experience, and to make a plan for reaching out when you are having an especially difficult time. People with BPD often report significant loneliness or social isolation, which may worsen symptoms. Improvements in this area are one indication of recovery. Aside from any existing sources of social connection, are there activities (eg, hobbies, volunteer work, interest groups) that you could join that would help you feel more connected to others?

If you are having trouble thinking of people who can offer support, you still have options. One of the benefits of a diagnosis is the ability to connect with others around a common framework, set of symptoms or similar experiences. We recommend seeking out support groups for BPD in your area, or joining remote support groups. Emotions Matter is one organisation that offers peer support groups.

Support groups range in size and format, and you might want to try more than one to find the right fit. Regardless of these differences, support groups offer a non-judgmental, safe space for you to speak about your experiences and to learn from others who have faced similar challenges. You can expect to feel supported and empowered; to be encouraged (but not required) to share your story; to join with others to solve problems; and to learn what recovery looks like for others.

Prepare for talking about the diagnosis with others

In some circumstances, connecting with support may require disclosing your diagnosis. And although a BPD diagnosis can be critical for finding support and understanding yourself better, the unfortunate reality is that it is associated with significant stigma. Many people with BPD have encountered negative attitudes about the condition among people in their everyday lives, as well as from media sources and healthcare providers. This stigma is associated with discrimination, including in healthcare and work settings. Support groups can be helpful for working through your reactions to stigma and learning ways to advocate for yourself if you face any discrimination.

Sharing the lived experience of BPD with others is an important way to reduce stigma. But it can be helpful to pause and think about whether, when and how you want to share your own experience. Consider what you will gain from disclosure – it can be powerful to feel understood by someone, for example – but there’s also the potential for a negative reaction. Consider the person you might tell about your diagnosis: do they seem interested in understanding you, and open to learning more? Does this person need to know your diagnosis in order to understand you?

We hope that you do find people with whom you feel empowered to share your story. When talking about your diagnosis with loved ones or friends for the first time, it may be useful to have materials about BPD to share with them, particularly if you think they might have a stigmatising reaction to your disclosure. Stigma is often the product of misunderstanding. We’ll provide some resources in the Links & Books section below that were developed for families and friends. Although it can be difficult to navigate disclosure, well-informed friends and family can be excellent sources of support as you make your way toward recovery.

The path to recovery

One of the most effective treatments for BPD, dialectical behaviour therapy (DBT), was developed by Marsha Linehan, who herself has BPD. Linehan’s book Building a Life Worth Living: A Memoir (2020) is a powerful account of her life, covering her past experience being subjected to misguided, shocking and harmful treatment, and her path to becoming one of the most influential researchers in clinical psychology. Linehan is proof that BPD need not limit one’s life trajectory, and her memoir is a prominent example of the importance of what she has called ‘building a life worth living’.

In both DBT and good psychiatric management (GPM), patients are encouraged to build lives that are meaningful to them, through employment, education, volunteering or hobbies. Engaging in valued activities often provides important social stability for people with BPD, for whom relationships, particularly romantic relationships, can be challenging and destabilising. Moreover, establishing life goals, feeling a sense of competence in valued activities, and finding purpose are ways of building a coherent and positive sense of self, and they can all increase motivation for treatment. As part of these therapeutic approaches, patients are also helped to work past self-limiting beliefs – for instance, the belief that one’s goals are out of reach – and to recognise that building a life of valued pursuits is an important part of recovery.

Take, for example, one patient who had long struggled with intense emotions, tumultuous relationships, physical self-harm, and other common symptoms and signs of BPD. She received several diagnoses, was prescribed multiple medications that did not help, and felt she was going around in circles. This changed when she found a therapist who diagnosed her with BPD in her early 30s. While she was reluctant to accept the diagnosis at first, having heard negative things about it, she found that it helped her understand her problems. It also helped her connect with a therapist who provides DBT and a network of peers with similar experiences.

Now in her late 30s, she has completed a degree in veterinary technology and holds a stable job doing work with animals, which she loves. She continues to see a therapist on a semi-weekly basis and is a leader of a local peer-support group for people with BPD. She has learned to set healthy boundaries with her family, and regularly spends time with her young nephews. When she was diagnosed with BPD, she put romantic relationships on hold. Now that she has a better understanding of herself, she is beginning to think about dating again. She also has the goal of becoming a veterinarian, and is ‘taking it easy’ with one class at a time. She still feels emotions intensely, but has found healthy coping strategies and feels grounded in a life of purposeful work and meaningful hobbies.

The majority of people with BPD will reach a point in their lives when they no longer meet the diagnostic criteria for BPD. This is sometimes referred to as being ‘in remission’, more commonly as being ‘in recovery’. Recovery in BPD is not a fixed state, but rather an ongoing process of learning and symptom management. It is possible that symptoms will go away for years and then come back in the wake of an unexpected hardship. Still, with time and dedication, people with BPD are regularly able to build meaningful relationships, gain financial and emotional independence, and gradually develop a more stable sense of self. Those in recovery describe feeling more connected to others, in control over their behaviours and reactions, hopeful for their futures, and compassionate toward themselves.

Recovery may bring a greater sense of calm to your life, but it doesn’t mean that you will become a boring, emotionless version of yourself. Having emotions, even strong emotions, is a natural part of the human experience. In fact, people recovering from BPD have reported feeling more in touch with their emotions, as well as being better able to understand what they are experiencing.

Emotions Matter is a nonprofit organisation dedicated to improving the lives of people with BPD through advocacy, raising awareness and fostering connection among people with BPD and their families. Its website offers useful facts about BPD and a list of resources, such as books, podcasts and videos, that has been reviewed by people with lived experience of BPD. And this document summarises strategies for finding a therapist, also recommended by people who have experience with BPD.

Another helpful nonprofit organisation, the US National Education Alliance for BPD (NEABPD), offers a broad range of resources and programming through its website. Of particular note are its resources for family members of people with BPD, including its free Family Connections programme.

The Sashbear Foundation is a Canadian organisation that provides support and advocacy for patients and families affected by emotion dysregulation, suicidality and related mental health concerns, all of which are relevant to BPD. Check out its website to learn more about the educational programming it offers for patients and families.

Mental health webinars are provided free of charge through McLean Hospital in Massachusetts, part of the Harvard Medical School system. Although some of these webinars are designed with mental health professionals in mind, many are useful for people with BPD and their families.

Even YouTube has useful information, but caution is necessary, as there is a great deal of problematic or stigmatising content. We recommend starting with YouTube channels developed by people who have personal experience with BPD. The BPD Bunch features people who are in functional recovery, with weekly ‘talk show’-style videos that explore how the experience of BPD differs between people, pathways to recovery, and other topics. Another channel, BorderlinerNotes, was developed by a filmmaker who has BPD. It features interviews with experts, example assessment of therapy sessions, and more.

We work hard to bring you the most trustworthy, expert and up-to-date information on psychology and mental health in our Guides. You can learn more about how we ensure that they are a reliable source of information here. This Guide is provided as general information only. It is not a substitute for independent, professional medical or health advice tailored to your specific circumstances. If you are struggling with psychological difficulties, we encourage you to seek help from a professional source.