The question of whether Borderline Personality Disorder (BPD) is being overdiagnosed is complex, with experts holding divided opinions and data pointing to both overdiagnosis in some contexts and widespread underdiagnosis in others.
Several things can make BPD more common now:
The Myth that BPD Isn't Treatable
Today, unfortunately, many professionals continue to think that BPD is not treatable despite growing evidence that it is. This leads some professionals to avoid giving the diagnosis even when someone meets the criteria.
Part of the reason for this is that it has some overlap with other disorders. For instance, BPD commonly includes post-traumatic stress disorder (PTSD), depression, and anxiety, although being diagnosed with these alone can mask the bigger issue. BPD is also frequently misdiagnosed.
A small study of 700 participants showed that diagnostic criteria for BPD put patients with BPD at risk of being misdiagnosed with BD, as it found that 40% of those diagnosed with BPD report having been misdiagnosed with BD.
Some of the symptoms of BPD are also symptoms of other conditions, which can lead to a misdiagnosis. Examples of these symptoms include impulsivity, shame, anger, feelings of emptiness, intense emotions and suicidal thoughts. Conditions that have many of the same symptoms as BPD include: Bipolar disorder.
183 GPs said mental health problems were being over-diagnosed a lot, 259 said over-diagnosed a little, 197 said neither over-diagnosed nor under-diagnosed, 49 said under-diagnosed a little and 32 said under-diagnosed a lot.
Why BPD Symptoms Peak in Early Adulthood. In the 20s, identity formation and independence conflict with emotional vulnerability. Research shows impulsivity and mood swings occur most frequently between the ages of 18-25.
It has no basis in the scientific study of personality and is used indiscriminately to describe myriad negative interactions in human relationships that have cause far beyond personality function, extending from simple disagreement to total functional breakdown.
Yes, people with Borderline Personality Disorder (BPD) can absolutely live normal, stable, and fulfilling lives, especially with effective treatment like therapy, which helps them manage symptoms and develop coping skills, leading to significant improvement or even remission, though "normal" might look different and require ongoing self-care and support. While BPD is a lifelong condition, symptoms often lessen with age, and with the right strategies, individuals can achieve long-term recovery and a high quality of life.
Neurodivergence includes Autism Spectrum Disorder (ASD), Attention Deficit and Hyperactivity Disorder (ADHD), Dyslexia, Dyspraxia, Dyscalculia, Dysgraphia, and Tourette Syndrome, as well as some long-term mental health conditions, such as depression and borderline personality disorder (BPD).
It is called 'borderline' because doctors previously thought that it was on the border between two different disorders: neurosis and psychosis. But these terms are no longer used to describe mental illness. It is sometimes called emotionally unstable personality disorder (EUPD).
Cognitive triggers
Thoughts that seem to come out of nowhere can trigger intense distress and other BPD symptoms. This is particularly true for people who have BPD related to traumatic events like child abuse. A memory, location or image of a past experience of trauma or loss can bring about intense emotions.
The description of these symptoms includes paradoxical elements that are very characteristic of BPD adult patients: when faced with minor stress, patients have a disproportionate reaction, while they are sometimes able to manage major stress without any particular reaction (5, 6).
Conclusions: Parental externalizing psychopathology and father's BPD traits contribute genetic risk for offspring BPD traits, but mothers' BPD traits and parents' poor parenting constitute environmental risks for the development of these offspring traits.
Over time, many people with borderline personality disorder (BPD) overcome their symptoms and recover. Additional treatment is recommended for people whose symptoms return. Treatment for BPD may involve individual or group psychotherapy, carried out by professionals within a community mental health team (CMHT).
Clinicians can be reluctant to make a diagnosis of borderline personality disorder (BPD). One reason is that BPD is a complex syndrome with symptoms that overlap many Axis I disorders.
Obsessive-Compulsive Disorder (OCD) Arguably, the most misunderstood mental illness out there is obsessive-compulsive disorder or OCD. And if it doesn't take the number one spot, it's certainly up there vying for the title.
A common misdiagnosis and coexisting disorder with BPD are bipolar disorders. Both conditions have crossover traits that can be difficult to distinguish from one another. However, both disorders are conceptualised differently: BPD as a personality disorder and bipolar disorders as a brain disease.
In general, the BPD group was faster to remit than the comparison group of patients with other PDs. Taken together, these results suggest that patients with BPD are able to achieve remission of symptoms, and that the longer the remission lasts, the lower the risk of relapse.
Understanding High Functioning BPD
Individuals with this diagnosis may have impulsive behaviors, experience intense anger, and undergo frequent mood swings that drastically affect how they interact with others. As a result, maintaining stable relationships can be difficult due to their emotional and behavioral state.
The "3 C's of BPD" typically refer to advice for loved ones of someone with Borderline Personality Disorder, reminding them: "I didn't cause it, I can't cure it, I can't control it," to help set boundaries and avoid taking on undue responsibility for the person's actions or illness. Another set of "C's" describes core BPD traits for individuals: Clinginess (fear of abandonment), Conflict (intense relationships/moods), and Confusion (unstable self-image).
You can only be given medication after an initial 3-month period in either of the following situations: You consent to taking the medication. A SOAD confirms that you lack capacity. You haven't given consent, but a SOAD confirms that this treatment is appropriate to be given.
The “Big 3” misdiagnose conditions
Research by Johns Hopkins has pinpointed three major categories where these medical errors are most likely to occur. Dubbed the “Big Three” — cancers, vascular events and infections — these conditions account for nearly half of all serious, misdiagnosis-related injuries.
If you think depression, schizophrenia, or bipolar disorder are the mental illnesses most commonly linked to an early death, you're wrong. Eating disorders—including anorexia nervosa, bulimia, and binge eating— are the most lethal mental health conditions, according to research in Current Psychiatry Reports.