Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD),[9] is a mental illness characterized by a long-term pattern of unstable relationships, a distorted sense of self, and strong emotional reactions.[4][5][10] Individuals often engage in self-harm and other dangerous behavior.[4] Those affected may also struggle with a feeling of emptiness, fear of abandonment, and detachment from reality.[4] Symptoms may be triggered by events considered normal to others.[4] The behavior typically begins by early adulthood and occurs across a variety of situations.[5] Substance abuse, depression, and eating disorders are commonly associated with BPD.[4] Approximately 10% of people affected die by suicide.[4][5]

BPD's causes are unclear, but seem to involve genetic, neurological, environmental, and social factors.[4][6] It occurs about five times more often in a person who has an affected close relative.[4] Adverse life events also appear to play a role.[7] The underlying mechanism appears to involve the frontolimbic network of neurons.[7] BPD is recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a personality disorder, along with nine other such disorders.[5] Diagnosis is based on the symptoms, while a medical examination may be done to rule out other problems.[4] The condition must be differentiated from an identity problem or substance use disorders, among other possibilities.[5]

BPD is typically treated with therapy, such as cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT).[4] DBT may reduce the risk of suicide.[4] Therapy may occur one-on-one or in a group.[4] While medications do not cure BPD, they may be used to help with the associated symptoms.[4] Some people require hospital care.[4]

About 1.6% of people have BPD in a given year, with some estimates as high as 6%.[4][5] Women are diagnosed about three times as often as men.[5] It appears to become less common among older people.[5] Up to half of people improve over a ten-year period.[5] People affected typically use a high amount of healthcare resources.[5] There is an ongoing debate about the naming of the disorder, especially the suitability of the word borderline.[4] The disorder is often stigmatized in both the media and the psychiatric field.[11]

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