The exact cause of borderline personality disorder is not known. However, several psychological hypotheses rely on biological, social, and psychological factors to understand people with this disorder. The person with a borderline personality is impulsive in areas that have a potential for self-destruction. Risk factors include abandonment issues in childhood or adolescence, sexual abuse, disruptive family life, and poor communication within the family. This personality disorder is often associated with schizotypal, histrionic, narcissistic, and antisocial personality disorders. It tends to occur more often in women.

Relationships with others are intense and unstable. The person will go through frantic efforts to avoid real or imagined abandonment by others, and express mood instability and inappropriate anger. There may also be identity uncertainty concerning self-image, long-term goals or career choice, sexual orientation, choice of friends, and values.

People with this disorder tend to see things in terms of extremes, either all good or all bad. They view themselves as victims of circumstances and take little responsibility for themselves or for their problems.

Other symptoms include:

• Unstable interpersonal relationships
• Frequent displays of temper
• Inappropriate anger
• Recurrent suicide gestures
• Feelings of emptiness and boredom
• Intolerance of being alone
• Impulsiveness in at least 2 of the following areas: money, substance abuse, sexual relationships, reckless driving, binge eating, shoplifting

• Psychological history
• Psychological evaluation

Self-destructive behavior may be modified through peer relationships in social and therapeutic environments. Peer reinforcement of appropriate behavior may be successful because difficulties with authority often impede learning. Group therapy can be helpful in modifying specific impulsive behaviors, as peer pressure in the group may restrain rash behavior.

Drug therapy includes the use of mood stabilizers such as lithium and carbamazepine, antidepressants, and low-dose neuroleptics are also common treatments.

Borderline personality disorder has a poor prognosis (probable outcome) as noncompliance with treatment is common. However, people with this disorder who make it through their 30's and maintain sobriety, may begin to improve.

• Drug abuse
• Suicide attempts
• Eating disorders
• Depression

Go to the emergency room or call the local emergency number (such as 911) if you want to hurt yourself or are abusing drugs or food.