By Dr. David Woo - June 19, 2023

Borderline personality disorder, or BPD, is a mood disorder characterized by having an unstable self-image and problems with emotional regulation that can be disruptive to the sufferer’s well-being, career, family, and social life. BPD can be difficult to live with, but it is treatable, and it’s important to recognize symptoms early so that the correct treatment can be sought as soon as possible. When the disease is recognized and treated, BPD sufferers actually have a better long-term prognosis than sufferers of other disorders such as depression (1). In this article, we will look at the symptoms of BPD, including quiet BPD symptoms, and explore treatment options for BPD.

Symptoms of BPD

BPD produces a range of symptoms, which can be grouped into 4 main categories(2). These are:

• Emotional instability, also known as “affective dysregulation,” includes intense feelings of rage, despair, loneliness, unworthiness, and other negative emotions.
• Disturbed patterns of thinking or perception, also known as “cognitive or perceptual distortions,” can include hallucinations or fears (e.g., that your loved ones secretly hate you).
• Impulsivity, especially urges to self-harm or engage in risky behavior.
• Intense but unstable relationships characterized by an intense fear of abandonment and/or of smothering/closeness that creates a love/hate dynamic.

‘Quiet’ BPD Symptoms To Watch Out For

Research has shown that dramatic, acute symptoms of BPD (e.g., self-mutilation or suicide attempts) attract more attention and treatment than the so-called ‘quieter’ symptoms such as feelings of loneliness and isolation, that tend to persist (3,4).

Not every BPD symptom will be dramatic or public, so it’s important to be aware of and watch for these so-called ‘quiet’ symptoms too.

BPD Symptoms In Women Vs BPD Symptoms In Men

Symptoms of BPD in females can often differ from male BPD symptoms. For instance, male BPD sufferers are more likely to display aggression, anger, and impulsivity. Among women, mood swings and self-harm are more common. Unfortunately, men with BPD are also slower to seek care and receive a diagnosis than women (5,6).

It also is worth noting that studies of BPD among transgender or gender-diverse (TGD) individuals suggest a higher rate of occurrence among this group compared to cisgender people, but concluded that this is likely due to the additional societal stressors that affect gender non-conforming people.

Despite these differences, not everyone is typical and it is important not to let gender bias lead us to dismiss signs of BPD or delay seeking help. Whatever an individual’s gender, they should be encouraged to seek treatment.

Treatment Options For BPD

Typical treatments for BPD include  cognitive behavior therapy (CBT), dialectical behavior therapy (DBT), and medications. Patients for whom prescription drugs have not worked, or who wish to avoid potential side effects, should also consider Transcranial Magnetic Stimulation (TMS).

TMS uses a head-mounted device to reach the areas of the brain associated with mood disorders by sending tiny electromagnetic pulses to  stimulate neurons in a way that alleviates symptoms. TMS has a great success rate in treating depression and anxiety, and studies have shown it to be also effective in treating BPD symptoms.

TMS For BPD In NYC

If you or a loved one is experiencing symptoms of BPD, it is important to seek help as early as possible. TMS can be a great drug-free way to find relief from BPD symptoms, especially if other treatments have not been effective.

To make an appointment with a licensed healthcare professional at Madison Avenue TMS & Psychiatry, contact us online or call (212) 731-2033.

Sources:

1. Borderline Personality Disorder (BPD). Health Guide. Link. Accessed May 7, 2023.
2. Symptoms – Borderline personality disorder. NHS. November 7 2022. Link. Accessed May 7, 2023.
3. Zanarini, Mary C. Ed.D. Frankenburg, Frances R. M.D.D. Reich, Bradford M.D. Silk, Kenneth R. M.D. Hudson, James I.M.D., Sc.D. McSweeney, Lauren B. B.A. The Subsyndromal Phenomenology of Borderline Personality Disorder: A 10-Year Follow-Up Study. The American Journal of Psychiatry. 2007; Published Online. Link. Accessed May 7, 2023.
4. Choi-Kain, Lois W., Zanarini, Mary C., Frankenburg, Frances R., Fitzmaurice, Garrett M., and Reich, Bradford. A Longitudinal Study of the 10-Year Course of Interpersonal Features in Borderline Personality Disorder. Journal of Personality Disorders. 2010;24(3). Link. Accessed May 7, 2023.
5. Qian X, Townsend ML, Tan WJ, Grenyer BFS. Sex differences in borderline personality disorder: A scoping review. PLOS ONE. 2022;17(12). Link. Accessed May 7, 2023.
6. Busch, Alexander J., Balsis, Steve, Morey, Leslie C., and Oltmanns, Thomas F. Gender Differences in Borderline Personality Disorder Features in an Epidemiological Sample of Adults Age 55–64: Self Versus Informant Report. Journal of Personality Disorders. 2016;30(3). Link. Accessed May 7, 2023.

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.