Borderline personality disorder (BPD), which affects about four million Americans, is a largely misunderstood mental health problem that is marked by a combination of troubling symptoms. These include intense emotions (such as anger, depression and anxiety), impulsive actions (including self-harm) and unstable relationships.

Until its inclusion in 1980 in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM–III), the “bible” of mental disorder classifications, mental health professionals did not consider BPD a valid mental disorder. Now, that has changed.

But even with widespread acknowledgement of BPD, mental health professionals still often miss BPD or mistake it for one of the following mental disorders, which commonly accompany the condition…

  • Mood disorders, such as depression and bipolar disorder.
  • Substance use disorders, including alcoholism and drug abuse.
  • Attention deficit hyperactivity disorder (ADHD).
  • Generalized anxiety disorder (GAD).
  • Panic disorder.
  • Post-traumatic stress disorder (PTSD).
  • Eating disorders, including bulimia and anorexia.

While a person with BPD may also have one of these disorders, when the diagnosis of BPD (and the opportunity to treat it) is missed, treatment of the co-occurring condition is less likely to be successful. Example: If you have an eating disorder, you may improve with treatment…but unless BPD is also identified and addressed, your eating problems are more likely to return.

Effective treatment for BPD and accompanying mental health problems requires a proper diagnosis of all mental disorders. For a proper diagnosis, see a licensed mental health professional such as a psychiatrist, psychologist or clinical social worker with experience diagnosing mental disorders. The professional will conduct a comprehensive clinical interview, which may include a review of previous medical records, and possibly interviews with friends and family.

Without adequate treatment, people with BPD are more likely to develop other chronic medical conditions and/or mental illnesses.