Borderline: causes, symptoms, consequences, treatment

Someone with borderline is unable to deal with emotions or feelings correctly. Borderline is a psychiatric disorder that falls under the personality disorders. About one to two percent of the Dutch population suffers from borderline. As with other conditions, there are both mild and severe cases. What is the influence of borderline on the person who suffers from it and what is the influence on the people in their immediate environment?

Article content

  • Borderline
  • A piece of history
  • Causes of borderline
  • Possible symptoms borderline
  • A nice person
  • Borderline diagnosis
  • Borderline treatment
  • The influence of borderline on the person who suffers from it
  • The influence of borderline on people in the immediate environment
  • Borderline prognosis
  • Borderline Foundation


Borderline is also called emotion regulation disorder . It is a psychiatric disorder and falls under the personality disorders . You talk about a personality disorder when someone suffers and/or is harmed by a long-term pattern of behavior and thoughts. Someone with borderline is unable to deal with emotions or feelings correctly. The diagnosis is made more often in women than in men, by a ratio of (approximately) four to one.

A piece of history

In 1938 , the term borderline disorder was first used to describe a mental disorder. Mental disorders at that time were divided into two categories: neuroses and psychoses . People who did not fit neatly into either category and had characteristics of both disorders were called borderline. A borderline case between neurosis and psychosis. Borderline literally means boundary. After that, not much attention was paid to the disorder for a long time. It was only in the 1960s that borderline came into the spotlight again thanks to a psychiatrist: Kernberg. It was not until 1980 that the disorder was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) . This is a book in which all mental disorders are described and their associated characteristics. Since then, borderline disorder has been classified as personality disorders. Borderline is no longer a borderline case, but a disorder in its own right. Borderline is defined in the DSMS as: someone with a profound pattern of instability in interpersonal relationships, self-image and emotional life, and of clear impulsiveness. This begins in early adulthood and manifests itself in various situations.

Causes of borderline

It is not yet clear how borderline develops. It is known that there are many risk factors. In borderline, biological predisposition as well as environmental and social influences probably play a role.

  • Biological predisposition : predisposition means that certain characteristics of borderline are present in the genes. It mainly concerns the predisposition to impulsiveness and mood swings. People with borderline have abnormalities in the metabolic processes that take place in the brain: a disorder in serotonin metabolism. Serotonin is one of the substances in the nervous system that ensures that stimuli can travel from one nerve to another.
  • Environmental factors : if borderline is present, there are many factors that play a role in the development of the personality disorder. Many people with borderline had problems when they were small children. This could, for example, concern emotional neglect, a mental illness in one or both parents, sexual abuse, physical abuse, divorce or the death of someone in the family.
  • Social developments : borderline seems to be more common in our Western culture and not so often in less modern and fast-paced societies. In fast-paced societies, people expect more and there is more pressure.

Possible symptoms borderline

  • Problems in relationships : with borderline you often see that there are constant problems in relationships with others. Someone with borderline may really like someone and want to be around them all the time, but this can suddenly change. That wonderful person is then suddenly a very bad person. This is also called black and white thinking, it is all or nothing. This allows relationships (including sexual ones) to follow each other quickly. This way of thinking also influences contacts with colleagues, care providers and of course it has influence in a family.
  • Emotional instability : someone with borderline may be depressed, anxious or very angry one moment and be ‘normal’ again the next. It is very difficult to maintain a good feeling. Anger can arise suddenly and this can also express itself in physical violence.
  • Suicidal behavior or threats of suicide : this behavior evokes a lot of emotions in people in the immediate environment. Eight to ten percent of people with borderline would die by suicide. An even greater number attempt suicide and even more people threaten it.
  • Impulsiveness : someone with borderline can start or stop something at a moment’s notice. For example, this could involve education, spending money on gambling, alcohol or drugs.
  • Self-harm : this is also called self-harm. It is experienced as very frightening by people in the immediate vicinity. It is a way for someone with borderline to reduce the emptiness and unpleasant feeling of dissociation. It can also be to show how difficult he or she is having it. It often happens, without the intention of actually committing suicide.
  • An unstable self-image : someone with borderline does not know who or what he or she is and often has little self-confidence.
  • Separation anxiety : often afraid of being abandoned. The fear can lead to great panic. The problem is that someone often does not function well in the presence of others. It is difficult for someone with borderline to regulate distance and closeness.
  • Feeling of emptiness : People with BPD often report feeling a sense of emptiness.
  • Doubt : someone with borderline often doubts what he or she does or feels. That is why others are constantly asked questions about how things should be done.
  • Using substances or abuse of substances : the use is not always due to impulsive behavior. It may also be that someone is simply addicted. It may also be that the substances, especially soft drugs, are used to avoid feeling the feelings of fear and emptiness.
  • Lying : someone with borderline can lie a lot, even in situations where it is clear that the truth is not being told. You should see lying as a way to gain control over things.
  • Negative assessment of the environment : the experience of situations is usually not positive. How someone with borderline perceives things is often different from reality. In the event of a disagreement you may be faced with two completely different stories.
  • Paranoid thoughts and dissociation : sometimes people with borderline suffer from paranoid thoughts or dissociative symptoms, often at times of stress. Paranoid thoughts include suspicion and not trusting the people around him or her. Dissociation means that someone has the idea of not being themselves, not being in their own body, not being in reality.
  • Fun : someone with borderline has difficulty enjoying holidays and family gatherings, for example. This leads to an even greater feeling of emptiness. Black and white thinking can also lead to arguments. Furthermore, separation anxiety can occur because a lot of attention is paid to other people.
  • Physical contact : some people with borderline prefer no physical contact, but there are also people with borderline who want a lot of physical contact.
  • Wanting to have control over the environment : because someone with borderline often has little control over themselves, he or she tries to control the environment.
  • Manipulation : manipulation in itself is not strange or deviant, but someone with borderline can manipulate in a very aggressive way. For example, by threatening suicide. However, it can also take place in a subtle way.
  • Claiming : this can have several causes. It may be due to separation anxiety or because someone with borderline often cannot remember the love of others when the person is not around. For example, someone may call a lot only to be told each time that someone still loves him or her. By claiming, someone can also try to maintain control over the environment.
  • Additional other psychological complaints : anxiety and depression are common.

A nice person

If you look at the above symptoms, you might think that someone with borderline cannot be nice. But that is certainly not true. Not everyone with borderline suffers from all symptoms and the extent to which can vary greatly. Many people with borderline are smart, intelligent, have a great sense of humor, are warm, friendly and are successful.

Borderline diagnosis

The diagnosis is made on the basis of symptoms that are present, the history of the person and his family and the doctor’s assessment of the psychological condition. A psychiatrist or psychologist talks to the person and asks about his or her ideas about life and work. The ideas and other characteristics associated with it are looked at to arrive at a diagnosis.

Borderline treatment

The treatment of borderline often raises questions, treatment is not always easy. Not every practitioner is suitable to treat people with borderline and there must also be a click between a practitioner and the person with borderline. Also, not everyone with borderline is motivated to seek treatment. Borderline treatment usually takes place on an outpatient basis: consultations at an outpatient clinic. It is also possible to follow part-time treatment or a clinical program. Which form of treatment is best depends on various factors such as: the severity of the problem, private circumstances, what kind of work someone does, ability to pay, and travel distance.

The influence of borderline on the person who suffers from it

The environment places demands on everyone. These demands can evoke fear and uncertainty, especially for someone with borderline. For someone with borderline, fear, uncertainty and the feeling of losing control is a breeding ground for the development of borderline behavior. It is often said that someone with borderline wants attention, it involves manipulating and hurting others. This may seem so, but it is not so. Someone didn’t ask for BPD. The constant mood swings, depressive feelings, impulsiveness, anxiety and pain often cause suffering. Someone with borderline suffers greatly from the disorder.

The influence of borderline on people in the immediate environment

In addition to the influence on the person with borderline, borderline also has an important influence on people in the immediate environment. Others want to reduce the feeling of stress associated with BPD. But the emotions prevent you from dealing with borderline behavior properly and that can prevent borderline behavior from decreasing and sometimes even worsen. It is possible that people in the immediate environment play an important role in triggering or maintaining borderline behavior. Without wanting this and without knowing how it could be otherwise. Borderline can affect the emotions of people in the immediate environment. But there can also be influence in the financial and material areas. Families can be driven apart.

Borderline prognosis

Borderline is difficult to treat, but the prognosis is better with treatment than without treatment. In people with borderline, the symptoms often decrease as they get older. The fact that someone no longer meets the criteria for borderline does not mean that the problems have disappeared, other symptoms remain.

Borderline Foundation

The foundation has the following goals:

  • Improve the image of people with borderline.
  • Enabling mutual support (contact with fellow sufferers).
  • To promote the self-reliance of people with borderline.
  • Improve the quality of care for borderline patients.
  • Sharing experiential knowledge about borderline personality disorders (BPD) with fellow sufferers, bystanders and those involved.