What is borderline personality disorder (BPD)?

Borderline personality disorder (BPD) is a mental health condition defined by a pattern of emotional instability, relationship turbulence, and rapid mood shifts. People with BPD often experience intense fear of real or imagined abandonment, leading to frantic efforts to avoid separation from others. This core anxiety can drive both clingy behavior and sudden emotional withdrawal.

Key diagnostic traits include unstable and intense relationships that alternate between idealization and devaluation, a fragmented sense of self that shifts with circumstances or company, impulsive actions (substance abuse, binge eating, reckless spending, risky sexual behavior), recurring suicidal gestures or self-harm, chronic feelings of emptiness, inappropriate anger that is difficult to control, and transient stress-related paranoia or dissociation.

Treatment combines medication and psychotherapy. Psychiatric medications such as antidepressants, mood stabilizers, and antipsychotics do not directly treat BPD but manage co-occurring symptoms like depression and impulsivity. Psychotherapies, particularly dialectical behavior therapy (DBT) and mentalization-based therapy (MBT), are evidence-based approaches that address emotional regulation, distress tolerance, interpersonal effectiveness, and the underlying relational patterns driving the disorder. Psychiatrists working with BPD patients in Milan often coordinate with therapists to ensure integrated care. Finding a provider experienced in adult psychiatry who specializes in personality disorders is important for effective treatment planning.