Borderline Personality Disorder (BPD) is a complex mental health condition characterised by difficulties in regulating emotions, leading to intense mood swings, unstable relationships, and impulsive behaviours. 87 It affects approximately 1.4% of the adult U.S. population, with symptoms often emerging in adolescence or early adulthood. 89 Despite its prevalence, BPD remains one of the most misunderstood and stigmatised mental illnesses, often portrayed in media and popular culture as untreatable or synonymous with “difficult” personalities. 29 This stigma not only affects those living with the disorder but also hinders access to effective treatments and perpetuates harmful myths. 31 In this article, we delve into the realities of BPD, debunk common misperceptions, explore its causes and symptoms, and highlight evidence- based treatments, drawing on recent research and expert insights as of 2025.
Understanding Borderline Personality Disorder: Symptoms and Causes
It’s essential first to establish what BPD entails to address misperceptions. According to the National Institute of Mental Health (NIMH), BPD is a mental illness that severely impacts a person’s ability to regulate emotions, resulting in increased impulsivity, distorted self-perception, and strained relationships. 87 Core symptoms include a profound fear of abandonment, unstable interpersonal relationships that oscillate between idealisation and devaluation (often called
“splitting”), identity disturbances leading to shifting self-image and goals, and impulsive actions such as reckless spending, substance misuse, or self-harm. 88 Individuals may also experience chronic feelings of emptiness, intense anger, paranoia under stress, and dissociative episodes. 89 These symptoms can co-occur with other conditions like depression, anxiety, post-traumatic stress disorder (PTSD), or substance use disorders, complicating diagnosis and treatment. 88 The causes of BPD are multifaceted and not fully understood, involving a combination of genetic, biological, and environmental factors. 65 Genetic predisposition plays a role, as studies show higher risks if a close relative has BPD or similar conditions. 63 Brain abnormalities, such as alterations in areas regulating emotions, impulsivity, and aggression, have been observed in neuroimaging research. 89 Environmental influences, including childhood trauma, abuse,
neglect, or unstable family dynamics, are common but not universal triggers. 88 Contrary to some beliefs, not all individuals with BPD have experienced trauma, and not all trauma leads to BPD, highlighting the disorder’s biopsychosocial origins. 1
The Historical Context and Roots of Stigma
BPD was first described in the 1930s as a condition “on the border” between neurosis and psychosis, a term that has persisted despite its inaccuracy and contribution to misunderstanding. 44 Over decades, it has been mislabeled as untreatable or a “wastebasket diagnosis” for challenging patients, fostering stigma even among mental health professionals. 45 Research indicates that BPD faces more stigmatising views than other disorders, with providers sometimes viewing patients as manipulative or dangerous, leading to reluctance in diagnosis or treatment. 33 This structural stigma—embedded in healthcare systems and societal attitudes—exacerbates isolation and delays care. 31 Public portrayals in films like Fatal Attraction or Girl, Interrupted often exaggerate violent or erratic behaviours, reinforcing fears and misconceptions. 38
Debunking Common Misperceptions
Numerous myths surround BPD, perpetuated by misinformation and bias. Below, we address some of the most prevalent ones with evidence-based facts.
Myth 1: BPD is Untreatable
One of the most damaging misconceptions is that BPD is a lifelong, incurable condition resistant to intervention. 4 In reality, BPD is highly treatable, with many individuals achieving significant recovery through evidence-based therapies. 59 Longitudinal studies show that up to 91% of people with BPD achieve at least a 2-month remission, with 85% achieving remission for 12 months or longer. 54 Treatments like Dialectical Behaviour Therapy (DBT) have proven effective in reducing self-harm and improving emotional regulation. 89
Myth 2: People with BPD are Manipulative and Attention-Seeking
This stereotype paints individuals with BPD as deliberately harmful or dramatic for personal gain, ignoring the underlying emotional pain. 3 Behaviours like self-harm or intense reactions stem from genuine distress, fear of abandonment, and difficulty managing emotions, not manipulation. 3 Experts emphasise that what appears as “attention-seeking” is often a desperate attempt to cope with overwhelming feelings, and labelling it as manipulative increases stigma and discourages help-seeking. 7
Myth 3: BPD Only Affects Women
Historically, BPD diagnoses have been skewed toward women, with estimates suggesting 75% of cases are female. 89 However, recent research indicates men may be equally affected but are often misdiagnosed with conditions like PTSD, bipolar disorder, or antisocial personality disorder due to gender biases in symptom presentation. 19 Men with BPD might express symptoms through externalised behaviours like aggression, leading to under recognition. 22
Myth 4: BPD is the Same as Bipolar Disorder
BPD and bipolar disorder share symptoms like mood swings and impulsivity, but they are distinct. 10 Bipolar disorder involves episodic mania or depression lasting days to weeks, often independent of triggers, while BPD mood shifts are rapid (hours to days) and typically reactive to interpersonal stressors. 9 Bipolar disorder is primarily a mood disorder linked to brain chemistry, whereas BPD is a personality disorder rooted in emotional dysregulation and relationships. 18
Misdiagnosis can lead to inappropriate treatments, such as mood stabilisers alone without therapy. 14
Myth 5: People with BPD Can’t Have Healthy Relationships or Fulfilling Lives
Contrary to portrayals of perpetual chaos, many with BPD form stable relationships and lead independent lives with support. 0 While unstable relationships are a hallmark, therapy helps build skills for healthier interactions. 59 Success stories abound, with individuals thriving in careers and families post-treatment. 72
Myth 6: BPD is Solely Caused by Bad Parenting or Childhood Trauma
While trauma is a risk factor for many, it’s not the sole cause; genetics and brain differences contribute significantly. 1 Blaming parents oversimplifies the disorder and adds guilt, ignoring resilient individuals without traumatic histories. 65
The Impact of Stigma on Individuals and Society
Stigma surrounding BPD leads to discrimination in healthcare, where patients may face blame, fear, or avoidance from providers. 34 This results in delayed diagnoses, inadequate treatment, and higher suicide risks—BPD has an elevated lifetime suicide risk. 88 Socially, it fosters isolation, with individuals internalising negative labels, exacerbating symptoms. 43 Campaigns like those from NAMI and personal advocacy efforts aim to combat this through education and awareness. 29
Treatment Options in 2025
As of 2025, guidelines strongly recommend psychotherapy as the primary treatment for BPD. 77 DBT, Mentalisation-Based Therapy (MBT), and Transference-Focused Psychotherapy (TFP) are evidence-based options focusing on emotion regulation, interpersonal skills, and self-awareness. 89 Medications, such as mood stabilisers or antidepressants, are used adjunctively for symptoms but not as standalone treatments. 89 Emerging research explores personalised
approaches, including early intervention and peer support groups. 87 Hospitalisation may be necessary during crises, but long-term recovery emphasises self-management. 89
Voices from the Community: Challenging Stigma Through Stories
Advocates and those with lived experience are pivotal in dismantling myths. For instance, clinical psychologist Dr. Aaliyah Gibbons shared her personal and professional insights in 2025, emphasising recovery and breaking myths about BPD. 74 Online communities highlight that BPD is not a “moral failing” but a treatable condition, urging compassion. 76 Experts have advocated for renaming BPD to reduce its pejorative connotations, such as to “Emotional Dysregulation
Disorder.” 52
Conclusion: Toward a More Informed Future
Misperceptions of BPD perpetuate suffering, but education, empathy, and evidence-based care can change this narrative. By debunking myths and addressing stigma, we empower individuals to seek help and thrive. Resources like NAMI’s Helpline (1-800-950-NAMI) offer support if you or someone you know is affected. 89 Let’s commit to understanding BPD not as a label of dysfunction, but as a condition deserving of compassion and effective intervention.
References
[0] Borderline Personality Disorder Myths and Facts | NAMI – https://www.nami.org/borderline- personality-disorder/borderline-personality-disorder-myths-and-facts/
[1] Myths (and Facts) About Borderline Personality Disorder (BPD) – https:// www.therecoveryvillage.com/mental-health/borderline-personality-disorder/bpd-myths/
[3] 5 Common Myths About Borderline Personality Disorder – https://www.summitstone.org/ 2023/12/05/myths-about-borderline-personality-disorder/
[4] Dispelling the Myths Surrounding Borderline Personality Disorder – https:// www.socialworkblog.org/news/2024/06/dispelling-the-myths-surrounding-borderline- personality-disorder/
[7] Misconceptions about Borderline Personality Disorder by Sarah Hart … – https:// www.lotustherapygroup.com/blog/right-team-wm6wa-4pf94-4hpc9-dg5c6-eg94b-slzbl-dyzc9- rgsyl-7phdw-crps2-jny4p-wxxys-bbxfm-ekmjh
[9] The difference between bipolar and borderline personality disorder – https:// healthmatters.nyp.org/understanding-difference-bipolar-borderline-personality-disorder/
[10] Bipolar Disorder vs. BPD: Symptoms, Causes, Treatment – https://www.verywellmind.com/ bipolar-and-borderline-personality-disorder-425418
[14] Bipolar Personality Disorder? Learn The Difference Between BPD … – https:// www.optimumperformanceinstitute.com/bpd-treatment/bpd-vs-bipolar/
[18] Bipolar Disorder vs. Borderline Personality Disorder: – Healthline – https:// www.healthline.com/health/your-faqs-answered-bipolar-disorder-vs-borderline-personality- disorder
[19] Gender Patterns in Borderline Personality Disorder – PMC – https://pmc.ncbi.nlm.nih.gov/ articles/PMC3115767/
[22] Borderline Personality Disorder in Men: Symptoms, Stigmas, and … – https:// www.everydayhealth.com/bpd/does-borderline-personality-disorder-affect-women-more-than- men/
[29] The Stigma Associated with Borderline Personality Disorder | NAMI – https://www.nami.org/ Blogs/NAMI-Blog/June-2017/The-Stigma-Associated-with-Borderline-Personality
[31] Structural stigma and its impact on healthcare for borderline … – https:// ijmhs.biomedcentral.com/articles/10.1186/s13033-022-00558-3
[33] Borderline personality disorder, stigma, and treatment implications – https:// pubmed.ncbi.nlm.nih.gov/16990170/
[34] Why People with Borderline Personality Are Treated So Poorly – https:// www.psychologytoday.com/ca/blog/fulfillment-any-age/202201/why-people-borderline- personality-are-treated-so-poorly
[38] Borderline personality disorder is highly stigmatised and lonely – https://kentuckylantern.com/ 2023/03/07/borderline-personality-disorder-is-highly-stigmatized-and- lonely/
[43] Internalised stigmatisation in borderline personality disorder and … – https:// www.sciencedirect.com/science/article/abs/pii/S0165032719316660
[44] BORDERLINE PERSONALITY DISORDER – NCBI – https://www.ncbi.nlm.nih.gov/books/ NBK55415/
[45] The History of BPD: From Past to Present – https://www.optimumperformanceinstitute.com/ bpd-treatment/the-history-of-bpd/
[52] Why Is It Called Borderline Personality Disorder? – Verywell Mind – https:// www.verywellmind.com/borderline-personality-disorder-meaning-425191
[54] The Lifetime Course of Borderline Personality Disorder – PMC – https:// pmc.ncbi.nlm.nih.gov/articles/PMC4500179/ [59] Borderline Personality Disorder Treatment, Recovery, and Remission – https:// www.verywellmind.com/is-there-a-cure-for-borderline-personality-disorder-425468
[63] Causes – Borderline personality disorder – NHS – https://www.nhs.uk/mental-health/ conditions/borderline-personality-disorder/causes/
[65] Causes of Borderline Personality Disorder – Verywell Mind – https://www.verywellmind.com/ borderline-personality-disorder-bpd-causes-425154
[72] My Lifelong Journey with Borderline Personality Disorder | NAMI – https://www.nami.org/ Personal-Stories/My-Lifelong-Journey-with-Borderline-Personality-Disorder
[74] Living with BPD: Breaking Stigma and Finding Healing – https://lifestance.com/blog/living- with-borderline-personality-disorder/
[76] Personal Stories | National Alliance on Mental Illness (NAMI) – https://www.nami.org/blogs/ personal-stories/
[77] Treating patients with borderline personality disorder – https://www.apa.org/monitor/ 2025/04-05/treating-borderline-personality
[87] Borderline Personality Disorder – https://www.nimh.nih.gov/health/topics/borderline- personality-disorder
[88] Borderline personality disorder – Symptoms and causes – https://www.mayoclinic.org/ diseases-conditions/borderline-personality-disorder/symptoms-causes/syc-20370237
[89] Borderline Personality Disorder – https://www.nami.org/About-Mental-Illness/Mental-Health- Conditions/Borderline-Personality-Disorder