Anxiety and Borderline Personality Disorder

Micah Abraham, BSc

Written by

Micah Abraham, BSc

Last updated October 10, 2020

Anxiety and Borderline Personality Disorder

Not all mental health disorders are treated like diseases, where the symptoms simply need to be cured or eliminated entirely. In some cases, mental illness is about one’s experiences and behaviours that are tied to one’s underlying personality. For example, when one’s personality differs from social norms, one might be diagnosed with a personality disorder. In this case, treatment is focused on helping that person to cope in the most effective way possible.

Borderline personality disorder (BPD) is a common condition that is characterized by a host of different challenges and symptoms. One experience that’s frequently associated with borderline personality disorder is anxiety; and often people with BPD are also diagnosed with an anxiety disorder as well. Anxiety can control a person's life whilst also being the result of the way that one sees themself. In the case of BPD, both occur simultaneously and an important part of recovery is learning how to treat one’s anxiety.

What is Borderline Personality Disorder?

A personality disorders is a long-standing pattern of thoughts, feelings and behaviours that threaten a person’s well-being and mental health. There are 10 different types of personality disorders; BPD is one of the more common forms. This type of personality disorder is characterized by:

  • Rapidly shifting, unstable moods
  • An unstable sense of who they are in the world
  • Ongoing difficulties in relationships with others
  • Black/white, good/bad thinking
  • Self-harm
  • Increased suicide risk
  • Persistent feelings of emptiness
  • An intense fear of abandonment

Because those with BPD also experience significant shifts in mood, they tend to be more prone to anxiety. It is likely because those with BPD tend to experience very strong emotions and difficulties in regulating those emotions; so when they experience anxiety, fear, or stress, these experiences may be amplified and overwhelming.

How Common is Borderline Personality Disorder?

Personality disorders can be difficult to diagnose and differentiate from other behavioral/mental health problems, such as depression and anxiety. However, estimates put the number of people with BPD at somewhere between 1 to 2% of the population, with most estimates putting the number at 1.6%.

Many people live for years without knowing they have BPD, and many more diagnose themselves with BPD even though they don’t have it simply because people call them emotional. If you think you might have BPD, it is best to consult with a professional in order to get some expert input.

What Causes BPD to Lead to Anxiety

Unfortunately, it's not entirely clear exactly why BPD and anxiety are so closely interlinked. But more than half of those that struggle with BPD may also experience panic attacks and other anxiety symptoms. Here are some possible explanations for the link:

  • Interpersonal Problems BPD is characterized by interpersonal difficulties. Friendships, romantic connections, collegial relationships and family bonds are all essential aspects of social functioning. People with BPD who struggle with such relationships may develop anxiety that is linked to problems with social functioning.
  • Self-Worth/Value People with BPD often experience a low self-esteem. Self-confidence plays an important role when it comes to avoiding or managing anxiety, so the fact that people with BPD often have a poor self-esteem may put them at risk of developing anxiety.
  • Emotional Energy People with BPD struggle to self-regulate their emotions in general. This means they are more likely to experience and be overwhelmed by anxiety and related emotions of fear and worry.
  • BPD Behaviors BPD is associated with a wide range of behaviours: from conflict and self-harm to substance use and dietary restriction. All of these behaviours have the potential to cause or exacerbate anxiety.
  • Histories of abuse and attachment difficulties People who have experienced abuse as children - or any other experience that may have disturbed their attachment (i.e. bond) with their primary caregiver - are at risk of developing BPD. These same experiences may also cause the anxiety that is so often seen in people with BPD.

It’s also possible that BPD and anxiety disorders are interlinked as a result of one’s biology. What do we mean? For starters, there seems to be a genetic component to BPD. It’s possible that the same genetic variations which put someone at risk of BPD also put them at risk of anxiety. Furthermore, both disorders might be linked to a variations in a person’s brain chemicals (neurotransmitters), which are also linked to one’s genetics.

Fighting BPD Anxiety

As with any other psychiatric disorder, people with BPD can benefit greatly from psychological support. One popular option is Dialectical Behavior Therapy (DBT), which was developed specifically to help people with BPD.

DBT incorporates two other popular forms of therapy - Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Stress Reduction (MBSR). Ultimately, DBT helps people with BPD to better regulate their emotions and manage their behaviours. This is often seen as the gold standard for managing this condition. Can DBT be helpful for anxiety symptoms specifically? Absolutely.

However, DBT doesn’t work for everyone; and not everyone has access to this sort of a program. It is important, however, that you find some sort of support - some input to help you cope. Anxiety symptoms are highly distressing for anyone; and if you have BPD, anxiety likely makes your entire experience that much more challenging. It’s advisable, therefore, to find ways of reducing your anxiety, preferably whilst also taking steps to get support for your personality disorder more generally.

Questions? Comments?

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Where can I go to learn more about Jacobson’s relaxation technique and other similar methods?

– Anonymous patient


You can ask your doctor for a referral to a psychologist or other mental health professional who uses relaxation techniques to help patients. Not all psychologists or other mental health professionals are knowledgeable about these techniques, though. Therapists often add their own “twist” to the technqiues. Training varies by the type of technique that they use. Some people also buy CDs and DVDs on progressive muscle relaxation and allow the audio to guide them through the process.

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