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Anxiety and Borderline Personality Disorder

  Not all mental health disorders are treated like diseases. Some are patterns of experiences and behavior that differ from social norms. That is the case of borderline personality disorder, a personality type characterized by extreme shifts both in emotions and valuations of self-worth.

Borderline personality disorder has a host of different symptoms, but one issue often associated with it is anxiety. That anxiety can both control a person's life and be the result of the way they see themselves, and it's something that needs to be treated in order to help reduce the effects of borderline personality disorder.

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Anxiety is a Single Symptom

For many people struggling with mental health issues, anxiety is a disorder, not a symptom. Anxiety is specifically what needs to be cured, and then the person can live an emotionally healthy life.

With BPD, the personality disorder is the over-arching problem, and anxiety is simply a symptom of it. But that doesn't mean you can't reduce your anxiety using many of the same methods. My anxiety test is one of the best places to start.

What is Borderline Personality Disorder?

Everyone has a unique personality. When you think about yourself and your behaviors or your thoughts, you might describe yourself as a “nice person” or “shy” or “passionate about fashion.” What you’re describing is an attempt to summarize who you are. You’re not necessarily boxed into these definitions, but if someone got to know you, chances are they would use similar terms to describe you.

In most cases, a person’s personality can change easily and is generally considered to be positive (even if some of the descriptive words may seem negative, like “shy.” There is nothing necessarily negative about being shy).

But for some people, their personality tends to show trends that are largely negative to their long term happiness and function. If that’s the case, you may have what’s known as a “personality disorder.” One type is known as “borderline personality disorder.” This type of personality disorder is characterized by:

  • Rapidly shifting, unstable moods.
  • Black/white, good/bad thinking.
  • Dramatic actions, such as threatening self-harm to prevent losing a relationship.

Those with borderline personality disorder may also engage in self-harm, and other attention seeking behaviors, although attention seeking is difficult to diagnose, as many people seek attention from others.

Because those with borderline personality disorder 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, so when they experience anxiety, fear, or stress, that stress may be amplified. More than half of those that struggle with BPD may also show signs of panic attacks or panic disorder as a result.

How Common is Borderline Personality Disorder?

Personality disorders can be more difficult to diagnose than other types of mental health challenges, simply because it can be difficult to tell the difference between a behavioral/mental heath problem, like anxiety or depression, and a personality disorder.

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 have a professional diagnose you rather than try to guess it yourself.

But while it is not common, it is not rare. 1.6% of adults is almost 4,000,000 people.

How BPD Creates Anxiety

Borderline personality disorder is about mood shifts. People aren't usually simply "emotional." Rather, they tend to experience wild fluctuations in mood and emotions, and those shifts tend to feel extremely powerful.

One of the most notable aspects of BPD is that anxiety is often the "upper" emotion. BPD isn't like bipolar disorder, where a person switches back and forth between great emotions/mania and negative emotions/depression. Often the person switches between negative emotions and anxiety. Rarely does the person experience a long term sense of good feelings. Anxiety is usually present even during times of “positive” emotion.

Nearly 75% or more of those living with BPD also qualify for an anxiety disorder, so it's clear that anxiety is a serious problem with this condition.

What Causes BPD to Lead to Anxiety

Unfortunately, it's not entirely clear exactly why borderline personality disorder causes anxiety specifically. The answer may be in a person's genes. There are biological reasons that some people are more prone to these severe emotional shifts, and possibly the same genes make people more prone to anxiety as well.

BPD also tends to be "triggered." Meaning that not everyone with the gene experiences BPD, but some people - those that have experienced abuse, neglect, or other issues - seem to be more prone to getting it. Anxiety can have similar causes, so it's possible that they develop with each other rather than as a result of BPD itself. However, other possibilities include:

  • Interpersonal Problems BPD is characterized by interpersonal problems and an inability to handle most personal relationships. Friendships are actually an essential part of normal functioning, and many people that struggle with these friendships may run the risk of developing anxiety.
  • Self-Worth/Value One of the symptoms of borderline personality disorder is a lack of self-esteem or value. Confidence plays an important role in avoiding anxiety, so these emotions may contribute to further anxiety.
  • Emotional Energy Emotions can also cause a high amount of energy and uncertainty. Anxiety is an emotion, and it's very possible that those with BPD channel that emotional energy into feeling anxious.
  • BPD Behaviors BPD also creates behaviors that can contribute to the development of anxiety. Some of these, of course, are experiences. Some people with BPD engage in fighting and emotionally reckless behaviors that can cause fear. Others are much less noticeable. For example, those with BPD may develop eating disorders or alcoholism, or they may not exercise. All of those types of behaviors can lead to anxiety.

Very likely there are also issues going on at a chemical level. Anxiety is common in those with malfunctioning neurotransmitters, and it's very likely that deep within the mind there are issues that are leading to low levels of important neurotransmitters, either as a result of the disorder itself or because of the emotional swings. Neurotransmitters are effected by both biology and thoughts/feelings.

Fighting BPD Anxiety

Borderline type personality disorder absolutely requires treatment, and this treatment is often independent of any treatment for anxiety. One of the best is dialectical behavior therapy (DBT), which is a type of therapy based on cognitive behavioral therapy that has shown incredible success at reducing the effects of BPD.

Psychologists are still studying and learning what they can do to help those with borderline personality disorder. Dialectical behavior therapy is the gold standard, however, and can be an effective tool for fighting BPD.

But seeking help for your anxiety is important too. In fact, while it is useful to try to control your BPD, you can also address individual symptoms (such as anxiety) independently, and get at least some relief from the symptoms that are most problematic.

If you haven’t yet, strongly consider taking my free 7 minute anxiety test now. This test will show you what your symptoms say about you, and what you can do to fight it.

Start the test here.


Lieb, Klaus, et al. Borderline personality disorder. The Lancet 364.9432 (2004): 453-461.

Comtois, Katherine Anne, et al. Relationship between borderline personality disorder and Axis I diagnosis in severity of depression and anxiety. The Journal of clinical psychiatry 60.11 (1999): 752.

Herpertz, Sabine C., et al. Evidence of abnormal amygdala functioning in borderline personality disorder: a functional MRI study. Biological psychiatry 50.4 (2001): 292-298.

Author: Micah Abraham, BSc Psychology, last updated Nov 08, 2017.

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