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Anxiety and Borderline Personality Disorder

Daniel Sher, MA, Clin Psychology
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:

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: 

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.

Article Resources

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.

Koenigsberg, Harold W., et al. Characterizing affective instability in borderline personality disorder. American Journal of Psychiatry 159.5 (2002): 784-788.

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

Ogata, Susan N., et al. Childhood sexual and physical abuse in adult patients with borderline personality disorder. American Journal of Psychiatry 147.8 (1990): 1008-1013.

Siever, Larry J., et al. The borderline diagnosis III: identifying endophenotypes for genetic studies. Biological Psychiatry 51.12 (2002): 964-968.

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