Borderline Personality Disorder (BPD)

Borderline Personality Disorder (BPD) is a complex mental health condition marked by intense emotional instability, difficulty maintaining relationships, and an unstable sense of self. People with BPD often experience rapidly shifting moods, fear of abandonment, impulsive behaviors, and difficulty regulating emotions—all of which can disrupt daily functioning and interpersonal connections.

Symptoms typically emerge in late adolescence or early adulthood, and the condition affects about 1.6% of adults in the U.S., though many experts believe the true number is higher. With the right care and ongoing support, individuals living with BPD can learn effective coping strategies, strengthen relationships, and build a more stable and fulfilling life.

At Fine Tune Psychiatry, our team includes specialists experienced in evaluating, diagnosing, and treating BPD, offering both in-person and online psychiatric care to meet each individual’s needs.

What Are the Symptoms of Borderline Personality Disorder?

BPD is defined by a pervasive pattern of emotional dysregulation, unstable relationships, impulsivity, and difficulties with self-image.

Symptoms may vary in intensity but often include:

• Intense fear of abandonment, whether real or imagined
• Unstable or shifting relationships (swinging between idealization and devaluation)
• Rapid mood swings lasting hours to days
• Impulsive or risky behaviors (spending sprees, substance use, unsafe sex, reckless driving)
• Self-harming behaviors or recurrent suicidal thoughts
• A chronic sense of emptiness or lack of identity
• Difficulty controlling anger or experiencing intense, inappropriate anger
• Stress-related paranoia or dissociation

Because symptoms overlap with other conditions (such as depression, PTSD, or bipolar disorder), accurate diagnosis from an experienced psychiatrist is essential.

Types of Borderline Personality Disorder Presentations

While BPD is a single diagnosis, individuals often present with different patterns or subtypes:

• Impulsive Type: marked by risk-taking, substance use, and reckless behaviors.
• Petulant Type: characterized by irritability, difficulty trusting others, and frequent feelings of being let down.
• Discouraged Type: includes dependency, clinginess, and feelings of inadequacy.
• Self-Destructive Type: linked to self-harm, suicidal thoughts, and extreme emotional pain.

Recognizing these patterns helps providers tailor treatment to each person’s needs.

How Fine Tune Psychiatry Treats Borderline Personality Disorder

At Fine Tune Psychiatry, we believe every patient requires a personalized approach. Treatment plans are designed to address each person’s unique emotional patterns, co-occurring conditions, and life circumstances. Care may include therapy, medication support, and skill-building strategies to improve emotional regulation and daily functioning.

Your First Appointment for Borderline Personality Disorder

During the first visit, your BPD psychiatrist will conduct a thorough psychiatric evaluation that includes:

• Personal and psychiatric history
• Review of medications and prior treatments
• Family mental health history
• Safety and risk assessment
• Social, cultural, and relational context
• Screening for co-occurring conditions such as anxiety, depression, or substance use

From there, a personalized care plan is created to address both immediate concerns and long-term stability.

Therapy Options for Borderline Personality Disorder

• Dialectical Behavior Therapy (DBT): Considered the gold standard for BPD, DBT teaches skills in mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness. It has been shown to reduce self-harm and suicidal behaviors while improving emotional stability.
• Cognitive Behavioral Therapy (CBT): Helps individuals identify and reframe unhelpful thought patterns that contribute to emotional swings and impulsive behaviors.
• Schema-Focused Therapy: Works to change deep-seated patterns of thinking and behavior rooted in childhood experiences.

Our clinicians can incorporate therapy into their sessions. If a patient requires more intensive or focused therapy, our psychiatrists and psychiatric nurse practitioners will make recommendations for psychologists and therapists in your area, and will collaborate with them to provide coordinated care. We find that working with a team of specialized providers can result in the best outcomes, and we’re happy to take the time to do so.

Medication Management for Borderline Personality Disorder

While there is no single medication that “cures” BPD, certain medications may help manage symptoms like mood instability, anxiety, or depression. BPD psychiatrists may prescribe antidepressants, mood stabilizers, or antipsychotic medications as part of a comprehensive treatment plan.

At Fine Tune Psychiatry, we focus on using the lowest effective doses to provide stability without compromising a patient’s sense of self.

How to Find the Right Psychiatrist for Borderline Personality Disorder

To find a qualified BPD psychiatrist:

• Ask your primary care doctor for a referral
• Check with local hospitals or university mental health centers
• Search within your insurance network
• Look online for a “BPD psychiatry”
• Consult trusted friends or family for recommendations
• Use national mental health directories or organizations