What is borderline personality disorder?

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Health Assured team

17 July 2019

Personality disorders are a type of mental illness that affects a person’s thoughts, perception, and emotions.

People with personality disorders often experience a more rigid and unhealthy pattern of thinking and behaviour. This goes on to affect their ability to relate and react to different situations and people.

There are different types of personality disorders, some more common than others. They’re grouped into three clusters based on similarities in their symptoms and effects.

Within the work setting, you may find managing someone with a borderline personality disorder to be a challenge. The stigma around mental health has made it so employees are reluctant to divulge information about the issues they may be experiencing.

This piece explores borderline personality disorder (BPD) as it relates to the workplace. We’ll highlight some of the causes and symptoms of it and offer tips on how to help someone with borderline personality disorder.


What is borderline personality disorder?

The NHS defines it as a ‘disorder of the mood and how an individual interacts with other people’. It’s one of the most common types of personality disorder. In most cases, individuals experience a lack of interpersonal relationships and self-image.

The term ‘borderline’ refers to how the sufferer is on the midpoint between neurosis and psychosis.

Borderline personality disorder is also known as Emotionally Unstable Personality Disorder (EUPD). It’s one of four types grouped under cluster B on the list of personality disorders.

Others in that category include:

  • Antisocial personality disorder.
  • Histrionic personality disorder.
  • Narcissistic personality disorder.

These share the same characteristics, symptoms and effects. That includes dramatic, over-emotional, and unpredictable thinking or behaviour.


Borderline personality disorder symptoms

There's a wide range of symptoms associated with BPD. These are in four main groups:

  1. Emotional instability.
  2. Disturbed patterns of thinking of perception.
  3. Impulsive behaviour.
  4. Intense and unstable relationships.

Emotional instability refers to the sufferer’s range of intense and often negative emotions including fear, anger, shame, and sorrow. For example, within a work setting, an employee may feel rage or shame after receiving negative feedback on a task or project.

BPD affects different types of thought. It can exacerbate upsetting thoughts or contribute to episodes of strange experiences such as hearing voices or seeing things/people that aren’t there. These symptoms may require reassurance from other people that they’re not real.

One of the most common symptoms of BPD is impulse control. Sufferers may experience difficulty in trying to control an impulse to self-harm or to engage in dangerous or irresponsible activities like binge drinking, unprotected sex, drug abuse and more.

It’s not uncommon for people with BPD to experience difficulty maintaining relationships. Feelings are often between fear of abandonment and becoming overwhelmed. Other symptoms include:

  • Uncertainty around identity.
  • Feelings of emptiness and loneliness.
  • Issues with anger management.
  • Paranoia, psychosis, or disassociation.


Borderline personality disorder causes

Various professional research found that while there’s no one clear cause of or reason for BPD, there's a combination of factors that can contribute to it. These include:

  • Problems with brain chemicals.
  • Problems with brain development.
  • Environmental factors.

Genetics: While experts are yet to find any evidence of a gene for BPD, they do believe the genes inherited for parents can make their children more vulnerable to developing BPD. Individuals are more likely to be diagnosed with BPD if a member of their immediate family also has it.

Brain Chemicals: According to the NHS, research into sufferers of borderline personality disorder shows that many of them have issues with the neurotransmitters in their brain, particularly serotonin. This is said to be linked to depression and aggression, so issues with neurotransmitters (the messenger chemicals) mean the brain may be experiencing problems transmitting signals between brain cells.

Brain development: After studying the brains of people with BPD, researchers identified three parts that are responsible for mood regulation where development was smaller than expected or had unusual levels of activity. These are the amygdala, the hippocampus and the orbitofrontal cortex, all of which are also affected by early upbringing.

Environmental factors: Factors like abuse (emotional, physical and sexual), exposure to chronic fear or distress as a child or neglect by one or both parents all seem to be common among people with BPD. Relationships with close family and friends have the ability to determine how an individual sees the world and themselves so unresolved issues from childhood can contribute to or escalate this disorder.


Borderline personality disorder test

If an employee is concerned about their mental wellbeing and believes they may have a borderline personality disorder, their first port of call should be to their GP who may refer them to a community mental health team for further assessment.

During the assessment, they’ll be asked a set of questions aimed at eliminating the possibility of other illnesses (such as depression and anxiety).

The mental health professionals use an internationally recognised borderline personality disorder diagnostic criteria and diagnose based on a ‘yes’ answer to five or more questions relating to:

  • Suicide attempts.
  • History of unstable relationships.
  • Self-image and impulse issues.
  • Anger, loneliness and other emotional issues.


How to manage someone with a Borderline Personality Disorder at work

Your work environment can either be very helpful or detrimental to the wellbeing of an employee with BPD.

The ideal setting is to provide stability, continuity and professional development. However, it could also be a source of stress that can worsen the symptoms of BPD.

It shouldn’t come as a surprise that some employees may experience borderline personality disorder problems at work. Regular displays of the symptoms can lead to unstable relationships between colleagues, employers and clients. All of which can impact morale and the company’s bottom line.

With this in mind, it’s important for you to learn how to manage employees with BPD.

An important step is to create policies that reflect appropriate workplace etiquette and apply to all employees. An effective company policy should highlight the organisation’s position on issues such as harassment, discrimination, bullying and more. It should also include information relating to the repercussions of violating any of these policies.

You should also remember to keep an open mind when dealing with employees with BPD. While it may be easy to blame an outburst or conflict on them, it’s important to remember that issues may be as a result of other factors including the role, the company culture or other colleagues triggering their symptoms.

An important thing to remember is that sufferers of BPD aren’t likely to change their behaviour or feelings. It’s up to you to decide to change how you respond to them. With Employee Assistance Programmes, you can offer professional support to employees living with this disorder and train managers on how to deal with borderline personality disorders at work.


Get in touch for expert advice

To find out more information on any of the topics mentioned in this article, please contact Heath Assured on 0844 892 2493.

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