Borderline Syndrome – Causes, Symptoms & Treatment

Borderline Syndrome

Borderline syndrome or borderline disorder is a mental illness in the field of personality disorders . Those affected suffer from a lack of social skills. In particular, interpersonal relationships with other people are characterized by pathological instability. Strong mood swings are also common. The view of oneself (self-image) is exposed to strong distortions. Anxiety disorders , anger and despair are added.

What is Borderline Syndrome?

Borderline syndrome is a mental illness in which those affected live in extreme mental tension that is distressing and diffuse. The exact classification of the syndrome is still controversial. Borderline syndrome generally refers to “borderline” or “borderline” and initially came about as a term because it combined symptoms that doctors placed between neurotic and psychotic disorders.

Initially understood as an embarrassment diagnosis, the borderline syndrome is now recognized as an independent clinical picture. Accordingly, borderline syndrome is a specific personality disorder characterized by instability in interpersonal relationships and extreme impulsiveness, mood swings and a distorted self-image.

In addition to the term borderline syndrome, the terms emotionally unstable personality disorder or borderline personality disorder (BPD for short) are also used in technical jargon.


The background to borderline syndrome is not exactly clear. Research to date has found that the syndrome tends to develop in people who have been sexually abused for a long time, experienced strong rejection as children, were emotionally neglected, or have been subjected to physical violence. In this respect, borderliners are severely traumatized people who are exposed to extreme states of anxiety .

It is not certain who and how many people with such traumata have borderline syndrome, because the clinical picture is still not always recognized or precisely diagnosed. However, estimates assume that 1 to 2 percent of a population is affected on average. Around 70 percent of all those affected are women. Based on this estimate, borderline personality disorder would be more prevalent than other mental illnesses such as schizophrenia . Genetic causes can also cause borderline syndrome.

Symptoms, Ailments & Signs

Borderline patients have difficulty classifying and controlling their own emotions and impulses. They quickly give in to their feelings without considering the consequences. These include, for example, outbursts of anger, for which even minor reasons are enough. Mood swings are also among the typical symptoms: Borderliners experience strong emotional storms, which can also be positive, but are mostly short-lived and trigger a strong inner restlessness in them.

In this context, many patients tend to engage in self-destructive behavior. They “cut” themselves, i.e. injure their own body parts with knives or razor blades. Self-destruction can also manifest itself in heavy consumption of alcohol or drugs. Patients often take risks when driving or expose themselves to unprotected sexual intercourse.

They often threaten suicide or actually attempt suicide. Stress often leads to a loss of reality. One speaks of dissociative symptoms, which means that the patient’s perception changes. They perceive their environment as unreal and feel alien or detached from themselves.

Many patients also experience a constant feeling of emptiness – their life seems boring and aimless to them. At the same time, they are often afraid of being alone and enter into relationships, which often turn out to be unstable due to the symptoms.


The states of tension in people with borderline syndrome are characterized by depression , which occurs in almost all borderliners, and the feeling of inner emptiness on the one hand and strong impulsivity on the other. Borderliners have no sense of “normality”, they fluctuate between emotional extremes, live in unstable social relationships and tend to vent the strong inner pressure that can arise suddenly and unfoundedly through extreme behavior. In such cases, those affected injure themselves or put themselves in extreme situations.

Typical behaviors are excessive drug use , reckless driving or balancing on bridge railings. Such high-risk behavior serves to stabilize feelings of powerlessness and to create self-empowerment.

Borderliners are often at the mercy of their mood swings . The social behavior of people with borderline syndrome is therefore difficult to assess, since affective short circuits occur again and again and there is no impulse control, which is often not at all comprehensible to the outside world.


Physical complications are possible with borderline syndrome if the person concerned engages in self-harming or self-injurious behavior. Cuts and burns are common. Due to fear, lack of self-esteem or other reasons, those affected do not always seek help in a timely manner. The wounds can become inflamed or heal poorly. Damage to muscles and nerves is also possible. There is also an increased risk of suicide in borderline syndrome.

Conversely, however, some borderline use such injuries to experience care. In this case, a mental dependency on medical care can arise. Since the person concerned often seeks medical help in this case, negative consequences of the care are also possible, for example hospitalization.

Many people with borderline syndrome find it difficult to maintain long-term relationships with other people. The symptoms of the personality disorder often lead to conflicts. Some sufferers show contradictory behavior, wanting to have loved ones with them on the one hand, but distancing themselves from them on the other. As a result, their actual emotional needs often remain unfulfilled.

Social isolation is another complication that can develop from ambivalent social behavior. Psychotic or dissociative symptoms can also lead to disorientation or a temporary inability to act in everyday life.

In addition, borderline personality disorders often coexist with other mental health problems, most notably anxiety and obsessive-compulsive disorders, post-traumatic stress disorder, substance dependence or harmful use of substances, eating disorders, and ADD/ADHD.

When should you go to the doctor?

Anyone who recognizes at least five of the following nine typical symptoms of borderline syndrome should see a doctor:

  • Low anger threshold and uncontrollable outbursts of anger that can result in physical violence
  • Self-injurious behavior, from scratching the skin or inflicting burns to attempting suicide, drug use, and eating disorders
  • Sudden impulse to extreme risk-taking that may be life-threatening, such as B. Lawn on the highway, climbing on bridge railings, etc.
  • Strong fear of separation and loss and constant fear of being alone
  • Inner emptiness, constant boredom and aimlessness
  • Extreme and uncontrollable mood swings, the negative phases of which are getting longer and longer
  • Unstable interpersonal relationships due to the constant vacillation between clinging and rejection, black and white thinking
  • Loss of reality through the feeling of being in another world and experiencing feelings detached from oneself
  • Identity disorders in the form of sudden insecurity about who you are and what you can do

Treatment & Therapy

There is no consensus in medicine and psychology on how to treat borderline syndrome. Psychotherapeutic approaches are generally not certified as having particularly great results. Behavior therapy approaches have proven to be more successful , in which patients are shown how they can develop new behavior patterns in extreme situations and internalize them in the long term.

There are different schools that are more supportive or confrontational. Since traumatic childhood experiences are expressed in borderline syndrome, special trauma therapies are also recommended, although science agrees that re-traumatization should not occur.

Ultimately, however, the choice of the right therapy method for borderline syndrome depends on the person affected. Standardized procedures rarely have the desired effect. In addition, it is always considered particularly helpful to include the social environment in therapy. Treatment with drugs, the so-called medication, cannot treat the borderline syndrome as a whole, but at most combat individual symptoms.

Outlook & Forecast

Borderline personality disorder typically lasts for several years. As a rule, borderline syndrome becomes milder with age. The symptoms can recede to such an extent that the diagnostic criteria for the personality disorder are no longer met. Often, however, a remnant of the symptoms remains. However, this rest does not have to have a disease value, but can also form part of the normal personality spectrum.

At the same time, however, older age is also considered a risk factor for suicide attempts that ended in the death of the person concerned. Impulsivity, depression and abuse in early childhood also increase the statistical risk of suicide. In addition, another personality disorder can coexist with borderline syndrome and reduce the chance of improvement.

The dependent, anxious-avoidant and paranoid personality disorder are particularly common. If the borderline personality suffers from antisocial personality disorder, the risk of suicide is also increased. However, these statements are general statements – the individual course of the borderline personality disorder can deviate from the average.

A study showed that six years after diagnosis, a third of the patients still suffered from borderline syndrome. A clear decline was already recorded after two years. The development and dissemination of specific therapies such as dialectic behavioral therapy (DBT) has led to improved patient support over the past fifteen years.

You can do that yourself

Those affected by borderline syndrome can protect themselves from impulsive actions with negative consequences in everyday life by occasionally withdrawing from situations that favor overly negative or positive perceptions and actions. For this purpose, regular breaks can be considered, in which the affected person opts out of conversations and other interactions for a certain time.

During these breaks, however, those affected should not concern themselves with their perception of the events, but rather gain a little distance from what happened – whether it was something good or bad is irrelevant. There are various options for this, which can include, for example, listening to loud music, massaging yourself with massage balls or solving small puzzles. The possibilities for temporary distraction are manifold and can be explored and found by those affected themselves.

Temporarily distancing oneself from feelings about oneself and those around them helps those affected by borderline personality disorder to subsequently return to their social role in a more reflective and less impulsive manner. In this way, conflicts that may arise – sometimes objectively without a reason – can be prevented in advance.

The environment of the persons concerned should also be included. Communication about what is felt helps everyone involved in everyday dealings. Regular discussions that follow a certain structure make the emotional better understandable and often enable people with borderline syndrome to better assess and reassess a situation afterwards.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.