The Four Borderline Personality Disorders

When a person hears the term “borderline personality disorder (BPD),” confusion often follows. This term represents numerous disorders, each of which varies in severity and symptoms. Understanding the complexities of and distinctions between such mental health conditions can often be perplexing.

Prevalence of Borderline Personality Disorder

The National Education Alliance for Borderline Personality Disorders (NEA BPD) defines BPD as “a serious mental illness that centers on the inability to manage emotions effectively.” They also mention that “it typically starts during adolescence or early adulthood.”

According to the NEA BPD, the prevalence of BPD affects:

  • 5.9% of adults (about 14 million Americans) at some time in their life
  • 50% more people than Alzheimer’s disease and nearly as many as schizophrenia and bipolar disorder combined (2.25%).
  • 20% of patients admitted to psychiatric hospitals
  • 10% of people in outpatient mental health treatment

BPDs affect a person’s mental health primarily through emotions and result in an array of symptoms depending on the type.

An In-Depth View of Borderline Personality Disorders

According to the NIH and the Diagnostic and Statistical Manual on Mental Disorders, Fifth Edition (DSM-5), there are two different categories found in personality disorders: personality disorders and borderline personality disorders. Being able to distinguish one from the other can help when seeking diagnosis and treatment.

Personality disorders portray an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture. These patterns are typically consistent regardless of varying situations and lead to distress and even impairment.

Borderline personality disorders are considered to be serious mental disorders characterized by a pattern of instability in moods, behavior, self-image, and functioning. These instabilities often lead to unstable/chaotic relationships and can result in impulsive decisions and behavior. Additionally, individuals with borderline personality disorders may undergo episodes of intense anger, depression, and anxiety. These episodes can last only a few hours or multiple days.

Misdiagnosis often occurs among individuals facing BPDs. It is commonly misdiagnosed as bipolar disorder since both involve mood instability. However, the primary difference between the two consists of the duration of these mood changes. With bipolar disorder, mood changes can exist for weeks or even months. Mood changes in BPDs are significantly shorter and can even occur within a single day.

The DSM-5 recognizes 10 personality disorders in total, categorizing them into three clusters: Cluster A, Cluster B, and Cluster C. Borderline personality disorder falls under Cluster B, along with three others. Disorders in this cluster are understood to be severe and dramatic, emotional, or erratic in appearance.

Subtypes of Borderline Personality Disorder

While the DSM-5 doesn’t currently recognize subtypes of borderline personality disorder, Theodore Millon, a personality expert, believes there to be four types: discouraged, self-disruptive, impulsive, and petulant.


Individuals with this subtype of BPD display extreme emotional dependency on other people. They typically appear very needy and clingy. Regardless of the amount of attention they receive, they cannot be satiated. Passive behavior is also common among these individuals unless they perceive themselves as abandoned. Once this happens, problems with anger management and emotional stability will present themselves.


Extreme bitterness and self-hatred typically occur in individuals with the self-disruptive subtype. They exhibit a strong need for attention from others as a way to cope with their negative self-talk. This need can only be satisfied for a short time. When the attention wears off, or the need is ignored by others, these individuals may result to drastic attention-seeking measures, like dangerous adrenaline-seeking and substance abuse. Attempted suicide or suicidal threats are also common.


The trademark featured among individuals with the impulsive subtype is the inability to control one’s impulses. People with this condition tend to seek adrenaline rushes by any means necessary. This dangerous behavior can greatly increase the risk of self-harm and even result in suicidal thoughts or attempts. Untreated impulsive borderline personality disorder can result in poor life decisions, serious injuries or death, and greatly interrupt day-to-day life.


The petulant subtype is categorized by emotional eruptions of tumultuous anger and extreme feelings of unworthiness. A strong need to manipulate or control other people usually accompanies this disorder. These individuals tend to be very possessive and in charge of their personal lives which often leads to unstable relationships and general dissatisfaction with their partners. This behavior also often results in substance use or other unhealthy and destructive life choices.

Cause and Risk Factors

While the exact cause of BPD is unknown, there are a few factors that can contribute to an individual’s risk of developing it:

  • Genetic Factors: Those with a family history of borderline personality disorder have an increased chance of developing it than those who do not.
  • Biological Factors: Brain chemical issues and problems with brain development can also result in the development of this disorder.
  • Environmental Factors: Experiencing abuse (sexual, physical, or emotional), long-term childhood stress, or parental neglect are also contributing risk factors.

Treatment for Borderline Personality Disorder

The severity of borderline personality disorder when ignored or left untreated can have serious effects on a person’s mental health and daily life. Seeking treatment like psychotherapy is essential for one’s overall mental health and has been found to be effective in most cases. There are both in- and outpatient programs for the treatment of this disorder.

Inpatient treatment programs have been very successful in treating BPD. In these programs, individuals will receive 24-hour care from healthcare professionals. There are many benefits to in-patient programs. These include a positive and comfortable home-like environment, full-time access to the best help, and camaraderie. Clients are able to interact with and enjoy the company of other people who face similar challenges as them.

Alternatively, outpatient programs are also available. These programs are more flexible with individuals’ schedules and are still considered very effective in the treatment process. Whatever route an individual chooses, help is available and there is a brighter and happier future ahead.

Borderline personality disorder can take over your life and make you feel like there’s no hope left. You don’t have to face these challenges alone. Let us be the hope you need and the light that lights your path. At Alter Behavioral Health, we care about your happiness and the brighter days you deserve. Your future matters to us. Let us help you achieve happiness and stability in your everyday life from this moment forward. With our customized treatment programs, you can attain the life you want that is free of the difficulties of borderline personality disorder. Call us today at  (866) 691-4386  for more information and to get started.