Why is Borderline Personality Disorder the most painful mental illness?
- Vesna
- Dec 28, 2025
- 2 min read
Personality disorders are a group of mental health conditions characterized by behavior or actions that deviate from cultural or societal expectations. They are unhealthy, inflexible patterns that often cause problems in relationships, the work environment, and quality of life. These conditions can start very early in life, even in childhood, which is what makes them so inflexible. While there are multiple types of personality disorders, they are grouped into three clusters.
The first is Cluster A, which is for types that are classified as odd or eccentric. This can include things like distrust, lack of expression, or discomfort. The next is Cluster B which is classified by actions that are dramatic, emotional, or erratic. This often includes disregarding other people, instability, lack of empathy, or attention seeking. The final is Cluster C which is classified by anxious or fearful behavior, such as avoidance, dependence, or an obsession with control.
The personality disorder I will be going in depth on today is Borderline Personality Disorder, which is part of Cluster B. This condition is characterized by erratic mood swings often resulting in a lack of identity, and causes instability in personal relationships. While one of the causes is believed to be a genetic component, as direct relatives are 5 times more likely to develop the disorder, external factors such as trauma, neglect, and abuse can increase the chance of developing it. This is called gene environment interaction.
BPD often presents in mood swings and black + white thinking. It can also present as impulsive or inappropriate behavior and uncontrolled anger. Some symptoms include a fear of abandonment, a lack of self-esteem, and disassociation under stress. However, there are multiple possible treatments. The biggest is a lifestyle change to avoid using substances. The next step is behavior and mentalization based therapy. Finally, prescription medicine such as mood stabilizers and antipsychotics can help as well.
Globally, it is estimated that 140 million people around the world have borderline personality disorder, and without the proper treatment plan, it can cause serious complications, such as self harm, substance abuse, eating disorders, unstable employment, legal and financial problems, and the risk of being in abusive relationships. It is said to be the most painful because of how any feelings caused by an event can become amplified, which makes it hard to function in day to day life. However, with the appropriate treatment and support, it is completely possible to live a fulfilling life with borderline personality disorder.
It’s important to reach out to trusted family and friends, your primary care doctor, and in case of emergencies, your crisis hotline if you need help. (988 in the US and Canada)
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