Borderline Personality Disorder in Women: Symptoms and Treatment

Women make up 75 percent of diagnoses for borderline personality disorder. That’s according to the prevalence rate mentioned in the fifth edition of the American Psychiatric Association’s Diagnostic Statistical Manual of Mental Disorders.

The disorder affects your ability to control and manage your emotions, making it difficult to perform everyday tasks. But due to its higher prevalence rate among women, it raises questions about how treatment methods and symptoms differ. Let’s look at its symptoms, why it affects women at a higher rate, along with possible treatment options, such as therapy sessions for women.

What is Borderline Personality Disorder?

Borderline personality disorder is a mental illness that falls within the cluster B category of personality disorders. Cluster B disorders involve showing intensely emotional, dramatic, or unpredictable responses to things. When you develop BPD, you experience difficulty in regulating emotions, have unstable relationships, and go through extreme mood swings. The disorder starts during early adulthood and is persistent in various contexts.

Causes of Borderline Disorder Treatment In Women

Some studies indicate that women are three times likelier to develop the disorder than men. There’s no specific reason that women have a higher risk of developing the disorder. Rather, a combination of environmental, psychological, and biological factors has an impact.

  • Genetic predisposition: a variety of family and twin studies indicate that a genetic vulnerability could cause borderline personality disorder.
  • The gene-environment correlation model emphasizes the role of adverse life events. Exposure to such events can lead to the development of BPD in women who are at risk.
  • Research indicates that women with BPD had lower volumes of brain structures like the hippocampus and amygdala in both the left and right hemispheres.

But perhaps the biggest link is the correlation between borderline personality disorder and traumatic events such as childhood sexual abuse. And since women are more likely to experience sexual abuse as children, they have a higher risk of developing the disorder.

BPD Symptoms In Women

The diagnostic criteria for borderline personality disorder mention 9 symptoms, which occur in various contexts. For a diagnosis, you must have at least five of the following symptoms.

  1. Fear of Abandonment: People with borderline personality disorder are uncomfortable when alone since it makes them feel neglected or abandoned. This leads to feelings of fear, causing them to monitor a loved one’s whereabouts or keep them from leaving.
  2. Unstable Personal Relationships: Because the disorder leads to unstable affect, the way you feel about everyone changes abruptly. This makes it difficult to sustain healthy interpersonal relationships. You may idealize someone one moment and devalue them the next, which results in chaotic romantic relationships and friendships.
  3. Identity Disturbance: This symptom is characterized by inconsistent behaviors and beliefs and overidentification with a specific group. Having an unclear self-image can also cause you to change your goals, careers, and friends abruptly since you have difficulty committing to certain values.
  4. Impulsivity: In this symptom, you must show impulsivity in at least two situations that are potentially self-damaging. Some examples include excessive spending and substance abuse, but it doesn’t include suicidal behavior.
  5. Recurrent Suicidal Behavior: This involves engaging in self-harm behavior, like burning, injuring, or cutting, as well as suicidal thoughts.
  6. Affective Instability: This includes sudden mood changes and shifts in the way you feel about others and yourself. In most cases, these episodes only last a few hours.
  7. Feelings of Emptiness: You may experience feelings of worthlessness, boredom, and unfulfillment.
  8. Intense Anger: You may have episodes of intense anger, which are followed by feelings of shame and guilt.
  9. Transient Paranoid Ideation/Dissociative Symptoms may occur when you’re extremely stressed, such as when you fear abandonment.

Treatment Options Available For Women

The treatment plan you receive depends on whether you have a comorbid diagnosis and other factors, such as the presence of psychotic symptoms. Generally, however, treatment includes the following:

Dialectical Behavioral Therapy

Derived from the principles of cognitive behavioral therapy, DBT is developed specifically for the treatment of BPD. It involves teaching you certain skills that will reduce emotional dysregulation and help you cope with overwhelming emotions. The four main areas of skills are:

  • Mindfulness: It focuses on being in the present, so you learn to observe your surroundings, describe them, and participate in experiences. You’ll learn to experience emotions, sensations, and thoughts without labeling them as good or bad.
  • Interpersonal Effectiveness: This area helps you assert boundaries in order to fulfill your needs and reduce conflicts in relationships.
  • Distress Tolerance: People with BPD tend to engage in impulsive behaviors as a reaction to strong emotions. Distress tolerance skills allow you to accept distress and tolerate it without engaging in behaviors that could make you feel worse down the line.

Family Therapy

Because unstable relationships are a major symptom of borderline personality disorder, family therapy is crucial for the treatment program. During a family therapy session, the therapist will psychoeducate your loved ones so they understand why you act the way you do.

It also gives your family a safe space to open up about how your behavior affects them and vice versa. It promotes better understanding and helps create a supportive environment on the path to recovery.

Group Therapy

In group therapy sessions, you interact with other people who have borderline personality disorder. It provides the opportunity to practice your coping skills with others and learn new ways to manage intense emotions, which is highly effective for reducing symptoms.


Depending on the severity of your symptoms, your psychiatrist may prescribe medication such as antipsychotics or antidepressants.

Inpatient Treatment

Because the disorder makes you unpredictable and unstable with regard to emotions, relationships, and self-image, inpatient treatment is a viable option. It involves staying at a dedicated facility under the care of a multidisciplinary team of physicians, therapists, psychiatrists, and nurses. In addition to the evidence-based therapies mentioned above, a residential treatment plan also includes holistic therapies.

These focus on overall wellness and relaxation through techniques like yoga, therapeutic massage, animal-assisted therapy, and acupuncture. When combined with privacy and comfortable living conditions, it ensures better outcomes at the end of the treatment process.

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