Woman living with borderline personality disorder and self-harm

Borderline Personality Disorder and Self-Harm

A key symptom of borderline personality disorder (BPD) is that individuals have trouble managing their emotions effectively. They feel things deeply, and their moods may change rapidly. It differs from other disorders involving unstable moods, such as bipolar disorder, in that mood states in BPD may only last a few days or even just a few hours.


People with BPD are often susceptible to feeling abandoned, which can lead to relationship instability. They may have an unhealthy and unstable relationship with themselves and experience alternating periods of self-esteem and self-loathing.


A BPD symptom shared with post-traumatic stress disorder is that people with both conditions often experience dissociation, in which they don’t feel fully connected to their bodies. Current Psychiatry Reports notes that about two-thirds of people with borderline personality disorder experience it. 


People with BPD may act on their emotions or attempt to manage them in counterproductive ways. They may engage in risky behaviors like drug or alcohol abuse, reckless driving, unsafe sex, binge eating and misspending money. They may also self-harm through behaviors like cutting, burning, piercing, hair pulling or hitting. 


The journal Borderline Personality Disorder and Emotion Dysregulation notes that borderline personality disorder and self-harm are common combinations, with an estimated 65-80% of people with BPD engaging in some form of self-injury. Self-harm has been linked to a number of BPD symptoms, with dissociation being the symptom most associated with the frequency of self-injuring behaviors.


As in other populations, people with BPD may self-harm for a variety of reasons. It may be an attempt to stimulate certain body chemicals, distract from emotional pain or punish themselves. For many people, the link between self-harm and dissociation indicates that self-harm may be a way to bring themselves back into an awareness of their body.


Treatment for BPD and Self-Harm

Fortunately, there are effective treatments.  The National Education Alliance for Borderline Personality Disorder reports that treatment for BPD effectively improves overall functioning and social adjustment, and decreases suicide attempts, anger and self-harm. The best treatment for self-harm in an individual with BPD is personalized and tailored to their unique needs. 

A treatment plan may include some of the following:

  • DBT – Dialectical behavior therapy (DBT) was originally developed to treat the condition and is now used to treat many others. The journal Psychiatry reports on a study finding that DBT reduced self-harm more than treatment-as-usual in women with BPD treated in a mental health treatment center. It includes a focus on mindfulness, distress tolerance, interpersonal effectiveness and emotional regulation. DBT balances the opposing forces of acceptance and change.
  • CBT – Cognitive-behavioral therapy (CBT) focuses on the relationship between thoughts, feelings and behavior. There’s a focus on identifying untrue or unproductive thoughts and reframing and restructuring them.
  • Expressive Therapy – Creative therapies involving things like music, art or drama can help people express themselves in new ways and access the sometimes hidden parts of themselves. They can help with mind-body integration and relationship building. 
  • Group Therapy – BPD treatment may involve both individual and group therapy. In a group, people can learn from each other, identify patterns in others that are hard initially to see in themselves and work on interpersonal relationship skills.


Living with borderline personality disorder can feel isolating, but you are not alone. At Promises Five Palms, we’ll give you the tools to help you manage your borderline personality disorder in a healthy way. 

If you or your loved one needs help, we are here for you. Call us today at 1.844.675.1022 to speak with our compassionate care team about what options are best for you. 

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