More threads by David Baxter PhD

David Baxter PhD

Late Founder
NAMI HelpLine Fact Sheet: Borderline Personality Disorder
Borderline Personality Disorder (BPD) is characterized by impulsivity and instability in mood, self-image, and personal relationships. It is fairly common and is diagnosed more often in females than males.

What are the symptoms of BPD?
Individuals with BPD have several of the following symptoms:
o marked mood swings with periods of intense depression, irritability, and/or anxiety lasting a few hours to a few days;
o inappropriate, intense, or uncontrolled anger;
o impulsiveness in spending, sex, substance use, shoplifting, reckless driving, or binge eating;
o recurring suicidal threats or self-injurious behavior;
o unstable, intense personal relationships with extreme, black and white views of people and experiences, sometimes alternating between "all good" idealization and "all bad" devaluation;
o marked, persistent uncertainty about self-image, long term goals, friendships, and values;
o chronic boredom or feelings of emptiness;
o frantic efforts to avoid abandonment, either real or imagined.

What causes BPD?
The causes of BPD are unclear, although psychological and biological factors may be involved. Originally thought to "border on" schizophrenia, BPD now appears to be more related to serious depressive illness. In some cases, neurological or attention-deficit disorders play a role. Biological problems may cause mood instability and lack of impulse control, which in turn may contribute to troubled relationships. Difficulties in psychological development during childhood, perhaps associated with neglect, abuse, or inconsistent parenting, may create identity and personality problems. More research is needed to clarify the psychological and/or biological factors causing BPD.

How is BPD treated?
A combination of psychotherapy and medication appears to provide the best results for treatment of BPD. Medications can be useful in reducing anxiety, depression, and disruptive impulses. Relief of such symptoms may help the individual deal with harmful patterns of thinking and interacting that disrupt daily activities.

However, medications do not correct ingrained character difficulties. Long-term outpatient psychotherapy and group therapy (if the individual is carefully matched to the group) can be helpful. Short-term hospitalization may be necessary during times of extreme stress, impulsive behavior, or substance abuse.

While some individuals respond dramatically, more often treatment is difficult and long term. Symptoms of the disorder are not easily changed and often interfere with therapy. Periods of improvement may alternate with periods of worsening. Fortunately, over time most individuals achieve a significant reduction in symptoms and improved functioning.

Can other disorders co-occur with BPD?
Yes. Determining whether other psychiatric disorders may be involved is critical. BPD may be accompanied by serious depressive illness (including bipolar disorder), eating disorders, and alcohol or drug abuse. About 50 percent of people with BPD experience episodes of serious depression. At these times, the "usual" depression becomes more intense and steady, and sleep and appetite disturbances may occur or worsen. These symptoms, and the other disorders mentioned above, may require specific treatment. A neurological evaluation may be necessary for some individuals.

What medications are prescribed for BPD?
Antidepressants, anticonvulsants, and short-term use of neuroleptics are common for BPD. Decisions about medication use should be made cooperatively between the individual and the therapist. Issues to be considered include the person's willingness to take the medication as prescribed, and the possible benefits, risks, and side effects of the medication, particularly the risk of overdose.


seeking help

I'm wondering where an Ottawa family would begin looking for direct support/therapy for BPD.

David Baxter PhD

Late Founder
Probably inquiring at the Ottawa branch of the Canadian Mental Health Association (CMHA):

The Canadian Mental Health Association
Ottawa Branch
1355 Bank Street, Suite 301
Ottawa, Ontario
K1H 8K7

Phone: (613) 737-7791 Fax: (613) 737-7644

Monday to Friday: 8 a.m. to 4 p.m. (from June 1 to Sept 1)
Monday to Friday: 9 a.m. to 5 p.m. (normal hours of operation)


therapy for bpd

My husband and I have been to several sessions with a counsellor. He (husband) has now decided that he will not continue the process with me. He has not been diagnosed bpd and our counsellor did not believe labels to be helpful. His suggestions for behaviour change were not accepted by my husband.

I've read many books and know that my husband meets all criteria (or part of each). I only care about the label so far as it could facilitate access to the right kind of help. I am losing hope for this marriage.

My question: Will a person who is in 95% outward denial of their problems
ever seek professional support? I've tried to be supportive, but not enabling, but my husband's behaviour affects me to the point that I too become over-emotional, unhappy and counter-productive.

Thank You

David Baxter PhD

Late Founder
Will a person who is in 95% outward denial of their problems ever seek professional support? I've tried to be supportive, but not enabling, but my husband's behaviour affects me to the point that I too become over-emotional, unhappy and counter-productive.
If he doesn't sincerely think he needs to change, or doesn't make a commitment to putting in the effort to do so, there's little you can do.


If a person is determined to deny their own problems, there is little anyone can do to make them own up. As to whether such people will EVER seek professional help, that depends on the person and their circumstances, I think. Sometimes, if a person realizes that they will lose everything dear to them if they do NOT accept help, that will be enough to convince them to see a professional and accept the fact that they have issues to work on.


Yes, thanks. It's hard to give up on someone you care about, but at some point it becomes unhealthy to be together, I realize.


Indeed, when I separated from him, my husband began to search for some answers. After suffering anxiety so severe he visited emergency, he was given some counselling. After a second trip to emerg. months later he has begun to go to AA. On his own, he has confronted his difficulties to a greater extent than he would have when we were together.
Unfortunately free counselling doesn't last for long.

David Baxter PhD

Late Founder
Before making an appointment, why not ask if anyone in counseling services has experience with DBT (Dialectical Behavior Therapy) or CBT (Cognitive Behavior Therapy) and depression (no need to mention BPD or SI or suicide attempts at this point).

At the very least, even if no counseling is available, you should expect some relief from seeing a doctor who can prescribe appropriate medication to relieve the depressive symptoms.


I agree with David 100%. If your husband does not see that he has problems that are contributing to the difficulties you are experiencing in your marriage, there's nothing more you can do, hon. You can't "fix" him yourself. He has to be motivated to make changes to his behaviors himself.

Sometimes, when faced with the loss of a marriage, people who are sailing the sea of denial will wake up and smell the roses. Other times, they won't. However, for most who are refusing to accept their part in a problem, the only thing that stands a chance of making them accept it is the realization that to continue to deny is to lose everything. :(
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