Of all the personality disorders, Borderline Personality Disorder (BPD) is one of the most diagnosed, and may be the most misunderstood. Too often, people with BPD are labeled as “manipulative,” “too much,” or even “hopeless.” In reality, BPD is not a moral failing or a personality flaw. Like many severe personality disorders, it’s a serious mental health condition shaped by a mix of genetics, environment, and insufficiently-resolved trauma [1]. In my work as a therapist at a residential treatment center, I’ve walked alongside many people with BPD who’ve done the hard, courageous work of healing. They’ve shown me—and themselves—that real change is possible. In this post, we’ll look at how BPD shows up, some of the myths and realities, and most importantly, how it can be healed.
What BPD Looks Like and What’s Really Happening
BPD often shows up as intense emotions, fear of abandonment, unstable relationships, impulsive decisions, and a shaky sense of self. Hallmark borderline personality disorder symptoms can differ in severity but often include swinging quickly from feeling close to someone to fearing rejection or betrayal. They may act out of desperation to avoid feeling alone or unsafe—sometimes through self-harm, angry outbursts, or clinging to relationships that aren’t healthy. On the inside, many live with deep emotional pain, shame, and a constant sense of being “too much” or “not enough” [2][3]. What looks like manipulation from the outside is often a frantic attempt to manage unbearable feelings.
To make things more difficult, BPD often comes with other mental health challenges, such as depression [4] and anxiety [5]. This makes diagnosing and treating the disorder that much more difficult. It can also lead to confusion about what needs to be treated and in what order. Sometimes, it leads to myths about whether the borderline disorder is “real” or a manifestation of other disorders that are more familiar and thus less threatening to many practitioners.
One of the most damaging myths is that people with BPD can’t get better. That simply isn’t true. Over the years, I’ve worked with clients who entered treatment feeling out of control and convinced they had to manipulate or test everyone around them to survive. With time, support, and a lot of determination, I’ve seen those same people reach a place where they no longer met the criteria for BPD. They found they no longer engaged in chaotic relationships and didn’t have to add chaos to the ones they still had. They no longer turned to self-destructive means to escape their feelings. They no longer feared abandonment at every turn, not only because they realized their fears were out of proportion, but because they realized that even if they were abandoned, they could still be okay. That is true freedom from BPD. They still sometime felt emotions deeply and were tempted to turn to old coping mechanisms—because our brains never completely forget these things—but they gained tools to manage those feelings, trust themselves, and build healthier relationships. The credit belongs to them; they did the hardest work of all.
Hope, Not Hopelessness
core tools in the management of borderline personality disorder, like Dialectical Behavior Therapy (DBT) have made a huge difference [6] for people with BPD. DBT teaches practical skills like emotional regulation, mindfulness, and healthy communication. These skills are crucial in helping individuals reduce BPD symptoms.
But that’s only part of the picture. Many of my clients also needed help addressing the underlying trauma that old-school treatment models used to avoid. Trauma is considered one of the foundational causes of borderline personality disorder, which is why ignoring it often results in limited progress.
Therapies like Internal Family Systems (IFS) have helped clients heal the wounded parts of themselves driving their fear, anger, or shame. These modern borderline personality disorder therapies offer more than symptom suppression—they aim to address root emotional pain and stabilize a positive identity. When trauma is addressed safely and effectively, real emotional progress becomes possible.
In this blog series, we’ll continue exploring what BPD is, how it can be treated, and how both individuals and their loved ones can move toward healing together. The journey isn’t easy—but it is absolutely worth it. Understanding borderline personality and seeking evidence-based care can lead to long-term recovery and emotional growth.
How We Use This Information to Help People
At Windmill Wellness Ranch, we see our clients at human beings, not pathologies. Where some professionals may shy away from doing the more difficult work, we embrace it. This means that we work with clients who experience the pain of BPD and help them find their true selves underneath. This includes creating hope, using evidence-based practices, and helping them find better relationships with both themselves and those who love them.
Since people with BPD often struggle with substance use as well and have more complicated recoveries as a result [7], our residential setting provides safety and support to untangle and address both issues, because we understand that integrated care is key to healing.
We are also proud of the support we offer families. Our weekly family workshops and SMART Recovery Family & Friends meetings create a forum for our clients and their families to learn and practice new tools and ways of understanding each other. These resources are available indefinitely, because our alumni and families are welcome to keep coming to these meetings for as long as they like after treatment has concluded.
There Is Hope: BPD Recovery Is Possible
If you love someone with BPD—or if you’re living with it yourself—there is hope. People with BPD aren’t destined to stay stuck in cycles of chaos and pain. With the right support, they can build lives filled with meaningful relationships, emotional resilience, and a stronger sense of self. If you or someone you love is struggling, don’t hesitate to reach out and get help. Our admissions team can walk you through what to expect and answer any questions. Call 830-251-5606 or contact us online.
References:
[1] Wilson, N., Robb, E., Gajwani, R., & Minnis, H. (2021). Nature and nurture? A review of the literature on childhood maltreatment and genetic factors in the pathogenesis of borderline personality disorder. Journal of psychiatric research, 137, 131-146.
[2] Jørgensen, C. R., & Bøye, R. (2024). “I am ashamed that I exist. I feel like apologizing for existing”: The phenomenology of shame in patients with borderline personality disorder: A qualitative study. Personality Disorders: Theory, Research, and Treatment, 15(3), 181.
[3] Bozzatello, P., Rocca, P., Baldassarri, L., Bosia, M., & Bellino, S. (2021). The role of trauma in early onset borderline personality disorder: a biopsychosocial perspective. Frontiers in psychiatry, 12, 721361.
[4] Köhne, A. C., & Isvoranu, A. M. (2021). A network perspective on the comorbidity of personality disorders and mental disorders: an illustration of depression and borderline personality disorder. Frontiers in Psychology, 12, 680805.
[5] Shah, A. Q., Prasad, D., Caropreso, L., Frey, B. N., & de Azevedo Cardoso, T. (2023). The comorbidity between Borderline Personality Disorder (BPD) and Generalized Anxiety Disorder (GAD): A systematic review and meta-analysis. Journal of psychiatric research, 164, 304-314.
[6] Hernandez-Bustamante, M., Cjuno, J., Hernández, R. M., & Ponce-Meza, J. C. (2024). Efficacy of dialectical behavior therapy in the treatment of borderline personality disorder: a systematic review of randomized controlled trials. Iranian Journal of Psychiatry, 19(1), 119.
[7] Zanarini, M. C., Temes, C. M., Glass, I. V., Frankenburg, F. R., Fitzmaurice, G. M., Unruh, B. T., & Weiss, R. D. (2025). The 24‐year course of substance use disorders in patients with borderline personality disorder and personality‐disordered comparison subjects. The American Journal on Addictions.
FAQs
1. Do people recover from Borderline Personality Disorder (BPD)?
Yes, recovery is possible. With the right treatment, support, and resources, people with BPD can build meaningful relationships, develop emotional resilience, and lead fulfilling lives. Many individuals experience significant improvement over time.
2. Does having BPD mean someone will always struggle with unstable emotions or relationships?
No, people with BPD are not destined to remain in cycles of chaos or pain. Therapeutic interventions, especially evidence-based treatments like Dialectical Behavior Therapy (DBT), can help individuals learn to manage emotions and cultivate stability in their lives.
3. Is BPD untreatable or hopeless?
This is a myth. BPD is treatable, and many people go on to lead happy, stable lives. Early intervention, ongoing support, and a strong therapeutic alliance make a significant difference in recovery outcomes.
4. Should I feel ashamed or blame myself if I have BPD or love someone who does?
Absolutely not. BPD is a mental health condition influenced by complex factors—not a personal failing. Reaching out for help is a sign of courage and strength, and support is available for both individuals and their loved ones. Call 830-251-5606 or contact us online.