Why Does Borderline Personality Disorder Hurt So Much?

People with BPD experience intense mental-emotional pain as their baseline mood. Emotions are extremely intense, leading to episodes of depression, anxiety or anger.
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People often describe those who have borderline personality disorder (BPD) as manipulative, unstable, or clingy. From the outside, the outbursts and intense emotional reactions of a person with BPD may seem unreasonable, but from the perspective of someone who has this disorder, what others see is a manifestation of a world full of intense pain.

For those living with borderline personality disorder, intense mental and emotional pain is their baseline mood. The depth of this BPD emotional pain impacts their ability to behave in ways that others might consider “reasonable.” So, why does BPD hurt so much? Read on to learn more.

Characteristics of BPD

BPD is a deeply misunderstood mental health disorder. An individual developing borderline personality disorder begins to have difficulty managing their emotions, which impacts their relationships, their self-image, and their behaviors. Their emotions are extremely intense, which can lead to episodes of depression, anxiety or anger that may persist for days or even weeks.

They may also be consumed with an intense fear of abandonment, but at the same time, may engage in impulsive behaviors and have mood swings that push others away. When they’re not feeling overwhelming pain, sadness, or anger, they may feel a sense of emptiness.

Physical Symptoms of BPD

According to a National Institutes of Health study, there are also some physical symptoms of BPD. This disorder can lead to negative physical health outcomes, including an increased risk for chronic diseases like diabetes, heart disease, arthritis, and obesity.

Additionally, because some symptoms of borderline personality disorder overlap with other mental health disorders, like post-traumatic stress disorder (PTSD), it’s important to seek help from a mental health professional to ensure an accurate diagnosis.

Post-Traumatic Stress Disorder (PTSD) and Borderline Personality Disorder (BPD)

Since borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD) have many similar symptoms, they are sometimes misdiagnosed. They can also co-occur, meaning that an individual can have both disorders at the same time. And diagnosing mental health disorders can be challenging because there aren’t medical tests that can prove the correct diagnosis. But determining the accurate diagnosis is vital to ensure the most effective treatment plan can be created.

Challenges with Relationships

Relationships are an ongoing challenge and frequently a source of pain for someone with BPD because they’re eager for connection but they’re also terrified of having others abandon them. They may be demanding of their partner’s time and attention, which can trigger resistance or resentment from the partner.

Black-and-white thinking, another hallmark of borderline personality disorder, can quickly strain any relationship. If an individual believes that things and people are either all good or all bad, the slightest disagreement with a partner or friend can cause intense feelings of anger and hatred or guilt and shame. These negative feelings may be all-consuming for days on end, which may be followed by additional shame and guilt.

Shifting Self-Image

BPD emotional pain can impact the self-image of someone struggling with borderline personality disorder. They may feel like they have no idea who they are or what they believe in and may change who they are depending on what others want from them.

A person with borderline personality disorder is often unable to trust their own feelings or reactions. Lacking a strong sense of self leads to a sense of emptiness and sometimes a sense of being non-existent, which is another reason BPD hurts so much.

One of the Most Painful Mental Illnesses: Living with BPD Pain

Borderline personality disorder is one of the most painful mental illnesses since individuals struggling with this disorder are constantly trying to cope with volatile and overwhelming emotions. Those who don’t have this disorder sometimes have a hard time understanding the almost constant struggle with intense emotions. The problem is that the way a person with BPD behaves to escape the pain often leads to more pain.

Desperate attempts to escape from emotional pain can lead to self-destructive behavior like substance abuse, cutting, or suicide attempts. Others may think this behavior is manipulative or overly dramatic, however, it isn’t. It’s often an effort to obtain relief from almost constant pain.

Treating Borderline Personality Disorder

Not only is BPD one of the most painful mental illnesses, but it’s also intensified by stigma and being misunderstood by others. Fortunately, borderline personality disorder is a treatable condition, and the pain doesn’t have to be endless.

Positive, long-term outcomes are possible for people with BPD who commit to a comprehensive treatment plan, which may include treatment for a dual diagnosis like with substance abuse and addiction. Evidence-based treatments like cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) can help people experience less severe BPD symptoms. Both types of treatment help individuals with BPD manage uncomfortable emotions, tolerate distress, and improve their ability to relate to others.

If you or a loved one is struggling with or is developing borderline personality disorder, our mental health professionals are here to help. At Clearview, we offer several treatment programs and have experience with and expertise in treating BPD. Our treatment programs include our Dual Diagnosis Treatment Center, our Women’s Treatment Center, and our outpatient treatment centers.

To get started, call our mental health professionals at 855.977.4017 or fill out our contact form


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3443520/

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