Mood Swings in Borderline Personality Disorder

People with borderline personality disorder (BPD) often experience very intense mood swings. But how can these mood swings be distinguished from normal variations in mood, or from the types of mood swings associated with other disorders?

People with BPD often feel like they are on an emotional rollercoaster and typically have an unstable sense of self and extreme fear of abandonment. BPD is part of the Cluster B personality disorders, which are marked by dramatic, emotional, or erratic behavior.

Let's explore the typical pattern of mood swings in BPD, and how they are different from mood swings that we all experience from time to time. In addition, there are many co-occurring symptoms that a person with BPD will typically experience, which can help differentiate it from other conditions.

Mood Swings in BPD

Everyone experiences emotional ups and downs. However, there are some factors that help distinguish between regular fluctuations in mood and mood swings in BPD.

Intensity

While it's normal to have your mood shift from feeling good to feeling down, someone with BPD may experience very extreme mood shifts for minor reasons—going from feeling okay to feeling devastated, desperate, or utterly hopeless within a matter of moments.

Many people with BPD feel so overwhelmed by these intense emotional shifts that they engage in impulsive behaviors to feel better, including:

• Binge eating
• Self-harm
• Substance abuse
• Suicidal thoughts or behaviors

Frequency

These mood swings may also happen frequently. Someone with BPD can have many mood swings in the course of a day, whereas most people will only experience one or two major emotional shifts in the course of a week.

Duration

In addition, while most people have times in their lives when they are more emotionally vulnerable than other times, people with BPD experience emotional ups and downs consistently for years. This can result in unstable interpersonal relationships with loved ones, friends, and colleagues.

Presence of Other Symptoms

Some other symptoms of this disorder may include:

• Dissociation from oneself, including observing oneself from outside the body or not feeling in touch with reality
• Extreme sensitivity to perceived rejection and abandonment
• Feelings of emptiness
• Inability to self-soothe
• Intense anger that they have trouble controlling
• Paranoid thoughts

Mood Swing Triggers

Mood swings in BPD can also be distinguished from other types of mood problems by examining the triggers that precede the mood shift.

Other external triggers can include:

• Real or perceived abandonment or rejection
• Job loss
• Relationship breakup
• Traumatic events
• Reminders of past trauma
• Stress
• Lack of sleep
  

Though researchers are still trying to understand the borderline personality brain, they know that its fight-or-flight response is easily triggered, causing the brain's rational part to turn off and the survival instinct to turn on. This makes the person act in inappropriate or out-of-proportion ways to the situation.

Do Mood Swings Equal BPD?

Keep in mind that even if you have mood swings that fit the description above, this is just one of a number of symptoms of BPD. Having mood swings alone is not enough to warrant a diagnosis of BPD.

Other factors or conditions that can cause moods swings include:

• Attention-deficit hyperactivity disorder (ADHD)
• Bipolar disorder
• Dementia
• Depression
• Hormone changes
• Low blood sugar
• Medication side effects
• Menopause
• Pre-menstrual syndrome (PMS)
• Pregnancy
• Sleep deprivation
• Stress
• Substance use
• Thyroid conditions

If you find that your emotional ups and downs are interfering with your work, school, relationships, or enjoyment of life, it makes sense to seek professional help. Remember it's essential to take good care of your emotional health, just as you would your physical health.

Treatments for BPD Mood Swings

While BPD was characterized as challenging to treat in the past, more recent researchers have found that treatment can be effective. Therapy often focuses on aspects of emotional regulation and may include:

• Dialectical behavior therapy (DBT): A form of cognitive behavioral therapy (CBT) that incorporates aspects of mindfulness to help people tolerate distress, regulate emotions, and improve relationships
• Mentalization-based treatment (MBT): A form of therapy that helps people with BPD learn to better recognize their own mental state so they are better able to regulate emotions and behaviors.
• Transference-focused psychotherapy (TFP): A BPD treatment that utilizes the therapist-client relationship to help people learn to relate to others more effectively and have healthier social interactions
• Schema-focused therapy (SFT): A form of therapy that incorporates aspects of CBT and other therapies; it focuses on identifying and changing certain types of unhealthy thinking

Coping With BPD Mood Swings

BPD mood swings can be distressing and disruptive, but there are things that you can do to cope. Some steps that can help you manage the emotional ups and downs you might experience include:

• Getting treatment: If you have symptoms of BPD, it is essential to talk to a mental health professional. Getting a diagnosis and starting a treatment plan is critical for managing mood swings and others symptoms.
• Follow your treatment plan: Once you start treatment, adhering to your therapy schedule and taking your medication can lead to significant improvements. Research has found that consistent adherence to treatment can greatly reduce BPD symptoms.
• Identify your triggers: Because mood swings are often triggered by external sources, it is essential to figure out what tends to cause a shift in mood. Using a mood tracker or journal can help you spot patterns to utilize coping strategies when you encounter a stressful situation in your environment.

A Word From Verywell

Mood swings in BPD can create distress and disruptions in your life. They can make it difficult to maintain healthy relationships and can create a tremendous amount of emotional turmoil. Fortunately, you can significantly reduce mood swings and other symptoms of BPD with the proper treatment and coping strategies.