According to the APA Dictionary of Psychology, personality can be defined as “The enduring configuration of characteristics and behavior that comprises an individual’s unique adjustment to life, including major traits, interests, drives, values, self-concept, abilities, and emotional patterns” (American Psychological Association, 2018). As is highlighted here, personality is generally understood to be enduring, that is, unchanging, static, or even core to who we are.
BPD versus other diagnoses:
Being diagnosed with a personality disorder then can feel extremely overwhelming. While diagnoses like Major Depressive Disorder (MDD) or Generalized Anxiety Disorder (GAD) may be framed as a set of symptoms that can be treated, a diagnosis such as Borderline Personality Disorder (BPD) might feel more like being told you have a character flaw. If personality makes us who we are, what does it mean when it’s “disordered?”
BPD was introduced in the Diagnostic and Statistical Manual of Mental Disorders, more commonly called the “DSM” in 1980. The DSM has been colloquially called the “Bible” of Psychiatry, and in North America, serves as the source of all diagnostic criteria for psychiatric conditions. Between the introduction of BPD in the DSM-III, and the most recently published DSM-V, diagnostic criteria have mostly remained unchanged, and arguably, so has the way the world views BPD.
One of the first things I tell clients after they’ve received a diagnosis of BPD is “don’t Google it!” If you’ve ever entered “borderline personality disorder” into your search bar, you probably know the reviews aren’t great. You may have read that the FDA has yet to approve any medications in the treatment of BPD (true), that psychotherapy isn’t all that effective (not so true), or even come across anecdotal reports that this deep-seated personality defect is impossible to treat (definitely not true). No wonder we’re left to feel hopeless when this is the information most readily available.
Here’s the good news: underneath the message boards, pop-psychology articles, and outdated case conceptualizations, there is plenty of research that paints a hopeful picture for those who may be seeking treatment for BPD.
BPD & Other Coexisting Conditions:
Firstly, we must remember that BPD rarely (if ever) exists by itself (Leichsenring et al., 2024). There is a significant association between BPD and a handful of other diagnoses, including anxiety, depression, PTSD, OCD, and ADHD (to name a few). While it is true that no one medication has been shown to be particularly helpful in treating BPD specifically, medication can still be a useful tool in managing the symptoms of these co-occurring concerns. Furthermore, there are a vast number of psychotherapies that can effectively target these conditions, including CBT for anxiety and depression, EMDR for PTSD, and ERP for OCD.
Secondly, there is plenty of research to show psychotherapy can be an extremely effective treatment for BPD specific symptoms; it’s just about finding the right approach. Several therapeutic modalities have been found to be helpful in targeting BPD, including mentalization‐based therapy, transference‐focused therapy, and schema therapy (Leichsenring et al., 2024). Still, the gold-standard treatment remains dialectical behavioural therapy, or DBT. A study by Stiglmayr et al. (2014) found that 77% of individuals who underwent a comprehensive DBT program no longer met the criteria for BPD. Yes, you read that right: after undergoing DBT for a year, participants who had started with a personality disorder no longer had the diagnosis.
Treatment of BPD:
Treatment of any mental health concern is going to look different for everyone. For some, medication may play a big role, for others, psychotherapy will be the mainstay of treatment, and for many of us, it may be a combination of various factors, including medication, talk-therapy, and lifestyle changes such as diet, exercise, and social activities. Historically, borderline personality disorder has been thrown into the category of “hard-to-treat” conditions, but in reality, the evidence tells us there is plenty of hope for positive treatment outcomes. Although BPD may be categorized as a personality disorder, its symptoms are by no means enduring. The myth of hopelessness surrounding BPD is just that: a myth.
To learn more about dialectical behavioural therapy (DBT), check out our blog post here: https://unitiveclinic.ca/what-
Sources Cited:
American Psychological Association. (n.d.). Personality. In APA dictionary of psychology. Retrieved February 21, 2026, from https://dictionary.apa.org/
Leichsenring, F., Fonagy, P., Heim, N., Kernberg, O. F., Leweke, F., Luyten, P., Salzer, S., Spitzer, C., & Steinert, C. (2024). Borderline personality disorder: A comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry, 23(1), 4–25.
Stiglmayr, C., Stecher-Mohr, J., Wagner, T., Meißner, J., Spretz, D., Steffens, C., Roepke, S., Fydrich, T., Salbach-Andrae, H., Schulze, J., & Renneberg, B. (2014). Effectiveness of dialectical behavior therapy in routine outpatient care: The Berlin Borderline Study. Borderline Personality Disorder and Emotion Dysregulation, 1, Article 20.
