"... borderline individuals are the psychological equivalent of third-degree burn patients. They simply have, so to speak, no emotional skin. Even the slightest touch or movement can create immense suffering. Yet, on the other hand, life is movement."

Marsha Linehan, Cognitive-Behavioral Treatment of Borderline Personality Disorder, page 69.

"All the information on symptoms, behavior, destructive tendencies, random outbursts, insecurity, instability, etc are unquestioned and obvious - especially when you spend much time around these people. The descriptions cover all the amorphous manifestations of this problem. In my opinion however, the mental health community has apparently missed what is actually happening. What they are seeing aren't any number of spurious abnormal behavior patterns, symptoms or defense mechanisms meant to protect the person from threat or depression. As a matter-of-fact, much of their behavior is quite normal and deliberate. At this point, I hope you are wondering how. ..."


Authoritative recent review article on BPD:

"Borderline personality disorder." Klaus Lieb, Mary C Zanarini, Christian Schmahl, Marsha M Linehan, Martin Bohus Lancet July 31, 2004; 364: 453–61.

Pharmacotherapy Update

"Update on pharmacotherapy of borderline personality disorder." Zanarini MC. Curr Psychiatry Rep. 2004 Feb;6(1):66-70.

Informed speculation about BPD and other personality disorders:

"An approach to the psychobiology of personality disorders." MI. Posner, MK. Rothbart, N Vizueta, KM. Thomas, KN. Levy, J Fossella, D Silbersweig, E Stern, J Clarkin, and O Kernberg. Development and Psychopathology, 15 (2003), 1093–1106.

"New developments in the neurobiology of borderline personality disorder." Bohus M, Schmahl C, Lieb K. Curr Psychiatry Rep. 2004 Feb;6(1):43-50. Review.

BPD Prognosis:

"The longitudinal course of borderline psychopathology: 6-year prospective follow-up of the phenomenology of borderline personality disorder." Mary C Zanarini et al. Am J Psychiatry 2003 Feb; 160: 274-83.

"Axis I Comorbidity in Patients With Borderline Personality Disorder: 6-Year Follow-Up and Prediction of Time to Remission." Mary C. Zanarini, Frances R. Frankenburg, John Hennen, D. Bradford Reich, Kenneth R. Silk. Am J Psychiatry 2004; 161:2108–2114.

From ADHD to BPD?:

"History of Childhood Attention Deficit/Hyperactivity Disorder Symptoms and Borderline Personality Disorder: A Controlled Study." Andrea Fossati, Liliana Novella, Deborah Donati, Michela Donini, and Cesare Maffei. Comprehensive Psychiatry, Vol. 43, No. 5 (September/October), 2002: pp 369-377.

Eicosapentaenoic acid (in fish oil) helps with depression, BPD* and impulsivity in ADHD:

"Essential fatty acids and their role in the treatment of impulsivity disorders" Brian Hallahan and Malcolm R. Garland Prostaglandins, Leukotrienes and Essential Fatty Acids 71 (2004) 211–216.

[*Lieb et al, above suggests that fish oil is as effective as Depakote for treatment of the same BPD symptoms.]

The Agony of BPD:

"The Pain of Being Borderline: Dysphoric States Specific to Borderline Personality Disorder." Mary C. Zanarini et al. Harvard Review of Psychiatry (November/December 1998) 201-207.

"... this study suggest[s] a pervasiveness and intensity of inner discomfort and distress that have not previously been reported in the research literature.... the subjective pain of borderline patients may be both more pervasive and more multifaceted than has previously been recognized." (206)

Childhood Precursors of BPD - call for more research:

"Childhood Precursors of Borderline Personality Disorder." Joel Paris. The Psychiatric Clinics of North America. vol 23 no. 1 (March 2000) 77-88.

Additional sources

What are the most effective treatments for BPD?

Marsha Linehan, Cognitive-Behavioral Treatment of Borderline Personality Disorder

John G. Gunderson, Borderline Personality Disorder: A Clinical Guide

Robert O. Friedel, Borderline Personality Disorder Demystified: An Essential Guide for Understanding and Living with BPD

(The first two books listed above are intended for professionals; the latter aims for a wider audience and is very up-to-date.)

Last updated Monday, August 22, 2005 8:05 PM