Borderline Personality Disorder For Dummies
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Borderline personality disorder inflicts an amazing toll on sufferers, families, and society. For a long time, experts assumed that about 2 to 3 percent of the general population had BPD. However, some findings suggest that this estimate may have greatly underestimated the extent of the problem and that up to 6 percent of the population may warrant receiving this diagnosis at some point in their lives.

BPD costs © Shidlovski /

This article takes a look at the personal costs, both physical and financial, of BPD for the people who suffer from BPD and the people who care about them.

In spite of the bleak topics covered here, many people with BPD manage to have brilliant careers and live long, fairly successful lives. Furthermore, the passage of time typically results in reduced severity of BPD symptoms, and therapy can accelerate this process. In other words, don’t give up, because you have many reasons for hope!

Health costs

Experts consider BPD one of the most severe mental illnesses. About 10 percent of the people with BPD eventually kill themselves, and many more of them seriously injure themselves in suicide attempts. Multiple studies conducted from the 1940s to the present have consistently found that people with severe mental illnesses (such as BPD) die young — shockingly, studies show that people with BPD live lives that are 20 to 25 years shorter than the lives of people without mental illnesses.

Many factors contribute to these premature deaths. First, people with mental disorders, including BPD, often resort to smoking cigarettes — an obvious risk factor — as a desperate coping strategy. Furthermore, people with mental illnesses usually have greater difficulty controlling impulses and, thus, find quitting even more daunting than other people do.

In addition, researchers find higher rates of obesity and diabetes among sufferers of BPD — researchers now consider both of these conditions to be almost as bad as cigarette smoking in terms of the health risks they pose. Additional risks that people with BPD carry with them include heightened probabilities of heart disease and stroke. Unfortunately, some of the medications that mental health professionals use to treat mental illnesses make matters worse by leading to additional weight gain (and its accompanying increased risk for heart disease, stroke, and diabetes). Furthermore, people with chronic mental illnesses usually receive inadequate basic healthcare because they lack financial resources.

Accidental death rates and death from violence are also significantly higher in people with mental illnesses such as BPD. Risky, impulsive behaviors may result in unintentional deaths because of traffic accidents, drug overdoses, or sexually transmitted diseases. People with mental illnesses are also more likely to be homeless, which in turn creates additional risks due to poor nutrition, lack of health care, poor living conditions, and victimization.

Financial and career-related costs

BPD can exert a ruinous effect on employment and careers. People with BPD tend to be chronically underemployed — in part, because they may start out idealizing new job possibilities, only to end up disillusioned and disappointed when jobs don’t live up to their inflated expectations. People with BPD often experience problems with knowing who they are, which often causes them to drift from job to job because they don’t know where they want to go in life. Finally, because many people with BPD struggle to get along with other people, they often lose or quit their jobs because of relationship problems in the workplace.

On the other hand, some people with BPD are highly successful in their careers. They may be unusually skillful and gifted. Most of these surprisingly accomplished people still relate to their coworkers in problematic ways. For example, they may misinterpret coworkers’ intentions and react to the slightest provocation with oversensitivity and anger. Their successful careers stand in stark contrast to their failed relationships.

The toll on family and friends

Marriage isn’t as common among people with BPD as it is among people without the disorder. And, when people with BPD do marry, not as many of them choose to have children compared to the general population. Perhaps surprisingly, their rate of divorce doesn’t appear to be strikingly different from the rate among the rest of the population.

Family members of people with BPD suffer right along with their loved ones. Watching their loved ones cycle through periods of self-harm, suicide attempts, out-of-control emotions, risky behaviors, and substance abuse isn’t easy. Partners, parents, and relatives often feel helpless. Friends often go from trying to help to walking away in frustration and anger.

Furthermore, families of people afflicted with BPD must deal with the frustrations of scarce treatment programs, discrimination, and stigmatization. Even when families do secure treatment, the treatment process is prolonged and costly. Clearly, BPD casts a wide net of anguish that captures a lot of people in addition to its specific victims.

The effects of BPD on the health care system

BPD costs the worldwide health care system a lot of money, and, surprisingly, BPD possibly costs more money when it isn’t treated than when it is. Some of these costs result from the personal health problems that often accompany BPD. These health problems cause people with BPD to go to the doctor more often, and because of chronic underemployment, a disproportionate number of people with BPD receive their health care at emergency rooms, which is the priciest source of medical care.

BPD is associated with at least 10 percent of all mental health patients. We strongly suspect that this estimate is low because many mental health professionals are reluctant to assign this diagnosis to their patients. This reluctance is a direct reaction to concerns about stigmatizing patients. In addition, since BPD often comes with other, co-occurring mental health diagnoses, it’s sometimes is overlooked.

Furthermore, BPD accounts for 15 to 20 percent of all inpatients in mental health hospitals. Inpatient mental health treatment tends to be extremely expensive, so costs mount quickly. Politicians often view these costs as prohibitive — a view that results in the underfunding of such services. Because publicly financed mental health treatment programs are woefully inadequate, some people with BPD end up homeless or in prisons and jails rather than in hospitals or outpatient settings.

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