The Link Between Impulsive Behavior and Borderline Personality Disorder

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If you have borderline personality disorder (BPD), you may find yourself struggling to manage impulsive behaviors. From hasty decisions to getting into fights, these actions can harm you and your loved ones. In addition to problems with relationships, impulsivity can lead to problems with physical health and finances, as well as legal issues. Learning more about impulsivity in BPD and treatments that target it can help reduce the impact this troublesome behavior has on your life.

Understanding Impulsivity

According to the Diagnostic and Statistical Manual of Mental Illnesses, 5th edition (DSM-5), impulsive behaviors are a hallmark of BPD. Impulsivity is a tendency to act without thinking about the consequences of your actions. These actions usually occur in reaction to some event that has caused you to have an emotional response.

For example, imagine you are waiting in line at the bank and someone cuts in front of you. People with a reasoned mindset may roll their eyes, but they realize it's a small problem or inconvenience and it's not worth it to escalate the situation. However, for those with BPD, the response can be quite different. Someone with BPD may act aggressively towards the person who cut in line, yelling at him, threatening him, or even taking physical action.

A person with BPD is less likely to take into account potential consequences, such as getting hurt, being detained by security, or even arrested by police. Impulsivity is also linked to poor self-control and severe urges. This can lead to self-harming behaviors like binge eating or excessive alcohol or drug use as a means of coping with stress or feelings of anger or emptiness.

It's important to note that occasional impulsive behavior is not necessarily indicative of a diagnosis of BPD. Everyone acts impulsively from time to time. Only when this type of behavior becomes either frequent or serious is it considered dangerous or a potential symptom of BPD.

Examples of Impulsive Behaviors

There are many behaviors that can become impulsive with BPD and each person is different. Yet there are some common scenarios where impulsivity becomes a larger issue, including:

  • Going on spending sprees
  • Driving recklessly
  • Promiscuous sex
  • Binge eating
  • Yelling, shouting, or screaming at others
  • Threatening to harm others
  • Self-mutilation
  • Destroying property
  • Shoplifting
  • Getting into physical fights with people

Treatment for Impulsivity

While impulsive behaviors can be serious and pervasive, this symptom can be successfully managed with therapy. Many treatments for BPD have components that target impulsivity. For example, dialectical behavior therapy (DBT) focuses on building skills that reduce your impulsive behaviors and increase your ability to reflect before acting. By using healthy coping mechanisms to handle intense emotions, a person with BPD is better equipped to handle different situations. 

Mindfulness, a skill taught in DBT, encourages you to stay in the moment. This can help you to remain more aware of your actions so you take the time to consider consequences. Practicing this technique can help you to take the time needed to reflect on your options, empowering you to make more rational decisions about how to respond to events around you. 

Medications like a selective serotonin reuptake inhibitor (SSRI) sometimes combined with a low dose of an antipsychotic may also help. This is particularly true if your impulsivity poses a threat to your personal safety. Medications are usually most effective when used in conjunction with psychotherapy through a therapist specializing in BPD.

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    Article Sources
    • American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: 2013.
    • National Alliance on Mental Illness (NAMI). Borderline Personality Disorder. Updated December 2017.