The Link Between Borderline Personality Disorder and Anger

Intense, inappropriate anger can be one of the most challenging symptoms of borderline personality disorder (BPD). This anger in BPD is often referred to as “borderline rage.”

Even so, while anger is a key feature of BPD, very little is known about why people with BPD experience anger differently than other people, or how their experience is different. New research, however, is shedding light on the nature of borderline rage.

What Is BPD Rage?

Borderline rage, or borderline anger, is more than just a standard emotional reaction. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), anger in BPD is described as "inappropriate, intense anger or difficulty controlling anger."

The reason anger in BPD is called “inappropriate,” is because the level of anger seems to be more intense than is warranted by the situation or event that triggered it.

For example, a person with BPD may react to an event that may seem small or unimportant to someone else, such as a misunderstanding, with very strong and unhealthy expressions of anger, including:

• Physical violence
• Sarcasm
• Yelling

Why BPD Rage Occurs

While borderline anger has long been a topic of debate and speculation among BPD specialists, it has only recently become a focus of careful research. Experts are now examining how borderline anger is different than normal anger and why it occurs.

More specifically, researchers are trying to understand whether people with BPD are more easily angered, have more intense anger responses, or have more prolonged anger responses than people without BPD (or whether it's some combination of these factors).

One study examined anger in people with BPD compared to those without BPD in response to an anger-producing story. This study found that people with BPD reported the same level of anger as the healthy controls (in response to the story). But, the healthy controls reported that their anger decreased more quickly over time than the people with BPD reported.

Furthermore, other research shows that anger in BPD may trigger rumination (when someone thinks over and over about their angry experience). This repetitive thinking creates a vicious emotional cycle that worsens the person's anger and increases its duration (as supported by the study mentioned above).

Eventually, the prolonged and intense anger triggers aggressive behavior, which a person engages in to relieve their rage.

Research in this area is very preliminary, and more work is needed to fully understand how and why people with BPD experience borderline anger.

Treatment for BPD Rage

There are a number of therapies that can be used to treat borderline personality disorder, including the often debilitating symptom of anger.

Psychotherapy

Most psychotherapies for BPD target the strong anger responses that people with BPD report and exhibit. For example, in dialectical behavior therapy (DBT), patients are taught skills to help them better manage their anger and decrease angry outbursts.

Other types of psychotherapy for BPD that target anger include:

• Mentalization-based therapy
• Schema-focused therapy
• Transference-focused therapy

Medications

While there are no medications for BPD that are currently FDA approved to treat the disorder, there are some that have been shown to reduce anger in BPD.

Some medications prescribed for people with BPD include: antidepressants (such as Prozac or Wellbutrin), antipsychotics (such as Abilify or Seroquel), or mood-stabilizing drugs (such as Depakote).

However, these medications are probably most effective when used in conjunction with psychotherapy. This is because while medications can alter the intensity of anger, they cannot fully prevent or erase a person's anger when a life stressor or difficult situation arises.

Coping With BPD Rage

There is no one-size-fits-all for coping with borderline rage, but the following strategies may be helpful in diffusing anger or curbing it before it escalates.

Address Your Stress Levels

It may be helpful to find productive ways of coping with stress, since stress is a known precursor to borderline rage. Try identifying triggers of stress, asking for help from family or friends, exercising regularly, eating a balanced diet, and getting enough sleep.

Find a Distraction

BPD anger often increases the longer you're exposed to a frustrating situation. When you feel yourself becoming angry, try to remove yourself from a situation, and take some deep breaths.

You can even do something else to distract yourself, such as watching a funny video or taking a brisk walk around your neighborhood.

Notice If You're Ruminating

If you have BPD and you're experiencing negative thoughts repeating on a loop—thoughts that only increase your anger—there are ways to help disrupt the cycle.

How to Deal With BPD Rage

If your loved one has BPD, you may find it difficult or even distressing to witness or be on the receiving end of their anger. Fortunately, there are many ways to increase your knowledge of borderline rage so that you can support your loved one and protect your emotional well-being.

• Attend a therapy session: It may be helpful for you to attend a therapy session (by yourself or with your loved one). A therapist can help you learn ways to deescalate a situation when your loved one is experiencing BPD rage.
• Work on communication: Clear communication is key when in a relationship with someone who has BPD. For instance, it may help to reassure them, praise them, and encourage them so they remember that you're on their side.
• Validate their feelings: Try saying, "I understand you're experiencing anger right now, but we can get through it together. How can I help support you?"
• Set boundaries: If possible, come up with boundaries together. For instance, you and your loved one might decide that if a borderline rage episode turns into a screaming match, you both take 15 minutes apart to regroup and calm down.
• Remember, BPD is a mental illness: Your loved one with BPD doesn't choose to get so angry, so try not to blame them for the symptoms of their illness. However, it's OK to hold them accountable for their actions, especially when they negatively affect you or other family members or friends.
  

A Word From Verywell

It's important to remember that anger itself is a normal emotion, so experiencing angry reactions does not mean you have BPD. Still, if you have difficulties with anger control, reaching out to a mental health professional is a good idea.

If you or a loved one has difficulties with borderline anger, please seek out care from a therapist or other mental health professional. You (or your loved one) can gain control over your anger and feel better.