Impulsive Behavior and Borderline Personality Disorder

A Principal Feature of BPD That Includes Self-Harming Behaviors

Self-harm. Credit: BSIP / Contributor / Getty Images

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 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.

What is Impulsivity?

According to the Diagnostic and Statistical Manual of Mental Illnesses, 5th edition, 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 is a small problem or inconvenience and it's not worth it to escalate the situation. However, for those with BPD, their responses 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 likely never takes into account potential consequences, such as getting hurt, getting detained by security, or even being 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 is 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 as a potential symptom of BPD. 

What are Examples of Impulsive Behaviors?

Some examples of impulsive behaviors include:

  • 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

Can Impulsivity Be Treated?

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 that encourages you to stay in the moment, can help you to stay more aware of your actions so that you take the time to consider consequences.

Practicing this technique can help you to take a moment 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 sometimes combined with a low dose of an antipsychotic (especially if a person's impulsivity is posing a threat to their personal safety) may also help. Medications are usually most effective when used in conjunction with ​psychotherapy with a therapist specializing in BPD.

Sources:

American Psychiatric Association. ​(2013). Diagnostic and statistical manual of mental disorders, 5th ed, text revision. Washington, DC, 

American Psychiatric Association. (2010). Practice Guideline for the Treatment of Patients with Borderline Personality Disorder

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