The Relationship Between BPD and Depression

Borderline Personality Disorder (BPD) is a personality disorder characterized by patterns of instability in mood, self-image and interpersonal relationships, associated with behaviors of impulsivity. Because BPD is often associated with suicidal ideation and self-harm behaviors, it may be misdiagnosed or mistaken for depression. However, in other cases, an individual may be experiencing comorbid depression and BPD. In order to properly identify whether you are struggling with Major Depression or Borderline Personality Disorder. AMFM Mental Health Treatment has over a decade of experience providing comprehensive mental health care for those struggling with mood and personality disorders. If you’re interested in depression or BPD treatment, call our compassionate admissions team today to learn more about the resources that are available to you.

bpd and depression

Overlap in Symptoms of BPD and Depression

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), to be diagnosed with BPD, an individual must meet at least 5 of the following criteria:1
  1. Frantic efforts to avoid real or imagined abandonment.
  2. A pattern of unstable relationships and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
  3. Identity disturbance: markedly and persistently unstable self‐image or sense of self.
  4. Impulsivity in at least two areas that are potentially self‐damaging.
  5. Recurrent suicidal behavior, gestures or threats, or self‐mutilating behavior.
  6. Affective instability due to a marked reactivity of mood.
  7. Chronic feelings of emptiness.
  8. Inappropriate, intense anger or difficulty in controlling anger.
  9. Transient, stress‐related paranoid ideation or severe dissociative symptoms.

Because of the themes of low self-esteem, emotional dysregulation, low self-image, feelings of worthlessness, suicidal thoughts, feelings of emptiness, and self-harm, BPD symptoms may also look like the symtoms of a depressive episode (in an individual with bipolar disorder) or Major Depressive Disorder

Classification of BPD

Though the symptoms of BPD may reflect those of an affective disorder like depression or bipolar disorder, BPD is not classified as a variant of either MDD or BD. There are important differences. For example, treatment of depression does not result in remission of BPD symptoms. An important longitudinal study found that effective treatment of BPD tends to result in remission of depression, and antidepressants often show only modest benefit for depressive disorders that co-occur with BPD.2 Depressive symptoms are present in the majority of people with BPD. To address the difficulty differentiating clinically distinct MDD from depressive symptoms that are integral to BPD psychopathology, recent studies suggested that depressive symptoms arising from a primary diagnosis of BPD (i) may exhibit transience and be stress reactive, (ii) lack a robust clinical response to antidepressant medication and/or electroconvulsive treatment and (iii) are responsive to BPD-appropriate psychotherapy.3

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Comorbid Depression and BPD

Though symptoms of BPD may be misdiagnosed or mistaken for Major Depressive Disorder, there are also cases of comorbidity of Major Depression and BPD. One recent study found that Borderline personality disorder (BPD) is diagnosed in 10-30% of patients with major depressive disorder (MDD), and the frequency of MDD among individuals with BPD reaches over 80%; the comorbidity of MDD and BPD is associated with more severe depressive symptoms and functional impairment, higher risk of treatment resistance and increased suicidality.4 If you’re struggling with suicidal ideation, particularly in the case of comorbid depression and BPD, call our helpline today.

More about BPD

People with BPD tend to have relationships that can be chaotic and intense, veering between a desperate neediness for others and fear of abandonment to an intense anger or dismissal of others when feeling rejected, even in situations where the other person may in fact be neutral or even positive.5 Additionally, people struggling with BPD and mood changes may be at increased risk of harm to themselves or others. If you are looking for a specialized treatment plan for BPD, our admissions team at AMFM Mental Health Treatment is ready to help.

Suicidal Ideation in BPD and Depression

Suicidal ideation is a side affect of a variety of mental health disorders, and refers to an action of planning or thinking about suicide. According to WHO estimates, approximately 1 million people are victims of suicide each year.6 Suicide is the leading cause of death, and affects people of all ages.7 If you or a loved one are struggling with suicidal ideation, you do not need to go through this alone. AMFM Mental Health Treatment can help you develop a safety plan, enact suicide prevention strategies, and develop crucial protective factors. Reaching out for mental health programming may help save lives; call us today for help.

Signs of Suicidal Behavior

People at risk of suicidal behavior tend to display certain warning signs prior to a suicide attempt. If you or someone you love is displaying the following behaviors, it may be time to reach out for professional clinical help, or to develop a safety plan:
  • Talking about wanting to die, no longer wanting to live, or a lack of purpose or interest
  • Feelings of hopelessness, extreme guilt and shame, drastic lows and emotional pain
  • Actions of making plans or researching ways to die, withdrawing from friends, family members and loved ones, engaging in self-harm, giving away important items of sentimental value, taking extreme and dangerous risks, drastic mood swings8

Help us to help you; if you’re currently experiencing thoughts of suicide or know people at risk of suicidal ideation, you can reach out to us at our 24/7 mental health hotline today.

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Suicide Prevention Resources

American Foundation for Suicide Prevention

The American Foundation for Suicide Prevention offers resources and shared conversations about suicide to the forefront of global discussions. They also sponsor “Out of the Darkness” campus walks to increase awareness of suicide prevention through social media outreach, volunteer opportunities, and more.

CDC’s Suicide Prevention Strategies

The CDC has shared some fact sheets surrounding suicide rates, suicide prevention strategies, risk factors and protective factors. Individual, Relationship, Community, and Societal Protective Factors outline support systems that can help reduce suicide rates by incorporating access to mental health care and conversations. They also outline seven strategies for suicide prevention in a video series here:9
  1. Strengthen economic supports
  2. Create protective environments
  3. Improve access and delivery of suicide care
  4. Promote healthy connections
  5. Teach coping and problem-solving skills
  6. Identify and support people at risk
  7. Lessens harms and prevent future risk (Postvention)

Suicide Prevention Programs

AMFM Mental Health Treatment offers residential, intensive outpatient and partial hospitalization programs for people at risk. If you’re interested in mental health programming for adults and adolescents, don’t hesitate to reach out today.

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More About Depression

Major Depressive Disorder (MDD) or Clinical Depression is a mood disorder that is known for causing persistent sadness, a loss of interest in pleasurable activities, and a range of other emotional and physical symptoms. Symptoms of depression can affect your daily routine, relationships, and overall quality of life.

Depression can affect individuals of varying ages and other demographics. While depression is more commonly diagnosed among women, men may experience more stigma regarding mental health difficulties, which prevents them from seeking help. Causes of depression can vary, including generics, experiences you’ve had in life, and a chemical imbalance within your brain. Depression therapy can help you in overcoming depression and may include the use of depression medications and holistic therapies.

Types of Depressive Disorders

Depression can present differently among those experiencing depressive symptoms. There are several types of depressive disorders, each of which have their own features and recommended treatments. While this is not an exhaustive list of mental health depression conditions, it does highlight some of the most common:

  • Bipolar Disorder (Bipolar Depression)
  • Seasonal Affective Disorder (SAD)
  • Major Depressive Disorder (MDD)
  • Postpartum Depression
  • Persistent Depressive Disorder (Dysthymia)
  • Psychotic Depression

Psychiatric Treatment for Depression and BPD

There are a variety of different antipsychotic medications and antidepressant medications that have been proven as effective treatment (in combination with psychological treatment) for depression and BPD. Some types of antidepressants are listed here, but inquire with a licensed medical professional or psychiatrist for detailed information on different treatments. Never take psychiatric medication unless it is prescribed to you, and be sure to consult with medical professionals in case of external risk factors. 

Lithium

For over half a century, Lithium has been used as a mood stabilizer to treat bipolar disorder, treating both the manic episodes as well as the bipolar depression.10 However, Lithium treatment can have side effects and complications in long-term use on the kidney and thyroid, and it’s important that an individual keep his or her clinical team in the loop on any side effects as they come up.

Antispychotics

Antipsychotics, or neuroleptics, are generally geared toward the neurotransmitters, whether they’re “dopamine receptor antagonists” or “serotonin-dopamine antagonists”.11 Antipsychotics are usually used to treat psychotic depression and schizophrenia. Some popular antipsychotics include Quetiapine (Seroquel), Aripiprazole (Abilify/Aristada), and Olanzapine (Zyprexa). 

Antidepressants

Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are antidepressant medications that treat different neurotransmitters in order to block the reabsorption of serotonin or norepinephrine, keeping more of the chemicals in the synaptic cleft. Some popular SSRIs include Sertraline, Fluoxetine Citalopram and Escitalopram. Both SSRIs and SNRIs are effective treatments for depression, but depend upon the individual, and should be approached with medical guidance and mental health professional advice.

If you’re currently on medications for any other medical conditions, it’s important to review any over-the-counter medications and their interactions with a medical professional. Click here to learn more about the importance of medication management

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Popular Forms of Therapeutic Treatment for Depression

Therapeutic treatment for depression and BPD is always recommended, whether in combination with psychiatric care, or separately from psychiatry. While small lifestyle changes like daily physical activity, regular exercise, and stepping outside into the sunlight when possible are helpful tactics, psychotherapy is highly regarded as the most effective method of mental health care for those struggling with mental disorders.

Cognitive-Behavioral Therapy (CBT)

Cognitive-Behavioral Therapy (CBT) is a form of therapy that’s focused on restructuring and reprogramming maladaptive and negative thought processes. Psychologists are trained to help you change your cognitive and emotional processes in order to outgrow coping mechanisms that may no longer be serving you.

Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) is most commonly referred to as “talk therapy,” and is designed to help process emotions. Qualified professionals offer psychological therapy to move forward with healthy ways of engaging in interpersonal relationships and alleviating physical and emotional distress.

Eye Movement Desensitization and Reprocessing Therapy (EMDR)

EMDR Therapy is a renowned method of reprocessing most often used in trauma therapy. By activating the prefrontal cortex through a series of bilateral stimulation, qualified professionals can lead you through traumatic experiences, helping you to alleviate the distress symptomized by trauma.

Electroconvulsive Therapy (ECT)

ECT is a form of “Shock Therapy,” designed for brain stimulation, and only utilized in cases of severe depression. While ECT has historically gotten a bad reputation, when properly administered it can be a useful tool for those who cannot accept psychiatric assistance.

Transcranial Magnetic Stimulation (TMS)

TMS is a type of therapy that uses magnetic pulses to treat depression by stimulating certain areas of the brain. This is a noninvasive method of treatment that some mental health programs offer.

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I understand that I may be contacted by telephone, email, text message or mail regarding my disability benefit case options and that I may be called using automatic dialing equipment. Message and data rates may apply. My consent does not require purchase. Message frequency varies. Text HELP for help. Reply STOP to unsubscribe.

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Contact From Admission Representative:

Complete the form to receive a prompt call back from a member of our experienced and compassionate admissions staff. All communication is 100% confidential.

Additional Mental Health Conditions for Treatment

AMFM Mental Health Treatment has extensive experience treating a variety of mental health disorders–through evidence-based therapies, support groups, mental health resources and more–including but not limited to the following:

  • Anxiety Disorders
  • Depression
  • Eating Disorders
  • Obsessive Compulsive Disorder (OCD)
  • Post-Traumatic Stress Disorder (PTSD) 
  • Crisis & Traumatic Events
  • ADHD
  • Bipolar Disorder
  • Mood Disorders
  • Psychosis 
  • Phobias
  • Schizophrenia
  • Panic Attacks

Recovery can feel isolating; mental health programming can provide treatment options and cohesive plans to help you or your loved one as you move forward.

Are You or a Loved One Struggling with BPD or other Mental Health Challenges?

Reaching out for help in your mental health journey can be difficult, emotional and overwhelming. With A Mission For Michael Mental Health Treatment, we’re with you throughout your journey, offering compassion, guidance, resources, and understanding the whole way. There are many mental health providers out there, and we want to connect you with the right fit. If you are interested, confused, or need help regarding mental health care, give AMFM a call. You or your loved one don’t have to walk through this alone. 

Leichsenring F, Fonagy P, Heim N, Kernberg OF, Leweke F, Luyten P, Salzer S, Spitzer C, Steinert C. Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry. 2024 Feb;23(1):4-25. doi: 10.1002/wps.21156. PMID: 38214629; PMCID: PMC10786009.

Beatson, J. A., & Rao, S. (2013, October 29). Depression and borderline personality disorder. 

Rao S, Broadbear J. Borderline personality disorder and depressive disorder. Australasian Psychiatry. 2019;27(6):573-577. doi:10.1177/1039856219878643

Więdłocha M, Marcinowicz P, Komarnicki J, Tobiaszewska M, Dębowska W, Dębowska M, Szulc A. Depression with comorbid borderline personality disorder – could ketamine be a treatment catalyst? Front Psychiatry. 2024 Apr 29;15:1398859. doi: 10.3389/fpsyt.2024.1398859. Erratum in: Front Psychiatry. 2024 Oct 28;15:1507504. doi: 10.3389/fpsyt.2024.1507504. PMID: 38742125; PMCID: PMC11089186.

Flayton, L. (2024, November 19). Understanding the difference between bipolar and borderline personality disorder. NewYork-Presbyterian. https://healthmatters.nyp.org/understanding-difference-bipolar-borderline-personality-disorder/ 

Ghasemi P, Shaghaghi A, Allahverdipour H. Measurement Scales of Suicidal Ideation and Attitudes: A Systematic Review Article. Health Promot Perspect. 2015 Oct 25;5(3):156-68. doi: 10.15171/hpp.2015.019. PMID: 26634193; PMCID: PMC4667258.

“Facts About Suicide | Suicide Prevention.” CDC, 26 March 2025, https://www.cdc.gov/suicide/facts/index.html. Accessed 11 April 2025.

“Warning Signs of Suicide – National Institute of Mental Health (NIMH).” National Institute of Mental Health, https://www.nimh.nih.gov/health/publications/warning-signs-of-suicide. Accessed 11 April 2025.

CDC. (2022). Suicide Prevention Resource for Action: A Compilation of the Best Available Evidence. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. https://www.cdc.gov/suicide/pdf/preventionresource.pdf

Burdick KE, Millett CE, Russo M, Et. al, The association between lithium use and neurocognitive performance in patients with bipolar disorder. Neuropsychopharmacology. 2020 Sep;45(10):1743-1749. doi: 10.1038/s41386-020-0683-2. Epub 2020 Apr 29. PMID: 32349118; PMCID: PMC7419515.

Chokhawala K, Stevens L. Antipsychotic Medications. [Updated 2023 Feb 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519503/