Borderline personality disorder (BPD) is a complex mental health condition characterized by difficulties with emotions, relationships, and sense of self. One common question that arises is whether BPD causes obsessive thoughts or behaviors.
What is BPD?
BPD is marked by a pattern of instability in moods, behavior, self-image, and functioning. People with BPD often experience intense emotions and impulsivity as well as problems in relationships.
Some common symptoms of BPD include:
- Intense but unstable relationships
- Fears of abandonment
- Unclear or shifting self-image
- Impulsive, risky behaviors
- Self-harm
- Chronic feelings of emptiness
- Explosive anger
- Feeling suspicious or out of touch with reality
BPD affects about 1.6% of adults in the United States. It often begins in adolescence or early adulthood and occurs more frequently in women. The exact causes are unknown but likely involve a combination of genetic and environmental factors.
Obsessive-Compulsive Personality Disorder vs. Obsessive-Compulsive Disorder
Before examining the link between BPD and obsessiveness, it’s important to distinguish between obsessive-compulsive personality disorder (OCPD) and obsessive-compulsive disorder (OCD).
OCD is a separate mental health condition characterized by intrusive, unwanted thoughts and repetitive behaviors the person feels driven to perform. People with OCD experience obsessions and compulsions that are time-consuming, cause distress, and interfere with daily functioning.
In contrast, OCPD is a personality disorder marked by extreme perfectionism, preoccupation with orderliness, and rigidity. People with OCPD may have obsessive personality traits but do not experience true obsessions and compulsions like those seen in OCD.
The Link Between BPD and Obsessiveness
While BPD and obsessiveness are distinct conditions, research shows there are some associations between them:
- Around 25% of people with BPD also have OCD. This comorbidity rate is higher than what is seen in the general population.
- Compared to other personality disorders, BPD has a stronger link to obsessive-compulsive symptoms.
- People with BPD may exhibit obsessiveness in relationships. For example, they may be preoccupied with a partner, obsess over abandonment, or engage in obsessive contact after a breakup.
- Those with BPD often experience rapidly shifting emotions. While not true obsessions, they may become consumed or “obsessed” with emotions like anger, sadness, emptiness, or anxiety in the moment.
- A subset of those with BPD also meet criteria for OCPD. Around 11% of people with BPD have co-occurring OCPD.
However, BPD does not necessarily cause obsessions or compulsions in most cases. While a portion of people with BPD do exhibit obsessive-compulsive tendencies, it is not a core diagnostic criterion of BPD.
Overlapping Symptoms
There are some overlapping symptoms that may explain why BPD and obsessiveness are connected in certain individuals:
| BPD Traits | Obsessive Traits |
|---|---|
| Unstable, intense relationships | Obsessive preoccupation with relationships |
| Impulsivity | Repetitive impulses and behaviors |
| Identity disturbance | Perfectionism, rigidity |
| Emptiness | Need for control |
| Paranoia | Distrust, suspicion |
The table shows there are some parallel tendencies between BPD and obsessive traits, such as relationship fixation, impulsiveness, identity issues, and feeling out of control. This overlap may account for the comorbidity between the two.
Causes
There are several theories as to why BPD and obsessiveness are linked in some cases:
- Shared risk factors – BPD and OCD/OCPD have some similar risk factors like childhood trauma and family instability. These shared causes may predispose someone to both BPD and obsessive-compulsive tendencies.
- Overlapping brain abnormalities – Imaging studies show both BPD and OCD involve abnormalities in frontal-limbic brain pathways involved in emotion regulation and inhibitory control. These shared neural issues may manifest in symptoms of both conditions.
- Distress intolerance – People with BPD often have a low tolerance for emotional distress. Obsessiveness may be an unhealthy coping mechanism to control or numb difficult feelings associated with BPD.
- Attachment issues – Those with BPD commonly have insecure attachment styles rooted in childhood. Obsessiveness may be an attempt to feel attached and safe.
- Loss of identity – BPD involves a poorly defined sense of self. Obsessiveness may be a way to construct an identity and feel in control.
Overall, the overlap between BPD and obsessive-compulsive disorders seems to be explained by a mixture of shared origins and people utilizing obsessiveness to cope with BPD’s emotions and emptiness.
Treatments
For people with both diagnosed BPD and OCD/OCPD, an integrated treatment approach may be recommended. This involves addressing both conditions at the same time.
Some therapies and medications that can help both BPD and obsessive-compulsive disorders include:
- Psychotherapy, such as dialectical behavior therapy (DBT) or cognitive behavioral therapy (CBT)
- Mindfulness meditation and distress tolerance techniques
- Medications like SSRIs, antipsychotics, and mood stabilizers
- Family therapy or support groups
The core aim is helping the person better manage BPD emotions, compulsions, and relationship problems using medication, coping strategies, and therapeutic techniques.
Tips for coping with obsessiveness
For those with BPD who struggle with obsessiveness, some self-help tips include:
- Seek professional help to understand the roots of obsessive thoughts or behaviors
- Identify triggers and patterns to obsessiveness
- Find healthy distractions like exercise, social interaction, or enjoyable hobbies
- Practice mindfulness to sit with uncertainty and distress
- Limit impulsive actions and contact when obsessing over a relationship
- Challenge irrational thoughts with logic and evidence
- Build a stable sense of identity outside relationships or perfectionism
- Get support from loved ones, support groups, or therapists
While obsessiveness is common for some with BPD, treatment and coping skills can help manage both conditions. Setting healthy boundaries around relationships, emotions, and compulsions is key.
Conclusion
In summary, BPD and obsessiveness are connected in some, but not all, individuals with borderline personality disorder:
- Around 25% of people with BPD also have diagnosed OCD.
- OCPD also co-occurs in about 11% of BPD cases.
- Those with BPD may display obsessive traits like relationship preoccupation, impulsiveness, and attempts to control emotions.
- Overlapping brain abnormalities, childhood trauma, and insecure attachment may contribute to both BPD and obsessive disorders in some.
- Integrated treatment and healthy coping strategies can help manage obsessive tendencies associated with BPD.
While obsessiveness is a separate condition, it does commonly accompany BPD due to some shared underlying causes and risk factors. Proper diagnosis and tailored treatment helps address obsessive traits in the context of borderline personality disorder.
