Emotionally unstable personality disorder (EUPD) traits

Outlining some of the most common traits someone with EUPD may have.

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If you're concerned that someone close to you is showing the signs of emotionally unstable personality disorder (EUPD), also known as borderline personality disorder (BPD), this blog outlines the common characteristics to look out for.

Priory has a network of hospitals and wellbeing centres located throughout the UK, and our specialist teams are highly experienced in supporting people with EUPD. By providing treatment that's tailored specifically to the person and their circumstances, we can help people to reduce the impact the condition has on their day-to-day life.

Common EUPD symptoms

Frantic efforts to avoid real or imagined abandonment

A person with traits of EUPD may react strongly if you arrive home late or have to spend time apart.

They'll make every effort to remain in your presence, which may include begging you to stay, physically trying to stop you from leaving, or self-harming. While you're away, they may constantly call and text, or phone you at unsociable hours, including in the middle of the night.

These behaviours happen because the person fears the possibility of separation or rejection.

A pattern of intense and short-lived relationships

Someone with EUPD is likely to fall in love or develop friendships quickly and intensely, but then fall out of these relationships just as rapidly.

They view most things in ‘black and white’ terms, seeing everything and everyone as entirely good or entirely bad. As a result, they can quickly shift from idolising to devaluing a person. This typically happens when they experience a real or perceived slight, which causes them to feel disappointed, betrayed, unloved or abandoned.

An unstable self-image and chronic feelings of emptiness

EUPD can result in a person making sudden changes to their opinions, values, friendship groups and sexual identity. They can also rapidly change their career goals and vocational aspirations. Some people may alter their identity depending on where they are and who they're with.

These changes happen as the person doesn’t feel like they know who they are or what to believe in. They may also feel as though they're non-existent.

Impulsive and self-destructive behaviour

Making hasty decisions is another EUPD trait, where the person finds it difficult to judge the possible consequences of their actions.

This can lead to the person behaving in a dangerous, impulsive and irresponsible manner. For example, they may misuse alcohol and drugs, spend excessively, drive recklessly or become involved in gambling. They may turn to self-harm behaviours too.

Repeated, rapid and abrupt shifts in mood, and inappropriate, intense anger

A person with EUPD may experience mood changes more frequently and rapidly than people without the condition. As a person with EUPD is less able to manage their emotional responses, they're also more likely to respond to situations in a way that falls outside what's expected.

They can quickly change from being reasonably to intensely angry or sad, panicked or afraid. It can feel as though you can't predict how they'll react to something or someone.

Stress-related paranoid ideation or severe dissociative symptoms

A person with EUPD may believe they can see messages and threats where people without EUPD wouldn't, such as in a casual glance, a conversation or in body language. They may also have distressing beliefs about groups such as the government or big corporations plotting to cause them harm.

Receiving treatment for EUPD at Priory

If someone you're close to is displaying EUPD traits, it's important to encourage them to visit their GP to talk about their symptoms and the impact they're having on their daily life.

Their GP may then refer them for an in-depth assessment and expert treatment at Priory. Our psychiatrists are highly experienced in working with people with EUPD, and providing them with access to the most effective treatment. In addition, while we prefer people to have a GP referral, this isn’t essential and your loved one can also contact Priory directly to discuss their needs and options for treatment.

To find out more about how we assess people for EUPD, please read our blog on the EUPD diagnosis process.

Residential treatment

If a person would benefit from a highly structured programme, it may be recommended that they receive residential based treatment. During this time, the person will receive 24-hour care and support. They'll be involved in psychotherapy sessions, rehabilitative workshops and creative classes to learn techniques for dealing with EUPD traits in their everyday life.

The psychotherapy treatment that we use for EUPD at Priory includes mentalisation-based therapy (MBT). This treatment can be very effective for people with personality disorders. It encourages people to closely examine and assess their thoughts and beliefs, to help them reduce their impulsive and reckless behaviours.

Talking therapies such as dialectical behaviour therapy (DBT) also form a core part of treatment for EUPD. Through group and one-to-one sessions, a person has the opportunity to recognise their feelings as real and acceptable, and learn ways to challenge these thoughts with alternative and more positive ways of thinking. It can help to free the person from seeing the world in such a rigid and ‘black and white’ way, and instead, view everything and everyone in a more helpful and positive manner.

Day and outpatient treatment

Day care and outpatient support are also available for people whose EUPD traits are less severe, or for people who've already taken part in residential treatment. This can provide people with access to therapy in a flexible and supportive environment, where they're able to integrate their treatment within their daily life.

Page clinically reviewed by Dr Ian Nnatu (MB BS, PG DIP (CBT), MSc, FRCPsych, MRCPsych) Consultant Adult Psychiatrist at Priory Hospital North London

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