Borderline schizophrenia is a term some use to describe a condition that encompasses both borderline personality disorder (BPD) and schizophrenia.

In the 1970s, experts campaigned that borderline schizophrenia should be given its own diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition (DSM-3). These professionals believed this was relevant to people who experienced both borderline personality disorder (BPD) and schizophrenia. Borderline schizophrenia, however, was never given its own diagnosis in the manual.

This article discusses borderline personality disorder, schizophrenia, and how they can co-occur.

Disclaimer on the validity of borderline schizophrenia

Borderline schizophrenia may be a term used to describe the combination of BPD and schizophrenia. However, it is not an established phenomenon, and it is not a supported diagnosis by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Text Revision (DSM-5-TR).

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BPD and schizophrenia are separate conditions and diagnoses. However, it is possible for the two conditions to co-occur. One small 2018 study found that psychotic disorders, like schizophrenia, were present in 38% of people with BPD.

There are even those who would argue that the split of the two conditions in the DSM-3 was unwarranted. Some professionals believe that BPD and schizophrenia hold enough similarities that they should both be included under the schizophrenia spectrum disorders.

In a small study conducted by these professionals, they found that the majority of people being treated for BPD met the diagnostic criteria for schizophrenia spectrum disorder. Among these, 20% met the criteria for schizophrenia.

BPD is a condition that involves difficulty in regulating emotions. This means that someone with BPD may experience emotions intensely and for a prolonged period of time. They may also find it difficult to return to a neutral baseline of emotion after a triggering event.

BPD affects an estimated 1.4% of adults in the United States.

BPD symptoms

BPD can lead people to have difficulty with impulsivity and poor self-image. It can also cause issues in relationships. The issues with self-regulation people with BPD experience can also lead to more dangerous behaviors, such as self-harm.

Not everyone with BPD will experience the same symptoms. The severity and frequency of symptoms also varies from person to person. Some common signs of BPD include:

  • making efforts to avoid real or perceived abandonment, such as quickly jumping to relationships or ending them just as quickly
  • having a pattern of unstable and intense relationships with family, friends, and loved ones
  • having a distorted and unstable sense of self or self-image
  • experiencing impulsive and potentially dangerous behaviors, such as spending sprees, sex without a condom or other barrier method, and reckless driving
  • experiencing intense moods that are highly variable, these may last anywhere from a few hours to a few days
  • having chronic feelings of emptiness
  • experiencing intense and inappropriate anger or issues controlling anger
  • experiencing feelings of dissociation, such as feeling cut off from oneself or feelings of unreality
  • experiencing self-harming behaviors, such as cutting
  • experiencing recurring thoughts of suicide

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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BPD treatment

Treatment for BPD typically involves psychotherapy. The most common types of psychotherapy for BPD include:

  • Dialectical behavioral therapy (DBT): This type of therapy was developed specifically to help manage BPD. It helps teach individuals skills to help manage their emotions, reduce self-destructive behaviors, and improve relationships.
  • Cognitive behavioral therapy (CBT): CBT can help individuals with BPD to change their core beliefs and behaviors that are based on inaccurate perceptions and issues interacting with others. It can also help to reduce symptoms of anxiety and mood swings.

Medication may help manage some of the symptoms people may experience. However, there is no specific medication that healthcare and mental health professionals use to treat BPD.

Schizophrenia is a serious mental health condition that affects less than 1% of the U.S. population. People with schizophrenia may experience:

  • hallucinations
  • delusions
  • disorganized speech
  • lack of motivation
  • difficulty thinking

Treatment can help manage and improve symptoms and can help reduce the likelihood of recurrence.

Schizophrenia symptoms

The symptoms of schizophrenia can vary from person to person. However, generally, they fall into three categories:

  • Psychotic symptoms:
    • hallucinations
    • delusions
    • unusual or illogical thinking
    • abnormal body movements
  • Negative symptoms:
    • having difficulty planning and sticking with activities
    • having difficulty feeling pleasure in everyday life
    • showing limited facial expressions
    • talking in a dull voice
    • avoiding social interactions or interacting in awkward ways
    • having low energy and a lack of motivation
  • Cognitive symptoms:
    • having difficulty processing information and making decisions
    • having difficulty using information after learning it
    • having difficulty paying attention or focusing

Schizophrenia treatment

Treatment for schizophrenia focuses on symptom management, improvement in day-to-day functioning, and achieving personal life goals.

Treatment typically includes:

  • antipsychotic medications
  • psychotherapy, such as:
    • CBT
    • behavioral skills training
    • supported employment
    • cognitive remediation interventions
  • educational programs for friends and loved ones
  • coordinated specialty care (CSC)

Borderline schizophrenia is a term that is used to describe the occurrence of both BPD and schizophrenia. However, it is not an established diagnosis.

BPD and schizophrenia are separate conditions that can occur together. They also share many similarities.

Both BPD and schizophrenia require treatment to help individuals manage their symptoms.