A Guide to When BPD and Depression Occur Together

Many people withborderline personality disorder (BPD)also experience problems with depression. In fact, it is very uncommon that BPD and depression donotco-occur. But what is unique about depression in BPD, and how might having both conditions affect your treatment options?

What Is Depression?

The term depression is actually not a specific diagnosis. Instead, this term refers to the experience of depressed (blue or low) mood. Depression ismore than normal sadness. There are a number of mental health conditions that may include elements of depression, includingmood disorders,schizoaffective disorder(a psychotic disorder that includes mood symptoms), and somepersonality disorders(such as BPD).

Individuals who experience one or more episodes of depressed mood may be diagnosed with amajor depressive disorderor another disorder depending on whether other symptoms are also present.

BPD and Depression: Scope of the Problem

There is a very high rate of comorbidity between borderline personality disorder (BPD) and depression. This means many people who have BPD also experience problems with depressed mood.

One study found that about 96% of patients with BPD met criteria for a mood disorder. In this study, about 83% of patients with BPD also met criteria for the major depressive disorder, and about 39% of patients with BPD also met criteria for dysthymic disorder.

Is Depression Different in BPD?

Many experts have noticed that depression often presents differently in patients with BPD than in those without. In other words, the quality of depression seems to be different in BPD. For example, whereas depression is typically associated with feelings of sadness or guilt, depression in BPD has been described as being associated with feelings of anger, deep shame (i.e., feeling emotionally like a bad or evil person), loneliness, and emptiness.

How Does BPD Affect Depression Treatment?

There is fairly conclusive evidence that patients with both a personality disorder and depression have poorer responses to treatment than those without a personality disorder. Ameta-analysisof studies examining treatment outcome in individuals with both personality disorders (PDs) and depression found that people with PDs have poorer responses to treatment regardless of the treatment modality (i.e., medications or psychotherapy).

The good news is that research has shown that if a patient with both BPD and depression istreated for BPDand sees improvement in those symptoms, the symptoms of depression also seem to lift. This effect seems to only work in one direction (i.e., treatment solely focused on depression does not seem to alleviate BPD symptoms in patients who have both conditions).

If you or a loved one are struggling with depression, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

For more mental health resources, see ourNational Helpline Database.

A Word From Verywell

If you think you may suffer from BPD and depression, talk to your mental health provider about the best approach to treatment. Research suggests that treatment focused on the BPD symptoms may be most effective inreducing the symptomsof both conditions.

The Best Online Help Resources for Depression

5 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Beatson JA, Rao S.Depression and borderline personality disorder.Med J Aust. 2012;1(4):24-27. doi:10.5694/mjao12.10474U. S. National Library of Medicine.Depression.U.S. National Library of Medicine.Bipolar disorder.Yoshimatsu K, Palmer B.Depression in patients with borderline personality disorder.Harv Rev Psychiatry. 2014;22(5):266-73. doi:10.1097/HRP.0000000000000045Newton-Howes G, Tyrer P, Johnson T, et al.Influence of personality on the outcome of treatment in depression: Systematic review and meta-analysis.J Pers Disord. 2014;28(4):577-93. doi:10.1521/pedi_2013_27_070Additional ReadingLuca M, Luca A, Calandra C.Borderline personality disorder and depression: An update.Psychiatr Q. 2011;83(3):281-292. doi:10.1007/s11126-011-9198-7.Silk KR.The quality of depression in borderline personality disorder and the diagnostic process.J Pers Disord. 2010;24(1):25-37. doi:10.1521/pedi.2010.24.1.25

5 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Beatson JA, Rao S.Depression and borderline personality disorder.Med J Aust. 2012;1(4):24-27. doi:10.5694/mjao12.10474U. S. National Library of Medicine.Depression.U.S. National Library of Medicine.Bipolar disorder.Yoshimatsu K, Palmer B.Depression in patients with borderline personality disorder.Harv Rev Psychiatry. 2014;22(5):266-73. doi:10.1097/HRP.0000000000000045Newton-Howes G, Tyrer P, Johnson T, et al.Influence of personality on the outcome of treatment in depression: Systematic review and meta-analysis.J Pers Disord. 2014;28(4):577-93. doi:10.1521/pedi_2013_27_070Additional ReadingLuca M, Luca A, Calandra C.Borderline personality disorder and depression: An update.Psychiatr Q. 2011;83(3):281-292. doi:10.1007/s11126-011-9198-7.Silk KR.The quality of depression in borderline personality disorder and the diagnostic process.J Pers Disord. 2010;24(1):25-37. doi:10.1521/pedi.2010.24.1.25

Beatson JA, Rao S.Depression and borderline personality disorder.Med J Aust. 2012;1(4):24-27. doi:10.5694/mjao12.10474U. S. National Library of Medicine.Depression.U.S. National Library of Medicine.Bipolar disorder.Yoshimatsu K, Palmer B.Depression in patients with borderline personality disorder.Harv Rev Psychiatry. 2014;22(5):266-73. doi:10.1097/HRP.0000000000000045Newton-Howes G, Tyrer P, Johnson T, et al.Influence of personality on the outcome of treatment in depression: Systematic review and meta-analysis.J Pers Disord. 2014;28(4):577-93. doi:10.1521/pedi_2013_27_070

Beatson JA, Rao S.Depression and borderline personality disorder.Med J Aust. 2012;1(4):24-27. doi:10.5694/mjao12.10474

U. S. National Library of Medicine.Depression.

U.S. National Library of Medicine.Bipolar disorder.

Yoshimatsu K, Palmer B.Depression in patients with borderline personality disorder.Harv Rev Psychiatry. 2014;22(5):266-73. doi:10.1097/HRP.0000000000000045

Newton-Howes G, Tyrer P, Johnson T, et al.Influence of personality on the outcome of treatment in depression: Systematic review and meta-analysis.J Pers Disord. 2014;28(4):577-93. doi:10.1521/pedi_2013_27_070

Luca M, Luca A, Calandra C.Borderline personality disorder and depression: An update.Psychiatr Q. 2011;83(3):281-292. doi:10.1007/s11126-011-9198-7.Silk KR.The quality of depression in borderline personality disorder and the diagnostic process.J Pers Disord. 2010;24(1):25-37. doi:10.1521/pedi.2010.24.1.25

Luca M, Luca A, Calandra C.Borderline personality disorder and depression: An update.Psychiatr Q. 2011;83(3):281-292. doi:10.1007/s11126-011-9198-7.

Silk KR.The quality of depression in borderline personality disorder and the diagnostic process.J Pers Disord. 2010;24(1):25-37. doi:10.1521/pedi.2010.24.1.25

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What Is Depression?#

BPD and Depression: Scope of the Problem#

Is Depression Different in BPD?#

How Does BPD Affect Depression Treatment?#

A Word From Verywell#

What Is Depression?

BPD and Depression: Scope of the Problem

Is Depression Different in BPD?

How Does BPD Affect Depression Treatment?

A Word From Verywell