About Borderline Personality Disorder & Anger: How to Deal With Anger Issues in BPD

About Borderline Personality Disorder & Anger: How to Deal With Anger Issues in BPD
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What Causes Borderline Personality Disorder Anger?

According to the National Institute of Mental Health (NIMH) borderline personality disorder anger issues can last for anything from a few hours to a whole day. NIMH further states that “People with BPD often have highly unstable patterns of social relationships,” and that they “…develop intense but stormy relationships,” which can often “shift from idealization (great admiration and love) to devaluation (intense anger and dislike).” The main triggers of BPD anger are fear of abandonment and unstable mental thinking.

Life and situational disappointments can also trigger borderline personality disorder anger. Once the anger begins, how does it manifest itself?

BPD Anger – How Does it Manifest?

In her book Get Me Out of Here, BPD sufferer Rachel Reiland (a pseudonym) details her first-hand experience of BPD symptoms including honest revelations about her typical anger days.

In Reiland’s book her borderline personality disorder anger comes out as verbal abuse of loved ones and even hatred for those in the firing line. Often this is for no other reason than something went wrong during the day such as a missed appointment or she felt that a sales clerk looked at her the wrong way.

Other examples of Reiland’s anger are revealed in her dealings with her therapist. If the therapist tried to touch on an unwanted subject or topic, Reiland would act out, using foul language and hurling abusive names. The principle reasons for Ms. Reiland’s anger toward her therapist were fear of abandonment and/or fear of a return to a mental health facility. After one bad session, Reiland placed a note on her therapist’s vehicle saying “I know where you and your family live now!”

Anger symptoms of BPD patients are revealed in many ways but almost always the intent is to harm and verbally attack someone so that the BPD person can feel empowered and maintain control. The NIMH also says that BPD individuals are “…highly sensitive to rejection, reacting with anger and distress,” and that feelings of abandonment “…trigger separation anxiety, anger and distress.”

Image Credit: MorgueFile/Anita Patterson

How is BPD Anger Treated?

Research at the NIMH reveals that antipsychotic drugs are a way to treat borderline personality disorder symptoms and can slow or help improve “distortions in thinking.” Along with dialectical behavior therapy (DBT), the NIMH has also seen improvements in BPD anger issues with antidepressants and mood stabilizers. Antipsychotic drugs such as fluphenazine and haloperidol may also be used when there are distortions in thinking to lighten moods and decrease anger episodes.

A Harvard University 1995 clinical trial by Salazman et al - The Effect of Fluoxetine (Prozac) on Anger Symptomatic Volunteers with Borderline Personality Disorder - found that there was a clinically and statistically significant decrease in anger among the fluoxetine patients (of the 22 subjects in this double-blind study, 13 received a placebo and 9 received Prozac).

Finally, other BPD organizations such as BPD Central lean toward the thought that intense, often biweekly or more therapy sessions can help BPD suffers control anger through role-playing and at-home exercises. The patient is given “what if” scenarios to determine how they will best handle each situation to avoid anger. The exercises are then reviewed by the therapist or another group support member to help recognize and change anger behaviors.


Siever LJ, Koenigsberg HW. The Frustrating No-mans Land of Borderline Personality Disorder. Cerebrum, The Dana Forum on Brain Science, 2000; 2(4). (NIMH)

Koerner K, Linehan MM. Research on dialectical behavior therapy for patients with borderline personality disorder. Psychiatric Clinics of North America, 2000; 23(1): 151-67. (NIMH)

Reiland, Rachel, 2004 (Hazelden Publishing) Get Me Out of Here: My Recovery from Borderline Personality Disorder, ISBN-10: 1592850995 / ISBN-13: 978-1592850990

Siever LJ, Koenigsberg HW. The frustrating no-mans-land of borderline personality disorder. Cerebrum, The Dana Forum on Brain Science, 2000; 2(4). (NIMH)

Harvard University 1995 Prozac clinical trial (Salazman et al) retrieved at https://www.ncbi.nlm.nih.gov/pubmed/7714224?dopt=Abstract

BPD Central - https://www.bpdcentral.com/index.php