The Consequences of Untreated Borderline Personality Disorder and the Benefits of Dialectical Behavior Therapy

Borderline personality disorder (BPD) is a severe mental health condition characterized by unstable emotions, intense mood swings, impulsive behaviour, and a pervasive pattern of unstable interpersonal relationships. It is estimated that nearly 1.6% of the adult population suffers from BPD, with a majority being female. If left untreated, BPD can lead to serious consequences, impacting an individual’s quality of life, relationships, and overall well-being. One of the most effective treatments for BPD is Dialectical Behavior Therapy (DBT), which has been shown to alleviate many of the symptoms associated with the disorder. In this article, we will explore the consequences of not treating BPD and delve into the benefits of DBT.

Consequences of Untreated Borderline Personality Disorder

Impaired Relationships

One of the most significant consequences of untreated BPD is the inability to form and maintain stable relationships. Individuals with BPD often have intense, unstable relationships marked by a constant push-and-pull dynamic, characterized by idealization and devaluation of their partners. This can lead to frequent breakups, volatile arguments, and eventual isolation from friends and family.

Self-Harm and Suicidal Behaviour

Individuals with untreated BPD are at a higher risk of engaging in self-harm and suicidal behaviour. It is estimated that up to 80% of people with BPD engage in self-harming behaviours, such as cutting or burning themselves. Furthermore, approximately 10% of individuals with BPD die by suicide. Early intervention and treatment are crucial for reducing the risk of self-harm and suicidal behaviour.

Substance Abuse

BPD is often co-morbid with substance abuse, as individuals with the disorder may turn to drugs or alcohol as a means of coping with their emotional pain. Substance abuse can further exacerbate the symptoms of BPD, leading to a vicious cycle of instability and addiction. Untreated BPD increases the likelihood of developing substance abuse issues, which in turn can lead to additional health problems, legal troubles, and financial instability.

Impulsive and Risky Behaviour

Untreated BPD is associated with a heightened propensity for impulsive and risky behaviour. This may manifest in various ways, such as reckless driving, promiscuity, overspending, or engaging in dangerous activities. These behaviours not only put the individual at risk of physical harm but also contribute to further instability in their lives.

Employment Difficulties

Individuals with untreated BPD often struggle with maintaining steady employment due to the symptoms of the disorder. Emotional outbursts, mood swings, and impulsive behaviour can make it challenging to hold down a job and maintain a stable work environment. This can lead to financial difficulties and further strain on relationships and overall well-being.

Impact on Physical Health

Untreated BPD can have serious ramifications on physical health as well. The stress and emotional turmoil associated with the disorder can exacerbate existing health problems or contribute to the development of new ones. Furthermore, self-harming behaviours and substance abuse can have long-lasting effects on an individual’s physical well-being.

The Benefits of Dialectical Behavior Therapy (DBT)

DBT is a type of psychotherapy specifically designed to treat individuals with BPD. Developed by psychologist Marsha Linehan, DBT combines elements of cognitive-behavioural therapy, mindfulness, and skills training to help individuals with BPD manage their emotions, improve interpersonal relationships, and reduce self-harming behaviours.

Emotion Regulation

A primary focus of DBT is helping individuals with BPD learn how to regulate their emotions more effectively. Through various techniques and exercises, clients are taught to identify, understand, and manage

their emotions in healthier ways. By developing a greater understanding of their emotional triggers and learning coping strategies, individuals with BPD can reduce the intensity and frequency of their mood swings, leading to increased stability in their lives.

Interpersonal Effectiveness

DBT also aims to improve interpersonal effectiveness by teaching individuals with BPD how to communicate their needs and set boundaries in relationships. Through role-playing and skills training, clients learn how to assert themselves, manage conflicts, and maintain healthier relationships. As a result, they can develop more stable connections with others and reduce the volatility that often characterizes their interpersonal interactions.

Distress Tolerance

Another core component of DBT is distress tolerance, which involves teaching individuals with BPD how to tolerate and cope with emotional pain rather than resorting to self-harm or other maladaptive behaviours. Clients learn various techniques, such as mindfulness, distraction, and self-soothing, to help them manage their emotional distress more effectively.


DBT incorporates mindfulness practices to help individuals with BPD become more aware of their thoughts, emotions, and bodily sensations. Through regular mindfulness exercises, clients can develop a greater sense of self-awareness and learn to observe their emotions without judgment. This increased self-awareness allows them to make more informed choices about how to respond to their emotions and experiences, ultimately leading to a greater sense of control over their lives.

Reduction in Self-Harm and Suicidal Behaviour

DBT has been shown to significantly reduce the risk of self-harm and suicidal behaviour in individuals with BPD. By providing clients with healthier coping mechanisms and strategies to manage their emotional distress, DBT helps to reduce the likelihood of engaging in self-destructive behaviours.

Improved Quality of Life

Overall, DBT has been proven to improve the quality of life for individuals with BPD by reducing their symptoms and helping them develop healthier, more adaptive behaviours. Numerous studies have shown that individuals who undergo DBT experience significant improvements in emotion regulation, interpersonal effectiveness, and overall functioning. These improvements often lead to increased stability in various aspects of their lives, including relationships, employment, and physical health.

Leaving borderline personality disorder untreated can have severe consequences, affecting an individual’s relationships, mental health, physical well-being, and overall quality of life. Dialectical behaviour therapy (DBT) has been shown to be an effective treatment for BPD, offering numerous benefits such as improved emotion regulation, increased interpersonal effectiveness, and reduced self-harm and suicidal behaviour. Early intervention and treatment with DBT can help individuals with BPD lead more stable, fulfilling lives and minimize the potentially devastating consequences of this complex mental health condition.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.

Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.

Nolen-Hoeksema, S., & Watkins, E. R. (2011). A heuristic for developing transdiagnostic models of psychopathology: Explaining multifinality and divergent trajectories. Perspectives on Psychological Science, 6(6), 589-609.

Stoffers, J. M., & Lieb, K. (2015). Pharmacotherapy for borderline personality disorder: Cochrane systematic review of randomised trials. The British Journal of Psychiatry, 206(1), 7-12.


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