Intense, inappropriate anger is one of the most troubling symptoms of borderline personality disorder (BPD). It is so intense that it is often referred to as “borderline rage.” While anger is a key feature of BPD, very little is known about why people with BPD experience anger differently than other people or even how this experience is different. New research, however, is shedding light on the nature of borderline rage.
What is Borderline Anger?
Borderline anger is more than just a standard emotional reaction. In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), anger in BPD is described as “inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).”
Clinically, anger in BPD is called “inappropriate,” because the level of anger seems to be more intense than is warranted by the situation or event that triggered it. For example, a person with BPD may react to an event that may seem small or unimportant to someone else (e.g., a misunderstanding) with very strong feelings of anger and unhealthy expressions of anger (e.g., yelling, being sarcastic or becoming physically violent).
Research on Borderline Anger
While borderline anger has long been a topic of debate and speculation among BPD specialists, it has only recently become a topic of careful research. Researchers are now examining how borderline anger is different than normal anger and why it occurs. For example, researchers are now trying to understand whether it is that people with BPD are more easily angered, have more intense anger responses or have more prolonged anger responses than people without BPD (or whether it is some combination of these factors).
For example, a recent study examined anger in people with BPD compared to people without BPD (healthy controls) in response to an anger-producing story. This study found that people with BPD reported the same level of anger as the healthy controls in response to the story, but that the healthy controls reported that their anger decreased more quickly over time than the people with BPD reported. So it may not be that people with BPD have a stronger anger reaction, but that their anger has a much longer duration than other people experience.
Research in this area is very preliminary, and much more work is needed to fully understand how and why people with BPD experience borderline anger.
How Is Borderline Anger Treated?
Most psychotherapies for BPD target the strong anger responses that people with BPD report and exhibit. For example, in dialectical behavior therapy (DBT), patients are taught skills to help them better manage their anger and decrease angry outbursts. Other types of psychotherapy for BPD, including schema focused therapy, transference focused therapy and mentalization based therapy, target anger as well.
While there are no medications for BPD that are currently FDA approved to treat the disorder, there are some that have been shown to reduce anger in BPD. BPD medications, however, are probably most effective when used in conjunction with psychotherapy.
Getting Help for Borderline AngerIf you or a loved one has difficulties with borderline anger and needs help, there are excellent specialists available with expertise in reducing borderline anger. For more information on how to find a therapist, check out this article on finding a therapist for BPD:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fourth Edition. 4th ed. American Psychiatric Publishing, Inc.; 2000.
Jacob GA, Guenzler C, Zimmermann S, Scheel CN, Rusch N, Leonhart R, et al. “Time Course of Anger and Other Emotions in Women with Borderline Personality Disorder: A Preliminary Study.” Journal of Behavior Therapy and Experimental Psychiatry. 39:391-402, 2008.