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Suicidality in Borderline Personality Disorder

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Updated April 05, 2008

Unfortunately, suicidal behaviors and completed suicides are very common in individuals with BPD. Research has shown that around 70 percent of people with BPD will have at least one suicide attempt in their lifetime, and many will make multiple suicide attempts. People with BPD are more likely to complete suicide than individuals with any other psychiatric disorder. Between 8 and 10 percent of people with BPD will complete suicide; this rate is more than 50 times the rate of suicide in the general population.

Why is Suicide so Common in BPD?

There are several factors related to BPD that may explain why suicide is so common.

First, BPD is associated with very intense negative emotional experiences. These experiences are so painful that many people with BPD report that they would like to find a way to escape. They may use a number of different strategies to try to reduce the emotional pain (e.g., deliberate self-harm, substance use), including suicide. Also, BPD is a chronic condition; it usually lasts for years. Conditions that are more chronic may lead to more risk for suicide since they do not tend to get better quickly without treatment. This may leave people with BPD feeling that there is no other way out, despite the fact that there are now effective treatments available for BPD.

BPD is also associated with impulsivity, or a tendency to act quickly without thinking about consequences. This may be another reason that suicide is common in BPD; individuals with BPD may engage in suicidal behaviors in a moment of intense emotional pain without fully considering the consequences.

Finally, BPD often co-occurs with substance use. The use of drugs or alcohol is a risk factor for suicide alone. However, substance use issues combined with BPD may be a particularly lethal combination; substance use can lead to even greater impulsivity. And, people who are using substances have access to a means for overdose.

I am Suicidal. What Should I Do?

If you are at immediate risk of committing suicide, you need to get help immediately. Call 911 (if you are in the U.S. or Canada), call the local police, or get yourself to your nearest emergency room. If you are not at immediate risk of suicide, but you are having thoughts of suicide and need to get support, call a helpline to talk about how you are feeling. For example, in the U.S. you can call the National Suicide Prevention Lifeline at 1-800-273-TALK. The emotional pain associated with BPD is very intense, and it can leave you feeling as if you are completely alone and will never feel better. There are people who know how to treat BPD and want to help.

I Think My Loved One is Suicidal. What Should I Do?

If your loved one is at immediate risk of committing suicide, you need to get them help immediately. You can call 911 yourself (again, in the U.S. or Canada), or call the police and tell them what is happening. Or, if they will let you, take your loved one to the nearest emergency room.

Sometimes friends or family pick up on signs of suicidality even if their loved one has not said anything about suicide. If you think your loved one may be thinking of suicide, but you are not sure, talk to them. Let them know that you are worried about them. Ask them whether your concerns are valid. Offer to help. This can be hard to do, because sometimes symptoms can make the person with BPD very difficult to deal with. But, for the time being the most important thing is to help your loved one stay safe.

Sources:

Soloff PH, Lynch KG, Kelly TM, Malone KM, and Mann JJ. "Characteristics of Suicide Attempts of Patients with Major Depressive Episode and Borderline Personality Disorder." American Journal of Psychiatry, 157:601-608, 2000.

Work Group on Borderline Personality Disorder. "Practice Guidelines for the Treatment of Patients with Borderline Personality Disorder." American Journal of Psychiatry, 158:1-52.

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