Suicidal Thoughts, Self-Harm, and BPD

October 20, 2023

Suicidal thoughts, self-harm, and BPD can profoundly impact individuals struggling with this complex mental health condition characterized by intense emotions and unstable relationships. We hope to foster understanding by exploring these important yet sensitive subjects while offering support and information for those navigating these challenges or seeking knowledge about them. It is crucial to approach this subject matter with compassion and empathy as we strive toward greater awareness and destigmatization of mental health issues.

BPD: Overview and Facts

Borderline Personality Disorder (BPD), is a complex mental health condition affecting how individuals think, feel, and relate to others. It typically emerges in adolescence or early adulthood and can cause significant distress and impairment in daily life.

People with BPD often experience intense emotions that are difficult to regulate, leading to frequent mood swings and emotional instability. They may struggle with an intense fear of abandonment and have unstable relationships marked by idealization followed by devaluation. This pattern can extend beyond personal relationships, including fluctuating self-image and chronic feelings of emptiness.

Another key feature of BPD is impulsive behavior that can manifest as self-harm, substance abuse, excessive spending, or risky sexual behaviors. Suicidal thoughts are also common among those diagnosed with BPD.

While the exact causes of BPD remain unclear, research suggests a combination of genetic factors, brain structure abnormalities, early childhood trauma, or neglect may contribute to its development.

Types of BPD

There are no specific types of BPD, as it is considered a single diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, some common subtypes individuals with BPD may exhibit include:

  • Quiet/Burned-Out Type: This subtype typically involves individuals who internalize their distress, struggling silently with self-destructive thoughts and behaviors. They may experience more depressive symptoms and engage in self-harm or substance abuse.
  • Impulsive/Acting-Out Type: People with this subtype often display impulsive behavior, difficulty controlling anger, and have a greater risk of engaging in reckless activities or self-harming behaviors such as gambling excessively, binge-eating, or promiscuous sex.
  • Petulant/Highly Sensitive Type: This variant of BPD tends to involve hypersensitivity to perceived criticism or rejection. Individuals may react strongly to even minor stressors and display angry outbursts, passive-aggressive behavior, or chronic feelings of emptiness.

Presentation in Older and Younger People

BPD can present differently in older and younger individuals, although it is essential to note that the disorder’s core symptoms generally remain consistent across age groups. Younger individuals with BPD may exhibit frequent mood swings, intense anger, or other intense emotional outbursts. Young people also engage in risky behaviors such as substance abuse, self-harm, unprotected sex, or reckless driving.

Furthermore, they can struggle with a fluctuating sense of identity and self-image, which may result in changing interests or goals frequently. They can also have difficulty maintaining stable relationships due to fear of abandonment or conflict-driven behavior.

In older people, with maturity and therapy, many individuals with BPD report better control over their emotions than when they were younger. Older individuals tend to have more insight into their thoughts, emotions, and behavioral patterns associated with BPD. While personal relationships may become more stable for some older individuals, the fear of abandonment and difficulties related to trust can persist. Additionally, a constant sense of emptiness is often reported.

BPD and Suicide Ideation

People with BPD may experience intense emotional pain, hopelessness, and difficulty regulating emotions, contributing to suicidal thoughts. The fear of abandonment and chronic emptiness can amplify these feelings. Co-occurring conditions such as depression or substance abuse further elevate the risk.

As such, BPD is strongly associated with an increased risk of suicide ideation, attempted suicide, and completed suicide. According to Borderline Personality Disorder and Emotion Dysregulation, about 65-80% of those diagnosed with BPD have engaged in self-harming behaviors at some point. Furthermore, Medicina states that, among individuals with BPD, approximately 10% die by suicide.

BPD and Self-Harm

Self-harm and BPD are strongly associated with each other. Some insights into the causes, reasons behind self-harm in BPD, and signs to look out for include:


Difficulty regulating emotions can lead to overwhelming feelings of anger, sadness, or emptiness that may drive individuals towards self-harming behaviors. The impulsivity characteristic of BPD can contribute to acting on urges without considering the consequences, leading to self-harm. Self-harm can be a maladaptive coping mechanism to relieve emotional distress or regain control over inner turmoil.

Reasons It Occurs:

Some individuals may engage in self-harming behaviors to release pent-up emotions and find temporary relief. The physical pain caused by self-harm can trigger the release of endorphins, providing a brief sense of calm or a numbing effect. For some people with BPD, self-harm is a way to communicate their inner struggles when they lack effective words or support systems.

Signs of Self-Harm:

  • Frequent unexplained injuries such as cuts, burns, or bruises
  • Wearing long sleeves or pants even in warm weather to hide scars
  • Isolation or withdrawal from social activities
  • Collection of sharp objects like knives or razors
  • Changes in mood, including sudden shifts from apparent distress to appearing calm

It’s vital for individuals who engage in self-harm to remember they are not alone and that help and support are available. 

BPD and Suicidal Risk Factors

Suicidal risk factors are related to the intense emotional swings and overwhelming feelings of hopelessness, worthlessness, or despair associated with BPD. The impulsive and reckless behavior also makes individuals more prone to acting on suicidal impulses without fully considering the consequences. 

People with BPD with co-occurring disorders, such as other mental health or substance use disorders, further contribute to their vulnerability. Additionally, childhood trauma associated with BPD can increase suicidal risks. Difficulties in regulating emotions and inadequate coping skills are also contributing factors. 

The Role of Therapy

Therapy plays a crucial role in treating BPD and addressing suicidal thoughts and self-harm behaviors. Several therapeutic approaches have shown effectiveness in managing symptoms, building coping strategies, and reducing suicidal risks. 

Effective therapy provides a supportive environment where individuals can explore underlying issues, learn healthier coping mechanisms, enhance emotional regulation skills, build resilience against overwhelming emotions, establish safety plans during crisis moments, and work toward reducing suicidal thoughts, self-harm, and BPD risk factors.

Compassionate BPD Treatment in Chattanooga, TN

At Time Wellness Tennessee, we understand the challenges and struggles people face when they have suicidal thoughts, self-harm, and BPD. Our caring and compassionate team provides specialized care focusing on understanding and support.

Take the first steps to healing and improved mental health by contacting us today