Impulsive Borderline Personality Disorder (BPD)

Signs & Symptoms of Impulsive BPD

In addition to experiencing the core symptoms of BPD, those with impulsive BPD tend to act quickly on desires, engaging in potentially dangerous behaviors without considering the consequences. They often feel pulled toward anything that offers instant gratification, as it helps them avoid a sense of emptiness or lack of fulfillment.

They may feel angered by criticism of these behaviors and relish any positive attention, such as compliments or remarks about how entertaining their stories are. So, while their actions may be frowned upon by peers, the attention they receive often reinforces the behavior.

Signs and symptoms of impulsive BPD include:

• Fear of abandonment
• Risky behavior (unsafe sex, substance misuse, driving under the influence, thrill-seeking)
• Aggressive behavior (such as yelling, fighting, breaking or damaging things, and getting physical with others)
• Impulsive self-harm or suicidality
• High emotional reactivity
• Lack of stability (e.g., frequently switching between jobs, starting and ending romantic relationships)
• Attention- and reassurance-seeking behaviors
• Thrill-seeking behaviors
• Bingeing (food, alcohol, etc.)
• Acting charismatic and dramatic despite often feeling empty or unfulfilled
• Overspending
• Making one’s mind up quickly or jumping to conclusions
• Changing one’s mind or opinion seemingly out of nowhere

How Impulsive BPD Impacts Life & Relationships

Impulsive BPD can significantly affect a person’s quality of life, disrupting daily routines, interpersonal relationships, and overall emotional stability. The impulsive behaviors and intense emotional responses characteristic of this subtype often lead to conflicts at home, challenges at work, and strained social interactions. Understanding these impacts can help individuals with impulsive BPD and their loved ones recognize patterns and seek support.

Impact on Relationships

Individuals with BPD often experience a pattern of intense, unstable relationships. Those with the impulsive subtype may find relationships even more difficult to sustain. Their high emotional reactivity and thrill-seeking behaviors paired with the classic BPD fear of abandonment can make having healthy relationships difficult. People with BPD tend to struggle to maintain long-term and fulfilling romantic relationships due to their low self-esteem, lack of trust or faith in others, and their novelty-seeking behaviors.

Impact in the Workplace

An employee with impulsive BPD can be difficult to work with and to manage. They may have trouble staying on task, especially if things feel “boring”, and are easily swept away by interpersonal dilemmas. People with impulsive BPD likely have a job history filled with short-term positions in which their emotional reactivity isn’t immediately seen as an issue. Holding a steady job with unmanaged impulsive BPD is an uphill battle and can look quite dysfunctional.

Impact on Family & Friends

BPD is a diagnosis that can have a tremendous impact on all those in the client’s life, especially their family and friends. The relationships with them can also feel turbulent and people often find themselves having to “walk on eggshells” around individuals with impulsive BPD. Family and friends of the client often struggle to watch the toxic behaviors unfold in the person with BPD. Their support system has difficulty understanding why the person makes the impulsive choices they do despite the consequences and will need to practice setting boundaries to protect their own mental health.

What Causes Impulsive BPD?

Impulsive BPD is believed to be caused by a combination and transaction of genetic and environmental factors, such as trauma or chronic invalidation. Some studies have also suggested that people with BPD have brain abnormalities in the areas responsible for controlling levels of impulsivity.

Possible causes of impulsive BPD include:

Genetics

While no specific gene has been identified as causing impulsive BPD (nor BPD in general), research shows that the development of BPD may have a genetic factor.³ In fact, many with impulsive BPD have a family history of impulsive disorders such as binge eating disorder, BPD, and ADHD.⁴

Brain Functioning

Some studies suggest that people with BPD have abnormalities in the areas of the brain responsible for emotional regulation and impulse control.⁵ It is also believed that decreased activity in the prefrontal cortex, common among those with BPD, contributes to certain aspects of impulsivity.⁶ For those who have experienced trauma, excessive production of cortisol and hypothalamic-pituitary-adrenocortical hyperactivity are other possible contributors.³

Childhood Trauma

Impulsive BPD may also develop in response to childhood trauma or other adversities including parental neglect or loss, sexual abuse, incest, or inconsistent parenting.⁴ Many children who experienced such events may have found that, as children, demonstrating risky behavior was the only way to get the attention of their caregivers, which reinforced the idea that impulsivity garners love and attention. Further, many people engage in risky behaviors, like unprotected sex and substance use, as a way of coping with the effects of trauma.

Other Environmental Factors

Other environmental and social factors, such as family conflict, chronic invalidation, rapid social change, and loss of social cohesion are possible predictors.⁴ It’s also been posited that impulsivity is a learned behavior, meaning it may arise as a result of modeling by caregivers or as a behavior children learn to engage in to get their needs met more quickly.⁶

How Is Impulsive BPD Diagnosed?

Impulsive BPD is not considered its own diagnosis according to the DSM-5, but it is widely accepted as one of the four subtypes of BPD. While there is not one definitive assessment professionals use to determine a diagnosis, many screening options could be utilized in addition to a thorough intake assessment to provide an impulsive BPD diagnosis.⁸ After a mental health professional completes their assessment, they will determine if you meet the criteria for BPD and have the specific symptoms that define the impulsive subtype.

Coping Skills for BPD

BPD, like other mental health diagnoses, can be effectively managed by using coping skills tailored to the person’s specific needs. By using strategies based in self care, self exploration, and self kindness, someone with BPD can learn to live with their symptoms so that they don’t impact their quality of life to an unmanageable level. Coping strategies that are focused on impulse control are exceptionally helpful to those with Impulsive BPD.

Some coping strategies for BPD include:

• Mindfulness: Mindfulness practices for BPD are also helpful for those diagnosed with impulsive BPD as it increases awareness of the present moment, which can help identify active urges and think through the potential consequences of acting on them.
• Grounding techniques: These are strategies that help connect your mindset back to the present moment. These include mindfulness practices focusing on using your five senses to connect to your physical surroundings. Grounding techniques help with emotional distress, overstimulation, and impulsivity, three of the common struggles in BPD.
• Distress tolerance: DBT teaches BPD clients how to improve their ability to manage and tolerate distress. One strategy is called TIPP, which stands for temperature, intense exercise, paced breathing, and progressive muscle relaxation. These are all ways to help regulate your  nervous system in times of emotional distress and many can be used for immediate relief.
• Self-care: It is important to practice self-soothing strategies regularly to help maintain a sense of calm in your nervous system. Taking a bath, listening to soft music, and doing gentle movements with your body like stretching, can help reduce emotional distress.
• Radical acceptance: Practicing radical acceptance is trying to acknowledge reality for what it is rather than judging it or fighting against it. People with BPD can utilize this skill to decrease their anxious, paranoid, impulsive, and catastrophic thoughts related to their disorder.
• Problem solving: In impulsive BPD, making rash decisions can often come from an inability to determine the best solution to an issue. Practicing problem solving skills by identifying issues, brainstorming solutions, and implementing them will provide long-term skills for managing BPD.
• Setting boundaries: People with impulsive BPD can benefit from creating and maintaining boundaries within their relationships with others and also within themselves. Boundaries can help provide structure to an otherwise chaotic internal and external life.
• Thought logs: This CBT strategy encourages individuals to track the patterns of their cognitive distortions and thoughts, which can help someone with impulsive BPD slow their train of thought and possibly intervene before problematic choices are made.
• Seek outside support: Creating a social support system is crucial for managing BPD symptoms. Having a range of different supports, like friends, family, therapists, and support groups, will bolster your ability to decrease your symptom intensity.

How Is Impulsive BPD Treated?

Dialectical behavior therapy (DBT) is often considered the treatment of choice for individuals diagnosed with impulsive BPD. DBT for BPD is a multi-dimensional approach to treatment for BPD that involves individual and group therapy, phone coaching in-between sessions, and a skills group that focuses on building skills in the following areas: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness.

While medication to treat BPD directly doesn’t exist, some medications may help manage symptoms like impulsivity, anxiety, or depression when used alongside therapy.⁷

Whether for you or a loved one, it’s important to find a therapist who has training and experience working with people who have BPD. A great way to find the right therapist is by searching an online therapist directory, where you can sort by a therapist’s specialty.

Finding the right therapist who is experienced in treating BPD is essential. Fortunately, many therapists now offer virtual services, and online therapy platforms provide flexible, accessible options for those seeking help. These platforms often include specialized care, such as online DBT therapy, which can be particularly beneficial for those with impulsive BPD who need consistent support and skills training.

Whether you’re seeking help for yourself or supporting a loved one, exploring an online therapist directory or virtual mental health platform can be an effective first step in finding the right care.