Despite not being recognized in the DSM-5, many consider impulsive borderline personality disorder a nonofficial subtype of borderline personality disorder (BPD). In addition to experiencing the symptoms of BPD, those with impulsive BPD tend to have a pattern of engaging in impulsive high-risk behaviors (e.g., unsafe sex, substance use, aggression) and have difficulty controlling impulses.
What Is Impulsive BPD?
While borderline personality disorder (BPD) in general is a pervasive pattern of impulsivity and instability of interpersonal relationships, self-image, and affect, impulsive BPD (occasionally and colloquially referred to as “impulsive personality disorder”) is a subtype of BPD characterized by acting on impulses and engaging in high-risk behaviors with a difficulty controlling such urges.1
Impulsivity, in general, involves seeking out immediate gratification without regard for past learning or consideration of future consequences, and without having planned ahead of time to engage in the behavior. Impulsive behaviors range from small, harmless actions (e.g., taking a spontaneous drive) to highly dangerous and potentially even fatal behaviors and patterns (e.g., attempting suicide).
Those experiencing impulsive BPD may engage in such behaviors to satisfy their own urges or desire for immediate gratification, to connect with others, or to get others’ attention, even though such attention tends to be superficial vs. deep or meaningful.
The symptoms of impulsive BPD often overlap with those of histrionic personality disorder. Both share externalized self-centered qualities with a seemingly theatrical expression of emotions, a need to be the center of attention, chaotic relationships, and sexual provocativeness.2
While these disorders share many characteristics and defining symptoms (and they may even co-occur), impulsive BPD is distinct in that those experiencing it are more prone to anger, feelings of emptiness, self-destructive behavior, and identity disturbance.
Signs & Symptoms of Impulsive BPD
In addition to experiencing the symptoms of BPD, those with impulsive BPD tend to be quick to act on urges and 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 in any positive attention (e.g., compliments or reports that their stories are entertaining.) So, while the behavior of someone with impulsive BPD may be frowned upon by their peers, they are often behaviorally reinforced due to the attention the behaviors garner.
Signs and symptoms of impulsive BPD include:
- Risky behavior (unsafe sex, substance misuse, driving under the influence, thrill-seeking)
- Aggressive behavior (such as yelling, fighting, breaking or damaging things, 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
- Binging (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
Causes of Impulsive Borderline Personality Disorder
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.
Factors that can cause impulsive BPD include:
Genetics
While no specific gene has been identified as causing impulsive BPD (nor BPD more generally), research shows that genetic factors do contribute to its development.3 In fact, many with impulsive BPD have a family history of impulsive disorders such binge eating disorder, BPD, and ADHD.4
Brain Functioning
Some studies suggest that people with BPD have abnormalities in the areas of their brain responsible for emotion regulation and impulse control.5 It is also believed that decreased activity in the prefrontal cortex, which is 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 causes.3
Childhood Trauma
Impulsive BPD may also develop in response to childhood trauma or other adversities (such as parental neglect or loss, sexual abuse, incest, or inconsistent parenting).4 Many children that experienced trauma or neglect 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 a way of coping with the effects of trauma.
Other Environmental Factors
Other environmental and social factors may also lead to the development of impulsive BPD. For example, 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 develop as a result of modeling by caregivers or as a behavior children learn to engage in to get their needs met more quickly.6
Treating Impulsive BPD
Dialectical behavior therapy (DBT) is often the treatment of choice for individuals diagnosed with impulsive BPD. DBT is a multi-dimensional treatment approach 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, emotion regulation, and interpersonal effectiveness.
Mindfulness practice is also helpful for those diagnosed with impulsive BPD as it increases awareness of the present moment, which can help identify present urges and think through the potential consequences of acting on them.
While a medication to treat BPD doesn’t exist, several medications are used to treat the symptoms of impulsive BPD (such as impulsivity, anxiety, and depression) and it is often recommended that they be used in tandem with psychotherapy.7
Whether for you or for 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 a therapist is by searching an online therapist directory, where you can sort by a therapist’s specialty.
Final Thoughts
Impulsive borderline personality disorder can be challenging to deal with, both as the person experiencing it and as a loved one. That being said, there are ways to cope and options for treatment that can increase your quality of life and help manage your symptoms.
Impulsive BPD Infographics
