Suicidal Thoughts and Behavior in People With BPD

Suicidal Thoughts and Behavior in People With BPD BPD Print Suicidality in Borderline Personality Disorder Why Its Common and How to Help By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. Learn about our editorial policy Kristalyn Salters-Pedneault, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on November 10, 2019 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD on November 10, 2019 Eric Audras / Getty Images More in BPD Diagnosis Treatment Living With BPD Related Conditions Information presented in this article may be triggering to some people. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911 immediately. Suicidal behaviors and completed suicides are very common in people with borderline personality disorder (BPD). Research has shown that about 75% of people with BPD will make at least one suicide attempt in their lifetime, and many will make multiple suicide attempts.?? People with BPD are also more likely to complete suicide than individuals with any other psychiatric disorders. It has been estimated that between 3% to 10% of people with BPD complete suicide, which is more than 50 times the rate of suicide in the general population.?? Why Self-Harm and Suicide Are Common in People With BPD There are several factors related to BPD that may explain why suicide, self-harm, and suicide attempts are so common, such as: Severe Emotional Pain: 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 their emotional pain, such as  deliberate self-harm  or substance use and even suicide.Duration: BPD is a chronic condition and usually lasts for years. One of the most unique aspects of BPD is suicidal ideation. People with this condition may consider suicide on a daily basis for months, even years.?? This may leave people with BPD feeling that there is no other way out, despite the fact that there are effective treatments available for BPD.Comorbidity: BPD tends to co-occur with other mental disorders, such as bipolar disorder, major depression, and schizoaffective disorder. When there are other mental disorders present, the risk of suicide increases.??Impulsivity: BPD is associated with impulsivity, or a tendency to a ct quickly without thinking about consequences. Individuals with BPD may engage in suicidal behaviors in a moment of intense emotional pain without fully considering the consequences.Substance Use: BPD often co-occurs with substance use and the use of drugs or alcohol is a risk factor for suicide all by itself. When substance use issues are combined with BPD, this may be a particularly lethal combination because substance use can lead to even greater impulsivity and people who are using substances have access to a means for overdose.??Brain Abnormalities: Brain imaging has shown that compared to healthy people, individuals with BPD tend to have abnormalities involving the brains structure, metabolism, and function. These abnormalities appear to contribute to symptoms of BPD such as impulsivity and aggression, both of which are associated with suicidal behavior. One study explored the relationship between impulsivity, aggression, and suicidal behavior in the brain structures of peopl e with BPD who had attempted suicide. The participants were put into two groups depending on how lethal their suicide attempts had been. In the group labeled High Lethality, meaning their suicide attempts had been extremely harmful, there was less gray matter in multiple areas of the brain than in the Low Lethality group.?? A similar study also showed a significantly reduced amount of gray matter in the brains of individuals with BPD when compared with healthy people. In people with BPD who had attempted suicide, there was less gray matter in 8 out of 9 areas and in people with BPD who had not attempted suicide, there was less gray matter in 5 out of 9 areas.?? And, similar to the other study, the higher lethality suicide attempters had notably less gray matter than the lower lethality attempters in certain areas. How to Get Help If Youre Having Suicidal Thoughts If youre at immediate risk of committing suicide, you need to get help now. Call 911 if youre in the United States or Canada, call the local police, or get yourself to your nearest emergency room. If youre not at immediate risk of suicide, but youre having thoughts of suicide and need to get support, call a helpline to talk about how youre feeling and to find resources near you. For example, in the United States, you can call the National Suicide Prevention Lifeline at 1-800-273-8255. Its open 24/7, 365 days a week, and its free and confidential. 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. Try to remember that there are people who know how to treat BPD and want to help you. Treatment can make a huge difference in your life. How to Help a Loved One With BPD Who Is Suicidal If your loved one is at immediate risk of committing suicide, you need to get him or her help immediately. You can call 911 yourself if youre in the United States or Canada, or call the police and tell them whats happening. Or, if he or she 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 hasnt said anything about suicide. If you think your loved one may be thinking of suicide, but youre not sure, talk to him. Let her know that youre worried about her. Ask him 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 no matter what. Showing care and concern for your loved ones safety and well-being can also go a long way.