What triggers a BPD episode?

Borderline personality disorder (BPD) is a mental health condition characterized by unstable relationships, difficulty regulating emotions, and intense outbursts of anger ^[1]. There are some specific triggers that can lead to the onset of a BPD episode ^[2].

Common BPD triggers

When a person lives with borderline personality disorder (BPD), they may experience episodes in which symptoms of BPD are especially pronounced or evident. Based on research of individuals who live with this psychiatric condition, there are some common factors that are known to trigger BPD episodes. These triggers are discussed below in further detail ^[2].

History of trauma

Trauma is known as a distal trigger for BPD episodes, meaning that trauma does not have to be occurring presently to trigger a BPD episode. A person who has a history of trauma is at increased risk of BPD, and when they are reminded of a past traumatic event, whether consciously or subconsciously, the reminder may trigger a BPD episode.

Feelings of rejection

An episode may be triggered in a person with BPD when they feel rejected. One of the core symptoms of BPD is frantic efforts to avoid abandonment ^[1]. When a person with BPD is rejected, it is likely to trigger their intense fear of abandonment, which can trigger BPD symptoms. Rejection may come in the form of criticism, being passed up for a promotion, or not getting the praise one feels they deserve.

Loneliness

Just as feelings of rejection can trigger abandonment fears in a person with BPD, loneliness can also trigger BPD episodes. For example, if a close friend or significant other of a person with BPD is busy with work, hobbies, or other activities, the individual with BPD may feel abandoned, leading to a BPD episode.

Experiencing failure

The experience of personal failure has also been linked to BPD episodes, which is likely a result of the unstable self-image that comes along with BPD ^[1]. Failure can threaten an already unstable self-image, leading a person with BPD to feel badly about themselves. Types of failure that can trigger a BPD episode include earning a bad grade, not performing well in sports, or being unsuccessful in meeting some sort of goal.

Poor interactions with others

Conflict with others can also trigger a BPD episode, especially when the conflict leads to significant anger or distress. For example, an argument with a significant other can lead to a BPD episode, which may result in a defense mechanism called splitting. When a person with BPD engages in splitting, their view of a person shifts entirely, based upon their emotions in the present moment ^[3].

This means that while they may have previously idealized a significant other, once they become angry during conflict, they will view the significant other as being entirely repulsive, unable to view their current anger as being a temporary state.

Stressors

Finally, a BPD episode may be triggered by a stressful event, such as a conflict with a coworker, financial problems, or a car accident. BPD is characterized by difficulty with emotional regulation, which can lead a person with BPD to have intense emotional reactions in the face of stress ^[1].

What happens during a BPD episode?

When a BPD episode is triggered, a person with BPD may experience a crisis, or at the very least, intense emotions that feel out of control. Research with individuals living with BPD has found that during an episode, these individuals feel overwhelmed, on edge, and as if they are “going to explode” ^[2].

In response to the intensity of a BPD episode, a person may show the following signs or behaviors ^{[1] [2]}:

• Dissociative experiences, which can lead a person to believe as if they are disconnected from the world around them
• Outbursts of extreme anger, which could result in physical fights or inappropriate displays of rage
• Intense mood swings, which seem out of proportion to the trigger
• Risky behavior, such as substance abuse, reckless driving, or unprotected sex
• Self-harming or suicidal behaviors
• Intense conflict with others, which may lead the person with BPD to end a relationship, only to return to the relationship after the episode passes

How to manage BPD triggers

If BPD triggers are interfering with your daily life, there are ways to cope with these triggers, so they do not cause as much distress and interruption. Research has demonstrated that learning to practice mindfulness, which requires a person to be attuned to the present moment, can be beneficial for individuals with BPD.  

Mindfulness interventions teach a person to accept negative emotional states, without passing judgment ^[4]. Meditation and yoga can be beneficial for cultivating a more mindful attitude. There are guided mindfulness meditation videos available on the Internet for those looking to develop this skill.

Other activities that can make BPD triggers less intense can include ^[5]:

• Taking time for relaxation
• Focusing on one thing at a time
• Self-soothing with paced breathing
• Engaging in intense physical exercise
• Prioritizing healthy sleep
• Avoiding the use of mood-altering drugs
• Treating any physical illnesses
• Eating balanced, nutritious meals
• Lighten your load if you’re feeling overwhelmed
• Applaud yourself for your successes

Ultimately, entering treatment can help you to develop stronger coping skills so that BPD triggers are more manageable. Several forms of therapy and counseling are beneficial for treating BPD symptoms.

For example, dialectical behavior therapy (DBT), a treatment modality created for BPD, can help you to develop stronger skills for tolerating distress, regulating emotions, and managing interpersonal relationships. If you’re having difficulty developing coping skills, it’s important to reach out for professional treatment.