I Hate You, Don't Leave Me

Inside the mind of a borderline.

The Borderline Grows Older

The Difference Age Makes in BPD

What happens to people with BPD as they age? We know that most of these individuals get better. But for those who don’t improve, there are significant differences between younger and older borderlines.

In one study (Journal of Psychiatric Research, 7/19/2013), both groups of symptomatic patients exhibited high levels of functional impairment and accompanying other diagnoses, such as depression or substance abuse. Younger adults (age 25 or younger) tended to be more impulsive, self-injuring, substance abusing, and more emotionally labile. Older adults (45 and older) reported greater social dysfunction, more lifetime hospitalizations, and feelings of chronic emptiness.

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Borderlines who do recover over time report a different experience. Researchers investigating long-term evolution of borderline patients report that those who are considered fully recovered are more likely to marry and have children. These patients marry later in life and are less likely to get divorced than those who remain symptomatic. Successful marriage and parenting are associated with higher IQ, absence of childhood sexual abuse, no history of substance abuse, and extraversion.

These studies suggest that older and younger borderlines may present with different problems. We know that most of these patients improve significantly, but those who make commitments, such as marriage when younger and while acutely ill are less likely to sustain healthy relationships. Like many illnesses, allowing time to heal may be the best medicine.

Jerold Kreisman, M.D., is a psychiatrist and best-selling author of numerous books.

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