Borderline Personality Disorder (BPD) is a mental health condition that is a commonly co-occurring condition for autistics, though it can also occur alone or with other conditions.

Women and non-binary people, it is reported, are often misdiagnosed with BPD, if autism isn’t considered as a possible diagnosis during assessment. This is for a number of reasons, including the frequent co-occurrence of the two conditions, and because a number of traits display very similarly in autistic people and those with BPD.

  • A key feature of BPD is a lack of emotional regulation. The same is true for many autistic people.
  • A fear of rejection is also a trait in both groups.
  • Both conditions create difficulties in sustaining relationships.
  • Self esteem is often low in both conditions.
  • Eating disorders and addictions are common in both.
  • Feelings of shame are frequent in BPD and in autistics.
  • Self-harm and suicide rates are high in both groups.
  • Both conditions commonly lead to abuse of all kinds by others, due to the vulnerability of both groups.
  • Feelings of emptiness are commonly reported in BPD and autism.
  • Black and white thinking, is claimed to be common in both conditions.

There are many other similarities but there are also differences:

  • BPD is not a neurodivergence – it is an acquired mental health condition that relates to attachment and fear of abandonment.
  • Those with BPD often idolise particular people in their lives and seek intense relationships, often to the exclusion of others.
  • Conversely, BPD causes those with the condition to avoid their friends, or even remove them from their lives in order to avoid being rejected (I would argue there’s some overlap with autistics here).
  • BPD causes a great deal of distress as, just because someone with BPD may be aware that their relationships are suffering, they are unable to change, due to their condition. This causes feelings of shame and self-blame.
  • Mood swings are very common, as is anger and impulsivity.

In fact, looking at the Mind’s page on What does BPD feel like? If you are autistic and you read that list, you’ll see why so many autistics are misdiagnosed or partially diagnosed (not seeing the autism beneath the BPD).

There are so many traits that are common to multiple other conditions, without a close relative having already been diagnosed (it’s thought to have a genetic element to it), it’s considered quite difficult to receive a diagnosis as it is widely misunderstood and with no agreed route to diagnosis or treatment. Mind states that, as well as overlapping with autism, conditions such as bi-polar, complex PTSD, depression and anxiety all share similarities. Diagnosis becomes harder still when someone is experiencing two or more of these conditions together.

Mind’s collection of BPD-related pages is excellent. There are lots of links for further support, support and advice for family and friends, and a really good page of tips on self-care, many of which will be equally as helpful to neurodivergents.