Borderline Schizophrenia: What It Is and More (2024)

It’s rare for borderline personality disorder (BPD) and schizophrenia to occur together, but it is possible.

Mental health conditions aren’t usually cut-and-dry conditions. It’s common for some people to have multiple mental health conditions that might be connected, such as living with depression and anxiety, or post-traumatic stress disorder (PTSD) and substance use disorder (SUD).

The same is true for some people with schizophrenia and borderline personality disorder (BPD), which can occur together.

To understand what the co-occurring disorders of borderline personality disorder and schizophrenia might look like, it can be helpful to familiarize yourself with what each disorder looks like separately.

And despite the seriousness of each condition, managing symptoms is possible with the right treatment plan.

You won’t find the term “borderline schizophrenia” in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM 5). It hasn’t been a recognized disorder since 1980.

Borderline schizophrenia — or “pseudoneurotic schizophrenia” — is an outdated term once used interchangeably with “borderline psychosis.” Later on, this was split into the current classifications of schizotypal personality disorder and borderline personality disorder (BPD).

But there are some overlapping symptoms between BPD and schizophrenia.

Can you have BPD and schizophrenia together?

It is possible for someone to have both disorders at the same time, though it is rare. But more research is still needed on the comorbidity of BPD and schizophrenia.

While 2014 research indicates that people with borderline personality disorder often experience co-occurring psychiatric conditions, the exact rate of schizophrenia and BPD comorbidity specifically isn’t clear just yet.

A 2010 study found that 17.6% of people diagnosed with schizophrenia also met the criteria for BPD. But research from 2018 illustrated that schizophrenia was present in only 2% of females with BPD.

If you or a loved one has both BPD and schizophrenia, learning the similarities and differences of these conditions can be helpful in understanding how they may interact.

Borderline personality disorder (BPD)

BPD is classified in the DSM 5 as a personality disorder, which is generally characterized by:

  • rigid thinking
  • atypical behavior
  • difficulty maintaining stable relationships

Research from 2008 found that up to 5.9% of people may experience BPD at some point in their lifetime. Onset typically occurs during adolescence or young adulthood.

Schizophrenia

Schizophrenia falls within the schizophrenia spectrum class of disorders in the DSM 5.

According to the National Institute of Mental Health (NIMH), schizophrenia affects less than 1% of the population, and is among the top 15 causes of disability worldwide, with symptoms indicating a diminished connection to reality.

Psychosis

Psychosis refers to a severe disconnection from reality. Psychotic episodes include hallucinations or delusions.

Psychosis can occur in both schizophrenia and borderline personality disorder, but psychotic episodes in BPD are, by definition, short, fleeting, and related to stress.

A significant but smaller percentage of people with BPD experience hallucinations than people with schizophrenia. According to research from 2021, an estimated 29% to 50% of people with BPD report hallucinations.

This is compared to an estimated 60% to 80% of people with schizophrenia who report experiencing these symptoms, based on a 2021 review.

And unlike schizophrenia, BPD psychotic episodes are generally not accompanied by negative symptoms or disorganization.

While it’s rare for BPD and schizophrenia to cooccur together, some symptoms may overlap.

Knowing the differences in how each condition’s symptoms can look and feel can be helpful.

Schizophrenia symptoms

Schizophrenia symptoms generally fall under three categories:

  • Positive symptoms: this includes psychosis (including hallucinations and delusions), disordered thinking and speech, altered sensations
  • Negative symptoms: these symptoms include reduced motivation, difficulty planning, suppressed emotions, social withdrawal
  • Cognitive symptoms: this can include trouble withattention or concentration, memory loss, difficulty absorbing information, trouble making decisions

BPD symptoms

Some of the most common symptoms of borderline personality disorder include:

  • sweeping shifts in mood and behavior
  • varying perceptions of self and others
  • emotional instability, including episodes of anger
  • depression and anxiety
  • unstable relationships with friends, family, and romantic partners
  • impulsivity
  • feeling a lack of purpose or emptiness
  • self-harm
  • suicidal ideation

A significant but smaller percentage of people with BPD may also experience:

If you’re considering acting on suicidal thoughts, please seek professional support immediately.

Calling or texting a crisis helpline will connect you with a trained counselor 24/7, any day of the year, completely free of charge:

The causes of both BPD and schizophrenia aren’t entirely clear to experts at this time, and more research is needed. It’s believed that genetics, physiology, and environment all play a role in the development of these conditions.

No single factor is likely to lead to the development of these disorders but rather a complex combination of multiple sources.

Genetics

Though no single gene has been identified as a cause of BPD or schizophrenia, it’s clear that family history may play a role in their development.

A 2017 review of twin studies found that if an identical twin develops schizophrenia, the other may have a higher chance of developing it, too.

Family members of those with BPD also have a higher chance of developing the condition, according to research from 2021.

But this doesn’t mean that having a family member with one of these conditions guarantees that you will develop it, too.

Environment

Experiencing trauma early in life can be a contributing factor to developing BPD.

A 2021 review indicates that up to 90% of people living with BPD experienced childhood trauma, including:

A different 2021 review suggests that environmental sources may account for between 15% to 40% of the chance of developing schizophrenia, but those sources are believed to be more diverse than those that contribute to BPD.

This may include:

  • complications at birth
  • certain infections during pregnancy
  • season of birth
  • social factors, such as migration and living in cities
  • adverse childhood experiences (ACEs), like abuse and neglect
  • drug use, especially cannabis

Physiology

Differences in neurotransmitter levels — especially serotonin and dopamine — may impact the development of both schizophrenia and BPD.

And, it’s not just your brain chemicals. Regions of the brain in charge of emotion regulation and impulse control — including the amygdala and hippocampus — may look and function differently in people with BPD.

Neuroimaging research from 2018 of people with schizophrenia showed significant differences in the size and activity of the frontal and temporal lobes, which play a large role in:

  • memory
  • emotion
  • language functioning

Both BPD and schizophrenia require professional treatment to manage. These conditions can be more difficult to address if you haven’t received an accurate diagnosis.

Working with a doctor or therapist on designing an effective treatment plan can help you manage symptoms.

Treatment plans for both conditions may consist of a combination of:

Finding the best treatment plan for your symptoms can take time. You may have to try multiple strategies before finding what works for you.

Therapy

Psychotherapy is considered a first-line treatment for BPD and is often used to treat schizophrenia in combination with medication.

Specific types of therapy used for BPD include:

Though research on how well transference-focused therapy performs is mixed.

For those with schizophrenia, therapy may focus more heavily on developing skills for managing everyday life.

Types of therapy commonly used include:

Medication

Currently, there are no FDA-approved medications available to specifically treat BPD. But some people with BPD may have overlapping mental health conditions and may be prescribed medications for those conditions, such as:

For people with schizophrenia, antipsychotic medication is commonly prescribed to help manage hallucinations and delusions, including:

  • haloperidol (Haldol)
  • aripiprazole (Abilify)
  • clozapine (Clozaril)
  • quetiapine (Seroquel)

Self-care

Stress can impact both BPD and schizophrenia, and lifestyle changes centered on self-care can be essential for managing symptoms of these conditions.

Some examples of self-care strategies include:

If you or someone you know is experiencing symptoms of BPD and schizophrenia, you’re not alone. It’s possible to manage the symptoms of these conditions with the right treatment plan.

Consider talking with your doctor or therapist as a first step. Being curious and educating yourself on what these two conditions can look like — as well as possible treatment options — can be a helpful place to start your mental health journey.

If you’re ready to get help but don’t know where to begin, you can check out Psych Central’s hub for finding mental health support.

Borderline Schizophrenia: What It Is and More (2024)

FAQs

What does it mean to be borderline schizophrenic? ›

Symptoms of Borderline Schizophrenia

Level of functioning in work, interpersonal connection, or self-care is impaired by the symptoms for a significant portion of time. Change in functioning is significant compared to previous level of functioning. Continuous signs of the disturbance for a six-month period.

Is borderline schizophrenia a real thing? ›

Borderline schizophrenia — or “pseudoneurotic schizophrenia” — is an outdated term once used interchangeably with “borderline psychosis.” Later on, this was split into the current classifications of schizotypal personality disorder and borderline personality disorder (BPD).

How do you deal with schizophrenia voices? ›

Coping with hearing voices
  1. Understand your voices.
  2. Communicate with your voices.
  3. Distract yourself from your voices.
  4. Talk to other people who hear voices.
  5. Look after yourself.
  6. Find spiritual help.

What is the brain like with borderline personality disorder? ›

Researchers have used MRI to study the brains of people with BPD. MRI scans use strong magnetic fields and radio waves to produce a detailed image of the inside of the body. The scans revealed that in many people with BPD, 3 parts of the brain were either smaller than expected or had unusual levels of activity.

How does a person with borderline personality disorder think? ›

A person with BPD is highly sensitive to abandonment and being alone, which brings about intense feelings of anger, fear, suicidal thoughts and self-harm, and very impulsive decisions. When something happens in a relationship that makes them feel abandoned, criticized, or rejected, their symptoms are expressed.

Are schizophrenics narcissistic? ›

Personality disorders such as antisocial, borderline, histrionic, narcissistic, avoidant, dependent and obsessive-compulsive types have been detected in one third to one half of schizophrenia patients (Nielsen, Hewitt & Habke, 1997; Solano & Chavez, 2000).

Which personality disorder is closest to schizophrenia? ›

Schizotypal personality disorder can easily be confused with schizophrenia, a severe mental illness in which people lose contact with reality (psychosis).

Are borderline people delusional? ›

Delusions have a prevalence of 26% in patients with borderline personality disorder. Hallucinations and delusions are frequently intermittent or even persistent. Persistent hallucinations can be severe, causing disruption of life. Careful assessment of psychotic experiences in borderline patients is warranted.

What activities are good for schizophrenics? ›

Sometimes when a person with schizophrenia is unwell they may turn against people they are normally close to. Encourage them to participate in one-to-one activities, for example card games, chess, jigsaw puzzles, walking. Don't leave them alone after a hospital visit.

What not to say to schizoaffective? ›

What not to say to someone with schizophrenia
  • Avoid dismissing them. Never tell your loved one that their symptoms are “not true,” “not real,” “imaginary,” or all in their head.
  • Aim to be nonjudgmental. ...
  • Don't pressure them to talk. ...
  • Avoid arguments about their beliefs. ...
  • Steer clear of accusations.
Jul 30, 2021

What jobs can I do with schizophrenia? ›

Some jobs that may be easier for those with schizophrenia are:
  • freelance writing or graphic design.
  • work-from-home data entry or accounting.
  • work-from-home website building or coding.
  • janitorial, maintenance, or landscaping services.
Jan 27, 2023

Can schizophrenic voices be friendly? ›

There is now evidence that some people who do not have any mental ill health may also hear voices during their life, and their voices are often benign or friendly.

Why do schizophrenics obey the voices? ›

Scientists believe that patients with schizophrenia have a defect in this circuit, so their brain incorrectly identifies a mismatch between their own voice and the voice they hear, making them think the voice belongs to someone else.

Can schizophrenics control the voices in their head? ›

While the voices go away for some, for many, they never completely fade. But it's possible to learn to manage them and take back some control in your day-to-day life.

What kind of trauma causes BPD? ›

Stressful or traumatic life events

Often having felt afraid, upset, unsupported or invalidated. Family difficulties or instability, such as living with a parent or carer who experienced an addiction. Sexual, physical or emotional abuse or neglect. Losing a parent.

What foods should people with borderline personality disorder avoid? ›

Consider cutting out all processed food and sugar for a few weeks and observe your energy level and your emotions. Avoid misusing alcohol or caffeine, as these also can intensify mood instability. BPD sometimes includes symptoms of self-harm or substance abuse.

How do you calm down borderline personality disorder? ›

You could:
  1. Wrap up in a blanket and watch your favourite TV show.
  2. Write all your negative feelings on a piece of paper and tear it up.
  3. Listen to music that you find uplifting or soothing.
  4. Write a comforting letter to the part of yourself that is feeling sad or alone.
  5. Let yourself cry or sleep.
  6. Cuddle a pet or a soft toy.

What is the most painful mental illness to live with? ›

Borderline personality disorder is one of the most painful mental illnesses since individuals struggling with this disorder are constantly trying to cope with volatile and overwhelming emotions.

Are people with borderline personality aware? ›

People with borderline personality disorders are aware of their behaviors and the consequences of them and often act in increasingly erratic ways as a self-fulfilling prophecy to their abandonment fears.

What is the best job for someone with BPD? ›

Many people with BPD feel emotions deeply and find working in a caring role fulfilling. If you are an empathetic person, consider jobs such as teaching, childcare, nursing and animal care.

Are schizophrenics manipulative? ›

In a study by Watson (14), schizophrenics tended to manipulate the impressions that they made on others via certain &!

What kind of people do schizophrenics see? ›

Visual. Someone might see lights, objects, people, or patterns. Often it's loved ones or friends who are no longer alive. They may also have trouble with depth perception and distance.

Is someone with schizophrenia a psychopath? ›

Psychopathy and schizophrenia are both frequently represented in popular culture—in thrillers and on TV shows—and they are both significantly more common among men than women, with the result that they are often confused and conflated. However, psychopathy and schizophrenia are two very different conditions.

Which personality disorder has the strongest relationship to schizophrenia? ›

Cluster A personality disorders and avoidant personality disorder seem most commonly to antedate schizophrenia.

Does a schizophrenic have a split personality? ›

DID and schizophrenia have some overlapping symptoms, but they are separate conditions. While people with either condition may experience delusions, depression, and suicidal thoughts, people with DID experience multiple identities or personalities, while those with schizophrenia do not.

Do schizophrenics know they are schizophrenic? ›

Unfortunately, most people with schizophrenia are unaware that their symptoms are warning signs of a mental disorder. Their lives may be unraveling, yet they may believe that their experiences are normal. Or they may feel that they're blessed or cursed with special insights that others can't see.

What are the strange behaviors of borderline personality disorder? ›

A distorted and unstable self-image or sense of self. Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating.

Are borderlines jealous? ›

Jealousy can prevent people from experiencing intimacy.

Jealousy is a prominent feature for those with Narcissistic Personality Disorder and Borderline Personality Disorder (NPD and BPD).

Is borderline Manipulative? ›

One of the most common ways of characterizing patients diagnosed with borderline personality disorder is that they are manipulative.

What to avoid with schizophrenia? ›

Balance your blood sugar and avoid stimulants

The incidence of blood sugar problems and diabetes is also much higher in those with schizophrenia. Therefore it is strongly advisable to reduce, as much as possible, your intake of sugar, refined carbohydrates, caffeine and stimulant drugs and eat a low glycemic load diet.

How do you calm a schizophrenic mind? ›

10 tips for handling a schizophrenia crisis
  1. Remember that you cannot reason with acute psychosis.
  2. The person may be terrified by their own feelings of loss of control.
  3. Don't express irritation or anger.
  4. Speak quietly and calmly, do not shout or threaten the person.
  5. Don't use sarcasm as a weapon.
Feb 24, 2023

What foods help schizophrenia? ›

The king of leafy greens, spinach is high in folate. (It's called folic acid when it's used in supplements or to fortify foods.) Folate can help ease symptoms of schizophrenia. Along with spinach, you can find it in black-eyed peas, asparagus, and beef liver.

What things make schizophrenia worse? ›

Drug and alcohol use

If you already have schizophrenia, research shows that using recreational drugs may worsen your symptoms. Some studies suggest that people who use high-potency cannabis ('skunk') when in recovery are more likely to have a relapse too.

Do schizophrenics remember their episodes? ›

People with schizophrenia experience difficulties in remembering their past and envisioning their future. However, while alterations of event representation are well documented, little is known about how personal events are located and ordered in time.

What triggers schizoaffective episodes? ›

Researchers don't know exactly what causes schizoaffective disorder. But it's likely to be caused by a combination of factors, such as: Stressful or traumatic life events.
...
Childhood trauma
  • Sexual or physical abuse.
  • Neglect.
  • Traumatic events.
  • Losing someone very close to you, such as a parent or carer.

What is the best living situation for schizophrenia? ›

Supervised Group Housing

This type of housing provides the most support for its residents. Trained staff members are present 24/7 to provide care and assistance with things like medication, daily living skills, meals, paying bills, transportation and treatment management.

Can you get a disability check for schizophrenia? ›

The SSA can assist a person with schizophrenia as the administration considers it a disability. To qualify for disability benefits, a person with schizophrenia will have to meet the SSA criteria and show that their condition is persistent and severe and prevents them from engaging in substantial gainful activity.

What does high functioning schizophrenia look like? ›

Symptoms of high functioning schizophrenia

These symptoms include those of psychosis, such as: hallucinations. delusions. disorganized thoughts and speech.

Do schizophrenics talk funny? ›

They may even stop talking mid-sentence, make up strange words, or use existing words that don't make sense in conversations with others.

What is schizophrenic voice? ›

Some people suffering from severe mental illness, particularly schizophrenia, hear “voices,” known as auditory hallucinations. This symptom, which afflicts more than 80% of patients, is among the most prevalent and distressing symptoms of schizophrenia.

What is it like to talk to a schizophrenic? ›

A person with schizophrenia may not respond in the way we might expect in a 'normal' conversation. Your words may be met with silence or monosyllabic answers. In some cases, the person may say that they are extremely interested in what you want to discuss, but their facial expression and tone may not reflect the same.

How do people with schizophrenia act? ›

The symptoms of schizophrenia are usually classified into: positive symptoms – any change in behaviour or thoughts, such as hallucinations or delusions. negative symptoms – where people appear to withdraw from the world around then, take no interest in everyday social interactions, and often appear emotionless and flat.

Why do schizophrenics mumble? ›

Those suffering from schizophrenia have severely impacted cognitive abilities including impaired speech and decreased motor skills. As a result, patients often project disorganized speech symptoms which when combined with poor task controls that may sound as if someone is mumbling.

Do schizophrenics think people are watching them? ›

Experts no longer consider paranoid schizophrenia a type of schizophrenia, but paranoia can be a symptom of schizophrenia. A person may believe people are watching, harassing, or persecuting them. This can give rise to anxiety and fear.

Why can't schizophrenics make eye contact? ›

People with schizophrenia suffer a wide range of social cognitive deficits, including abnormalities in eye gaze perception. For instance, patients have shown an increased bias to misjudge averted gaze as being directed toward them.

Do all schizophrenics talk to themselves? ›

Some people with schizophrenia appear to talk to themselves as they respond to the voices. People with schizophrenia believe that the hallucinations are real. Disordered thoughts. Thoughts may become jumbled or blocked.

Can someone be mildly schizophrenic? ›

Residual Schizophrenia

This specific type is characterized by when an individual doesn't display positive symptoms of paranoid schizophrenia (hallucinations, delusional thinking), although they still have the negative symptoms or more mild schizophrenia symptoms (no expression of emotions, strange speech).

Is borderline schizophrenia genetic? ›

Borderline Personality Disorder and Genetics

Two genes—DPYD and PKP4—have been identified as increasing a person's risk of developing BPD. 4 However, these genes are linked to schizophrenia and bipolar disorder risk, too.

How do I know if I'm borderline psychotic? ›

Rapid changes in self-identity and self-image that include shifting goals and values, and seeing yourself as bad or as if you don't exist at all. Periods of stress-related paranoia and loss of contact with reality, lasting from a few minutes to a few hours.

What does a mild case of schizophrenia look like? ›

In this early phase of schizophrenia, you may seem eccentric, unmotivated, emotionless, and reclusive to others. You may start to isolate yourself, begin neglecting your appearance, say peculiar things, and show a general indifference to life.

What mimics schizophrenia? ›

A few disorders have some of the same symptoms as schizophrenia (schizophrenia spectrum disorders), including:
  • Schizotypal personality disorder. ...
  • Schizoid personality disorder. ...
  • Delusional disorder. ...
  • Schizoaffective disorder. ...
  • Schizophreniform disorder.

Can you live a normal life with mild schizophrenia? ›

While it was once thought to be a disease that only worsened over time, schizophrenia is now known to be manageable thanks to modern treatment practices. With a dedication to ongoing treatment, often beginning with intensive residential care, most individuals can live normal or almost-normal lives.

What triggers schizophrenia? ›

The exact causes of schizophrenia are unknown. Research suggests a combination of physical, genetic, psychological and environmental factors can make a person more likely to develop the condition. Some people may be prone to schizophrenia, and a stressful or emotional life event might trigger a psychotic episode.

Is schizophrenia caused by trauma? ›

Research and experts suggest trauma, especially severe childhood trauma, can increase the likelihood of someone developing schizophrenia or expressing similar symptoms later in life. Although trauma cancause schizophrenia, traumatic life experiences usually don't lead to trauma-induced psychosis.

What does undiagnosed schizophrenia look like? ›

You could have: Hallucinations: Seeing or hearing things that aren't there. Delusions: Mistaken but firmly held beliefs that are easy to prove wrong, like thinking you have superpowers, are a famous person, or people are out to get you. Disorganized speech: Using words and sentences that don't make sense to others.

Who is attracted to borderline personality? ›

Borderline/dependent: A person with borderline personality disorder (BPD) is well-matched with a person who has a dependent personality disorder (DPD). The BPD has an intense fear of abandonment which is a good match for the DPD who will not leave even a dysfunctional relationship.

What is the most painful mental illness? ›

Borderline personality disorder (BPD) has long been believed to be a disorder that produces the most intense emotional pain and distress in those who have this condition. Studies have shown that borderline patients experience chronic and significant emotional suffering and mental agony.

How can I tell if I'm schizophrenic? ›

Schizophrenia involves a range of problems with thinking (cognition), behavior and emotions. Signs and symptoms may vary, but usually involve delusions, hallucinations or disorganized speech, and reflect an impaired ability to function.

Can you be aware of your own psychosis? ›

People who have psychotic episodes are often totally unaware their behaviour is in any way strange or that their delusions or hallucinations are not real. They may recognise delusional or bizarre behaviour in others, but lack the self-awareness to recognise it in themselves.

What not to say to someone with schizophrenia? ›

What not to say to someone with schizophrenia
  • Avoid dismissing them. Never tell your loved one that their symptoms are “not true,” “not real,” “imaginary,” or all in their head.
  • Aim to be nonjudgmental. ...
  • Don't pressure them to talk. ...
  • Avoid arguments about their beliefs. ...
  • Steer clear of accusations.
Jul 30, 2021

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