When Women Battle ADHD and Borderline Personality Disorder (2024)

fJessie had been impulsive and prone to tantrums since she was in kindergarten. As a teen, she was obsessed with social status and desperate to be liked by the popular girls. When she was included, she took great pleasure in lording her status over everyone. But when she was left out, she took it personally. Sometimes, she tried to buy friends with gifts; other times, she sought to get back at them.

At home, Jessie ran the house. In response to her angry demands, her mother indulged her, but, regardless of the concessions, Jessie kept up the threats. Eventually, the family’s home life revolved around anticipating her needs, and her parents were constantly exhausted from walking on eggshells. Jessie described herself as “super-sensitive and super-anxious,” and entered college an intense young woman who clung to anyone willing to be accessible, validating, and compliant. She felt miserable and alone.

Until recently, Jessie might have been labeled a normal teen. Society still doubts the credibility of women who appear too emotional, too demanding, or too needy. Today, Jessie’s impulsivity and low frustration tolerance might lead a clinician to consider a diagnosis of ADHD — or Borderline Personality Disorder (BPD). ADHD and BPD share many symptoms, which demand a challenging differential diagnosis. Because ADHD was rarely diagnosed in inattentive women until relatively recently, many lived with a misdiagnosis of BPD.

ADHD does often co-occur with BPD, but the combination brings severe impairments that can be debilitating without treatment and support. Here’s what women struggling with both conditions need to know.

BPD: Tough to Understand, Tougher to Treat

“Borderline” is a common personality style, affecting about six percent of the population. It usually develops in adolescence, alone or in combination with other disorders. The “Borderline style” reaches the level of a disorder when patterns of thinking, feeling, and behaving become so rigid that functioning is impaired. It develops as a result of genetic and temperamental vulnerabilities combined with childhood stressors. Considered to be a difficult disorder for family and friends to understand, it is also a difficult disorder for clinicians to treat. And it is the personality disorder most likely to co-occur with ADHD in women.

[Self-Test: Symptoms of Borderline Personality Disorder]

Women with BPD experience chronic instability — in their emotions, behaviors, relationships, and sense of self. They are impulsive in response to rapid mood changes. Their sense of self fluctuates based on their ability to cope with feelings of abandonment. However, their rejection sensitivity contributes to the need to make dramatic shifts in relationships, often sabotaging and then reestablishing connection. Many misinterpret the behaviors of Borderline women to be intentionally manipulative, and they are often stigmatized. Their demands escalate in response to their intolerable fear. Unfortunately, that emotional urgency evokes feelings of guilt or resentment in others. In fact, these women are in intense emotional pain, and feel unable to elicit what they need from others to feel safe.

For women with BPD, rifts with friends or breakups are often triggers for self-harm, suicidal thoughts, and suicide attempts. Self-destructive behaviors, like cutting or burning, can defuse their skyrocketing panic, and become strategies for emotional control. BPD women who are impulsive, emotionally unstable, with histories of trauma have the highest risk of acting on their suicidal ideation, especially if they had been diagnosed with ADHD as children.

Does BPD Camouflage ADHD Symptoms?

There is a lot of overlap between the symptoms of the two disorders. The experience of women with ADHD, BPD, or both is characterized by difficulties in self-regulation; feelings, behavior, relationships, and sense of self are chronically unstable. They are challenged by impulsivity and emotional volatility, especially in managing anger. In both disorders, impulsivity can lead to gambling, financial troubles, eating disorders, substance abuse, and unsafe sex.

Both groups are hypersensitive to sensory changes. With either or both disorders, the battle to self-regulate leads women to feel ashamed, unsupported, and alone, struggling with anxiety, depression, rage, panic, and despair. In some cases, the more dramatic BPD symptoms can camouflage the more classic ADHD symptoms.

[Self-Test: ADHD Symptoms in Women]

There are clear differences between the two diagnoses as well. The core symptoms of ADHD, such as persistent inattention, distractibility, and hyperactivity, are not among the criteria for BPD. Stress-related dissociative symptoms and paranoid thoughts that may occur in BPD are not ADHD symptoms. While women with either disorder may experience despair, women with ADHD are more likely to be responding to the shame and demoralization they feel about the choices they’ve made. Women with BPD are more likely to feel hopeless and frantic in response to perceived losses in relationships.

For untreated women with either or both diagnoses, there is the risk for self-harm and suicidality. However, the risk for these self-destructive behaviors is much higher for women with BPD. The risk of suicide is real, and must be taken seriously.

Does Childhood ADHD Increase the Severity of BPD Symptoms?

ADHD and BPD have a genetic component, although the hereditary aspect of ADHD is stronger. When parents have ADHD, home life is more likely to be inconsistent, unstructured, and emotionally volatile. Intense emotional responses may have been labeled as unacceptable over-reactions because the parents found them hard to tolerate. It seems that a history of childhood ADHD may increase the risk for developing BPD, and will increase the severity of BPD symptoms. In those with histories of early trauma, co-occurrence of the two disorders results in greater impulsivity and emotional dysregulation.

Does Trauma Contribute to BPD?

It is not surprising that childhood neglect and abuse increases the risk for developing a range of disorders as adults. In fact, studies have found that women with ADHD and BPD often have traumatic early histories. It is likely that early childhood trauma can exacerbate ADHD symptoms and contribute to the development of BPD. ADHD histories are more strongly associated with neglect and physical and emotional abuse, while BPD histories are more likely to involve emotional and sexual abuse. At least a quarter of those women with BPD will suffer from Post-Traumatic Stress Disorder (PTSD). There is also a high degree of overlap between PTSD and ADHD behaviors, including inattention, impulsivity, emotional dysregulation, and restlessness. Women with ADHD and BPD have been shown to have the highest levels of neglect in their histories.

The presentations of ADHD and PTSD can be remarkably similar. The state of hyper-arousal that typifies trauma survivors closely mimics the appearance of hyperactivity. Similarly, the dissociative state that can typify other trauma survivors closely mimics inattention. 
Stress-related dissociation is often a response to trauma in Borderline women, but it is usually not seen in ADHD. Since many women with ADHD are predominantly inattentive, differentiating between inattentive symptoms of ADHD and dissociative symptoms of trauma is challenging. Some women diagnosed with ADHD may have BPD, and may be manifesting the symptoms of early chronic trauma.

Does Early Intervention Improve Outcomes?

A recent reconsideration of criteria allows for the diagnosis of BPD in adolescents. This welcome change enables earlier intervention, which improves long-term outcomes. Dialectical behavior therapy (DBT) has been the gold standard for teaching the skills needed for managing emotional dysregulation. It is a structured program that acknowledges the needs for acceptance and change, and offers skills to handle both. Learning these adaptive skills as early as possible is better than having to unlearn unhealthy behaviors later.

Stimulants are helpful for managing the symptoms of emotional dysregulation connected to ADHD. However, these medications may over-stimulate traumatized brains, already on high alert, and exacerbate symptoms. Unfortunately, no medications have been consistently helpful in treating BPD symptoms. Medication options may be further limited by the likelihood of substance dependence or abuse. In addition, the goals of psychotherapy differ significantly. The focus for those with ADHD is inhibiting impulsive responses, while those with BPD and a trauma history work toward safely revealing their secrets.

The importance of correct diagnoses is underscored by these treatment differences, and highlights the necessity for trauma-informed evaluations, which are not yet part of ADHD evaluations. Without treating both disorders, the likelihood of therapeutic success is minimized.

Take-Home Messages for Women

As emotional dysregulation becomes more widely accepted as a core symptom of adult ADHD, its overlap with BPD becomes of greater importance. For women with ADHD, emotional hyper-reactivity is a prime symptom that undermines their sense of control. As an ADHD comorbidity, BPD heightens the chaotic experience of understanding the self and managing relationships. Managing the symptoms of ADHD and BPD gets more difficult as time goes on.

These are ample reasons to consider women with ADHD, BPD, and a history of trauma to be at the greatest risk for negative outcomes. It is critical that they be correctly identified, supported, and treated by clinicians who are experienced with both complex conditions.

[Read This Next: ADHD Comorbidity — An Overview of Dual Diagnoses]

Ellen Littman, Ph.D., is a member of ADDitude’s ADHD Medical Review Panel.

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When Women Battle ADHD and Borderline Personality Disorder (2024)

FAQs

How do you deal with ADHD and borderline personality disorder? ›

Psychotherapy, or talk therapy, can help with both BPD and ADHD, either alone or along with medications. Cognitive behavioral therapy, or CBT, is a type of talk therapy used with both conditions. Dialectical behavioral therapy, or DBT, may also be used with borderline personality disorder and ADHD.

Can you have ADHD and borderline personality disorder? ›

Borderline personality disorder (BPD) and attention deficit hyperactivity disorder (ADHD) are both considered neurocognitive conditions. You can have BPD and ADHD at the same time, and both conditions share impulsive behavior as a symptom. Some research suggests that these conditions share certain risk factors as well.

What are good coping mechanisms for ADHD? ›

10 Coping Mechanisms for Thriving With Adult ADHD
  • Make time for exercise every day. ...
  • Accept yourself and your limitations. ...
  • Find people that accept you. ...
  • Look for time in your day to unwind. ...
  • Create a system for prioritizing your day. ...
  • Use your own internal clock to your benefit. ...
  • Create deadlines for projects.
19 Aug 2018

Can ADHD feel like BPD? ›

ADHD can present with symptoms such as irritability, mood lability, low frustration tolerance and low self-esteem, making it easily confused with mood disorders and personality disorders.

Does ADHD make BPD worse? ›

It seems that a history of childhood ADHD may increase the risk for developing BPD, and will increase the severity of BPD symptoms. In those with histories of early trauma, co-occurrence of the two disorders results in greater impulsivity and emotional dysregulation.

Does ADHD medication make BPD worse? ›

While misusing Adderall can't cause BPD, it can make the symptoms of the condition more severe. Taking Adderall with borderline personality disorder can intensify irritability and agitation, even to the point of triggering episodes of rage.

What is the best mood stabilizer for borderline personality disorder? ›

Common anticonvulsants and mood stabilizers for BPD include:
  • Depakote (valproate)
  • Lamictal (lamotrigine)
  • Lithobid (lithium)
  • Tegretol or Carbatrol (carbamazepine)
10 Nov 2022

What medication is usually prescribed for borderline personality disorder? ›

Antipsychotics are widely used in BPD, as they are believed to be effective in improving impulsivity, aggression, anxiety and psychotic symptoms [Nose et al. 2006; American Psychiatric Association, 2001].

What personality disorder comes with ADHD? ›

Borderline personality disorder, also known as BPD, and attention deficit hyperactivity disorder, also known as ADHD, are two mental health conditions that can lead to difficulties in daily functioning. They share overlapping symptoms, however, they are very different.

How do I cheer up my ADHD? ›

Here are nine tips for managing mood swings right away:
  1. Schedule time to vent. ...
  2. Work on shifting your focus. ...
  3. Prepare for the days when you get the blues. ...
  4. Take control of your “hyperfocus” ...
  5. Exercise often. ...
  6. Put humor first. ...
  7. Consider a diet change. ...
  8. Set a solid sleep schedule.

How can I calm my ADHD energy? ›

Read on to find some great strategies for relaxing your mind, soul, and body.
  1. Practice Deep Breathing. The first of our ADHD relaxation techniques involves deep breathing. ...
  2. Try Journaling. ...
  3. Learn Meditation. ...
  4. Maintain Boundaries. ...
  5. Take an Exercise Break. ...
  6. Use ADHD Relaxation Techniques as You Go About Your Regular Day.

How do you hold a relationship with ADHD? ›

More ADHD Relationship Tools:
  1. Go on a date every week.
  2. Treat each other with respect. Learn to love each other's quirks.
  3. Don't worry about who is right. The goal is to move forward — not to stay stuck in an argument. It is more important to have a mutually satisfying relationship than it is to be right all of the time.
21 Jan 2021

What is BPD usually misdiagnosed as? ›

In particular, there is evidence that BPD is commonly misdiagnosed as Bipolar Disorder, Type 2. One study showed that 40% of people who met criteria for BPD but not for bipolar disorder were nevertheless misdiagnosed with Bipolar Type 2.

How do I know if it's ADHD or BPD? ›

BPD individuals have more problems using context cues for inhibiting responses and their impulsivity is stress-dependent, whereas ADHD patients have more motor impulsivity and therefore difficulties interrupting ongoing responses.

Should I keep helping my BPD daughter? ›

However, contrary to popular mythology and outdated thinking, BPD does not have to be an immutable state. With the right approach and treatment, you can nurture a healthier relationship with your child while giving them invaluable support as they learn to navigate their illness and find true recovery.

How common is ADHD and BPD together? ›

At least 14% of those diagnosed with ADHD in childhood later receive a diagnosis of BPD while between 18% and 34% of the adults with ADHD are estimated to have comorbid BPD.

Does BPD count as a disability? ›

The Social Security Administration placed borderline personality disorder as one of the mental health disorders on its disabilities list. However, you'll have to meet specific criteria for an official disability finding. For example, you must prove that you have the symptoms of the condition.

Why do stimulants help BPD? ›

This boost helps people prescribed amphetamines by increasing focus and alertness. However, since the dysregulation of neurotransmitters is associated with borderline personality disorder symptoms, amphetamines may affect BPD symptoms by increasing the levels of dopamine and serotonin.

What is the most effective treatment for borderline personality disorder? ›

Psychotherapy. Psychotherapy — also called talk therapy — is a fundamental treatment approach for borderline personality disorder.

Can you have a healthy relationship with someone with BPD? ›

People with BPD are good and compassionate, and they can have healthy relationships. It takes work, and lifelong challenges will remain. Therapists and doctors can work with you or your partner to develop a treatment plan.

What is the root cause of borderline personality disorder? ›

Environmental factors

being a victim of emotional, physical or sexual abuse. being exposed to long-term fear or distress as a child. being neglected by 1 or both parents. growing up with another family member who had a serious mental health condition, such as bipolar disorder or a drink or drug misuse problem.

How do you soothe BPD rage? ›

Here are some tips on healthy ways to manage your anger with BPD.
  1. Count to 10. Hero Images / Getty Images. ...
  2. Notice Your Anger Earlier. Hero Images / Getty Images. ...
  3. Take a Break. Betsie Van Der Meer / Getty Images. ...
  4. Distract Yourself. ...
  5. Take Deep Breaths. ...
  6. Ground Yourself. ...
  7. Listen to Calming Music. ...
  8. Practice Letting Go.
17 Mar 2021

How do you calm down a 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 first line treatment for borderline personality disorder? ›

First-line treatment for BPD is psychotherapy [5-7]. Psychotropic medications are used as adjuncts to psychotherapy, targeting specific BPD symptom clusters. Adjunctive use of symptom targeted medications has been found to be useful [8].

Can you live with BPD without medication? ›

Overcoming BPD without medication is possible, but you should always follow the guidance and treatment plan set forth by your doctor or health care provider. Medication isn't necessarily the primary treatment for BPD in most cases. It's typically only used to treat specific symptoms such as depression or mood swings.

Is borderline personality disorder a psychotic disorder? ›

CONCLUSION. Psychotic symptoms, especially hallucinations, are highly prevalent in patients with BPD. Recent studies suggest that hallucinations in BPD are similar to those in patients with psychotic disorders in terms of phenomenology, but their emotional impact seems to be even stronger in patients with BPD.

Is lack of empathy a symptom of ADHD? ›

Children with ADHD possess many notable characteristics. They tend to act impulsively, get bored easily, and become quickly distracted. One of the side effects of the combination of many of these symptoms can result in a lack of empathy.

Is ADHD a mental or nervous disorder? ›

Attention Deficit Hyperactivity Disorder (ADHD) is a neurological disorder that affects a person's ability to control their behavior and pay attention to tasks.

Is borderline personality disorder caused by trauma? ›

Researchers think that BPD is caused by a combination of factors, including: Stressful or traumatic life events.

What do ADHD mood swings look like? ›

Symptoms of Mood Swings in ADHD

Switching from excited one moment to sad, angry, or anxious the next. Fluctuating between having trouble paying attention and hyperfocusing on an activity. Having bursts of energy and fatigue through the day. Feeling emotions intensely and having difficulty regulating them.

Are ADHD people moody? ›

People with ADHD also tend to feel heightened emotions like anger, frustration, or disappointment. Although moodiness isn't unique to ADHD, poor self-control and impulsivity can cause mood swings, which are common symptoms of ADHD.

Does caffeine help ADHD? ›

The effects of caffeine consumption on ADHD remain largely anecdotal. The stimulant calms some people, while increasing anxiety in others. However, many parents and adults with ADHD, (and some studies) report light to moderate caffeine use as a way to help boost focus and concentration.

How to help a girl with ADHD? ›

Meeting the Needs of Girls with ADHD
  1. Create a structured home environment with predictable routines.
  2. Encourage her to use private downtime to regroup.
  3. Establish a separate, quiet, uncluttered homework area.
  4. Maintain a bedtime routine that helps her wind down gradually.
18 Apr 2022

What toys help with ADHD? ›

  • Fidget Spinners. Fidget spinners are small toys that come in a variety of hues and silhouettes. ...
  • Rubik's Cube. With its bright colors and perfectly hand-sized design, the classic Rubik's Cube is an excellent toy for ADHD. ...
  • Tangle Toys. ...
  • Shape-Shifting Boxes. ...
  • Stress Ball. ...
  • Magnet Balls. ...
  • Putty or Play Dough. ...
  • Liquid Motion Sandscape.
4 Jul 2022

What is ADHD burnout? ›

ADHD burnout is a feeling of exhaustion largely brought on by stress, made more complicated by ADHD symptoms. People with ADHD are more likely to experience burnout. Common signs of ADHD burnout include: irritability.

How to love a woman with ADHD? ›

TOP TEN TIPS FOR LOVING ADHD WOMEN
  1. Give positive feedback. ...
  2. Understand her need for freedom. ...
  3. “That's an interesting perspective” – JUST SAY IT. ...
  4. When offering feedback that is corrective, be gentle and reinforce the positive. ...
  5. Express emotions. ...
  6. Show vulnerability. ...
  7. Understand Time Blindness & DON'T TAKE IT PERSONALLY.

How does a person with ADHD love? ›

Intense emotions and hyperfocus

Kids with ADHD often feel emotions more deeply than other kids do. When teens with ADHD fall in love, the feelings of joy and excitement can be even more intense for them. Teens might feel a deep sense of intimacy and acceptance, perhaps for the first time.

Can people with ADHD have happy relationships? ›

Having a partner with ADHD can make them an exciting and exuberant person to be with, however their ADHD might also cause some problems in a long term relationship and/or marriage. We hope that this page will serve as a resource to help gain awareness of some of the issues adult ADHD can entail.

What illnesses overlap with BPD? ›

The symptoms of BPD are very broad, and some can be similar to or overlap with other mental health problems, such as:
  • Bipolar disorder.
  • Complex post-traumatic stress disorder (C-PTSD)
  • Depression.
  • Anxiety.
  • Psychosis.
  • Antisocial personality disorder (ASPD)

Why is it so hard to treat borderline personality disorder? ›

Borderline personality disorder often occurs with other mental illnesses, such as post-traumatic stress disorder (PTSD). These co-occurring disorders can make it harder to diagnose and treat borderline personality disorder, especially if symptoms of other illnesses overlap with symptoms of the disorder.

What other disorders overlap with BPD? ›

BPD typically coexists with depression, anxiety, and substance abuse. Symptoms of these conditions may lead the clinician to miss the diagnosis of personality disorder entirely.

Can BPD be mixed up with ADHD? ›

Yes, it is possible to have BPD and ADHD simultaneously. However, the prevalence of ADHD is around 5%, while for BPD, it is around 1–6%. Experts estimate that around 14% of individuals with an ADHD diagnosis in childhood later receive a diagnosis of BPD.

Does caffeine affect BPD? ›

Avoid misusing alcohol or caffeine, as these also can intensify mood instability. BPD sometimes includes symptoms of self-harm or substance abuse.

What are the signs of ADHD in female adults? ›

Adult ADHD symptoms may include:
  • Impulsiveness.
  • Disorganization and problems prioritizing.
  • Poor time management skills.
  • Problems focusing on a task.
  • Trouble multitasking.
  • Excessive activity or restlessness.
  • Poor planning.
  • Low frustration tolerance.
22 Jun 2019

Do borderlines get worse with age? ›

Borderline personality disorder usually begins by early adulthood. The condition seems to be worse in young adulthood and may gradually get better with age. If you have borderline personality disorder, don't get discouraged.

How do I live with my daughter with borderline personality disorder? ›

How Can I help my Daughter with Borderline Personality Disorder?
  1. Learn as much as you can about BPD and DBT. ...
  2. Take Care of Yourself. ...
  3. Look Past the Borderline Personality Disorder Label. ...
  4. Focus on Validation & Communication. ...
  5. Learn to show love while holding boundaries. ...
  6. Get professional help.
16 Jun 2016

Can borderlines be good parents? ›

People with borderline personality disorder can be very effective and nurturing parents, but because the symptoms of BPD can be very intense, for many people this does take some work.

Can you have ADHD and a personality disorder? ›

Consistent with this, nearly 90% of a sample of adults with personality disorders reported clinically significant ADHD symptoms in childhood (23). Taken together, these results suggest an association between childhood ADHD and later personality disorder.

How do you deal with an angry person with ADHD? ›

If you're an adult dealing with ADHD and anger, you can:
  1. Notice your triggers and consider new ways to respond to them.
  2. Give yourself permission to walk away if you feel emotions rising.
  3. Work with a therapist to build your self-regulating skills.
  4. Get plenty of rest and exercise.
30 Mar 2021

How do you respond to borderline rage? ›

How to Help
  1. Be patient.
  2. Be realistic.
  3. Try to separate facts from feelings.
  4. Validate feelings first.
  5. Listen actively and be sympathetic.
  6. Seek to distract when emotions rise.
  7. Do not allow yourself to be the product of the intense anger; attempt to diffuse it but sometimes you may have to walk away.
27 Jun 2014

What pills do you take for BPD? ›

Antipsychotics are widely used in BPD, as they are believed to be effective in improving impulsivity, aggression, anxiety and psychotic symptoms [Nose et al. 2006; American Psychiatric Association, 2001].

What does borderline rage look like? ›

Relationships and BPD Rage

Anger that is intense, uncontrolled or inappropriate can be a devastating symptom for someone who has BPD. They may be driven by a desire to be connected to others, yet loss of emotional control frequently drives others away. In some cases, the level of rage experienced can lead to violence.

What personality disorders are common with ADHD? ›

Interestingly, ADHD is often associated with several personality disorders; namely the Cluster B disorders including Antisocial, Narcissistic, Histrionic, and Borderline Personality Disorders. As the name implies, people with ADHD have a difficult time focusing their attention and staying on task.

What is Ring of Fire ADHD? ›

Ring of Fire Attention Deficit Disorder

Ring of Fire ADD gets its name from the familiar “red ring” that shows up in brain scans of individuals with this attention disorder. Essentially, a person who has this kind of attention deficit disorder has several overactive areas throughout their brain.

What does ADHD anger look like? ›

Anger is not on the official list of ADHD symptoms . However, many adults with ADHD struggle with anger, especially impulsive, angry outbursts . Triggers can include frustration, impatience, and even low self-esteem. A number of prevention tips may help adults with ADHD manage anger as a symptom.

Do people with ADHD get annoyed easily? ›

Problems with emotional dysregulation, in particular with anger reactivity, are very common in people with ADHD. You are not alone in struggling in this area. Anger may indicate an associated mood problem but often is just part of the ADHD. Either way, changes in traditional ADHD treatment can be very helpful.

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