QUESTION:

Dear Dr. Heller,

Can a diagnosed BPD grow out of BPD? Is there a reversal process due to age? At 34, can she be non-BPD from the process of aging alone?

DR. HELLER'S ANSWER:

The answer really depends on what the question means.

If it means that the person no longer fits 5/9 criteria on a consistent basis the answer would be yes.

If it means that the person learns to change his/her perception of stress to reduce the frequency of crashing, yes.

If it means that taking medication for a while combined with brain retraining can cause the unstable symptoms (unprovoked mood swings, chronic anger, emptiness and boredom) go away, then yes that can happen occasionally.

The neurological instability doesn't go away, however. Stress induced dysphoria (anxiety, rage, depression and despair) will continue to be a problem throughout life. Learning to alter the perception of stress combined with confidence that as needed medications can work can profoundly reduce the frequency of crashing. For many the unprovoked mood swings, chronic anger, emptiness and boredom will need long-term medication (Prozac is the best).

Aging may change how symptoms present (such as refusal to take medications, get tests performed or even eating), but doesn't make the BPD go away. Symptoms are usually more frightening and severe in adolescents compared with older individuals, but the underlying problem rarely goes away on it's own.

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