BPD And OCD: What You Need To Know

Obsessive-compulsive disorder (OCD) affects 2.5 million adults¹ in the United States. This mental health disorder can take many forms and interfere with your daily activities. If left untreated, symptoms of OCD can worsen and become debilitating.

For people who have OCD, the risk of facing a comorbid personality disorder is 52%. One such personality disorder is BPD (Borderline Personality Disorder). Around 1.4% of the adult population in the U.S.² lives with BPD. Nearly 75% of them are women.

Let's take a closer look at BPD and OCD.

What is BPD?

BPD is a personality disorder that causes a person to experience intense emotions and impacts the way they feel about themselves.

Those diagnosed with BPD typically feel unstable and insecure. They also have trouble managing emotions. This affects their everyday activities and social function.

The common symptoms of BPD are:

• Frequent mood swings

• Fear of abandonment

• Impulsiveness

• Uncontrollable anger

• Feeling of emptiness

• Dissociative feelings (feeling disconnected from thoughts or "out of body" experience)

• Paranoid thoughts

People who have BPD often engage in self-harming behavior. They also tend to have unstable relationships.

What is OCD? 

OCD is a mental health disorder that causes a cycle of obsessions and compulsions.

Obsessions

People with OCD have persistent thoughts and feelings, including fear of disaster, worries about harming themselves or others, anxiety about germs and bacteria, and more. These obsessive thoughts interfere with their way of life and can cause compulsive behavior.

Compulsions

To relieve fear, anxiety, distress, and worry caused by obsessions, people with OCD may engage in compulsive behavior. This behavior usually involves rituals.

For example, if a person worries about robbers, they might constantly check if the door is locked. Rituals take a significant amount of time and hinder the person’s ability to participate in regular activities. 

OCD affects people of all ages. Usually, it begins before the age of 25. The condition is more common in males among children but has a higher prevalence among females in adolescence and adulthood.  

BPD and OCD: similarities 

While symptoms of these two conditions are different, both impact a person's quality of life. If not treated, OCD and BPD can worsen with time and prevent the person from participating in regular activities, such as studying, working, and socializing.

The causes of these disorders are yet to be discovered. However, scientists believe risk factors for developing them may be a combination of:

• Family history – people who have close family (siblings, parents) with BPD and/or OCD are more likely to develop these disorders than people without such a family history.

• Brain structure – some research shows that people who have one or both of these disorders may have structural and functional changes in their brains.

• Environment – people who have experienced traumatic life events (e.g., childhood trauma, abuse, relationship conflicts) could be more likely to develop these conditions.

The treatments for OCD and BPD are also similar. Once your doctor confirms the diagnosis, they may suggest:

• Selective Serotonin Reuptake Inhibitors (SSRI) – SSRIs can treat impulsivity and aggression in people with BPD as well as reduce symptoms of OCD

• Cognitive Behavioral Therapy (CBT) – People with OCD can significantly benefit from a type of CBT called Exposure and Response Prevention (ERP); a type of CBT called Dialectical Behavior Therapy (DBT) may be beneficial for BPD

Around 70% of people with OCD can experience significant relief from medication, CBT, or a combination of both. Meanwhile, with treatment, around 93%³ of those with BPD experience remission that lasts at least two years.

BPD and OCD: the relationship 

While both conditions can occur on their own, they can also coexist. According to research studies,⁴ the prevalence of BPD among people who live with OCD is around 5%. If a person has both OCD and BPD, they are also likely to develop mood, anxiety, and eating disorders.

When a person with OCD develops BPD, they may show higher rates of certain obsessions (sexual, religious, and obsessional doubts) and compulsions (hoarding, control, arrangement). This may require more frequent hospitalization and complex pharmacological treatment.

If you have both of these conditions, your doctor can adjust the course of treatment to manage the combination. The key to keeping symptoms under control is timely diagnosis. If you think you may have BPD or OCD, contact your doctor.

Frequently Asked Questions (FAQ)

Can you have OCD and BPD together?

Yes, BPD is possible comorbidity of OCD. The treatment for these two conditions is similar. With timely diagnosis and proper treatment, the chances of improving your quality of life are high.

What personality disorders are comorbid with OCD?

Common comorbid personality disorders with OCD are BPD (Borderline Personality Disorder), DPD (Dependent Personality Disorder), APD (Avoidant Personality Disorder), OCPD (Obsessive Compulsive Personality Disorder), and SPD (Schizotypal Personality Disorder).

Is OCD a mood or personality disorder?

OCD is a mental health disorder. It can have comorbid personality disorders.

What is the most misdiagnosed mental illness?

Borderline personality disorder (BPD) is one of the most commonly misdiagnosed mental health conditions. This includes depression, bipolar disorder, ADHD (Attention Deficit Hyperactivity Disorder), and anxiety disorders. The stigma associated with mental illness makes it hard to diagnose since people may try to suppress symptoms or avoid seeking medical attention.

Does BPD make you obsessive?

Since BPD causes intense emotions that are hard to deal with, people with this condition often obsess about how they feel.

The lowdown 

OCD and BPD are mental health conditions. While they may occur independently, BPD can be comorbid with OCD. The course of treatment for BPD and OCD is similar. The chances of reducing symptoms and leading a normal way of life for people with such conditions are high.

If you have symptoms of OCD or BPD, contact your doctor. They can help diagnose the condition and implement an effective course of treatment.