Piirihäire

Piirihäire, also known as borderline personality disorder (BPD) in English, is a mental health condition characterized by pervasive instability in mood, self-image, and interpersonal relationships.

People with piirihäire may experience intense and rapidly changing emotions, episodes of anger, depression or anxiety, fear of abandonment, and difficulties maintaining stable relationships. They may engage in impulsive behaviors such as risky spending, reckless driving, substance use, or self-harm. Chronic feelings of emptiness and periods of dissociation or paranoia can also occur, especially during stress.

The causes of piirihäire are thought to involve a combination of genetic vulnerability, differences in brain regions related to emotion regulation, and environmental factors such as childhood trauma or invalidating caregiving. These interactions can lead to heightened emotional reactivity and difficulties with self-regulation and coping.

Diagnosis is typically based on criteria outlined in major Classification Systems (such as the DSM-5 or ICD-11) and requires a pattern of symptoms that is persistent and causes significant distress or impairment. Clinicians assess the range and duration of symptoms and consider differential diagnoses, including mood disorders and other personality disorders, as well as any comorbid conditions.

Treatment focuses on psychotherapy as the primary modality. Evidence-based approaches include dialectical behavior therapy (DBT), mentalization-based therapy (MBT), and other forms of psychotherapy such as schema-focused therapy. Medications may be used to treat co-occurring conditions (for example depressive or anxiety symptoms), but are not a first-line treatment for piirihäire itself. Supportive care and ongoing treatment are important for improving functioning and quality of life.

Prognosis varies; with consistent, evidence-based treatment, many individuals experience reduced symptom severity and better functioning over time, though the course can be chronic and fluctuating.