How Does Borderline Personality Disorder Impact Sex?

Personality disorders are mental health conditions that involve pathologically rigid behaviors and impairments in cognitive functioning. Left untreated, they can create chaos in a person's public and personal life.

There are three categories of personality disorders: cluster A, cluster B and cluster C. Borderline personality disorder (BPD) falls under cluster B, whose hallmark symptoms include unstable, eccentric and overly emotional patterns of behavior and thinking. For people with BPD, these impulsive behaviors are often risky, including unsafe promiscuity, one of the most common symptomatic manifestations.

The effects of BPD on sexuality

Experiencing borderline personality disorder is like living on a psychological roller coaster. Relationships, emotions, self-perception and even professional lives are unpredictable, even though this condition often stems from an aversion to instability. Risk factors include genetic predisposition, neurological abnormalities and prior trauma, particularly during childhood. Some studies report up to 70 percent of people with BPD have experienced some form of childhood trauma.

Borderline personality disorder disproportionately affects women, and symptoms usually reach a crescendo between late adolescence and early adulthood. The most notable symptoms include:

• Frequent, intense mood swings that can last from hours to days.
• Unstable sense of self, often with feelings of dissociation.
• Unhealthy, intense and fleeting relationships.
• Risky behaviors, such as drug use, professional misconduct, unsafe sex practices and poor financial management.
• Marked fear of being alone or abandoned.
• Increased risk for self-harm and/or suicide.

When combined, these factors equate to a wildly unstable life, which only exacerbates the condition. Though there is no cure for BPD, management is possible through ongoing psychotherapy and medication. Extreme cases may require hospitalization.

BPD and promiscuity

Promiscuity is not inherently a problem. There is a safe, healthy way to be engaged with multiple sexual partners, whether it be via polyamory or several separate relations. However, those with BPD show a disregard for these practices, which is congruent with the lack of forethought behind their other risk-taking behaviors.

Sex for someone with borderline personality disorder is is approached with a blasé attitude with little to no concern for lasting consequences. They may neglect contraceptives or protection, knowingly engage in sexual acts with someone who has an STD/STI and perform potentially dangerous activities or those that can be penalized, such as public indecency.

This indifference can be attributed to several of the aforementioned symptoms, particularly impulsivity, disrupted sense of self and the lack of ability to foster healthy relationships. Emotional irregularity caused by neurological malfunctions facilitates impromptu sexual behavior. Low self-esteem and dissociation mean the person has no standards for partners or concern for themselves. Insecure attachment styles that develop during childhood prevent the individual from forming meaningful connections through physical affairs. This leads to a shaky sexual and interpersonal life.

For example, someone with BPD may engage in a series of superficial, yet emotionally and physically charged, relationships. In these instances, they can vary from partner idealization and hypersexuality to abrupt dismissal. The termination is usually due to their own emotional instability and a preemptive strike against being abandoned rather than a rational cause—resulting in a lot of burned bridges.

In lieu of psychological recuperation, individuals with borderline personality disorder would customarily seek out a new partner to abate their feelings of loneliness, which only perpetuates the cycle of toxic interpersonal relationships. These in-between partner stages can be particularly dangerous as the person experiences a sense of desperation to regain stability, leading to acute risky behaviors such as unsafe sex. They are also at a higher risk of experiencing sexual assault.

Managing your BPD sex drive

With continued efforts, people affected by BPD can achieve management of their symptoms to improve their mental health and increase their overall quality of life. A combination of medication, such as a mood stabilizer or antipsychotic, and consistent psychotherapy (namely dialectical behavioral therapy) has shown the most promising results. In some cases, an emergency inpatient hospitalization is necessary, such as if they are showing signs of harming themselves or others.

If someone you know has borderline personality disorder and engages in dangerous promiscuity, encourage them to get regular STD/STI screenings and to get help from a mental health professional or, if needed, the National Suicide Prevention Lifeline.