By Madison Avenue TMS & Psychiatry - Published on November 24, 2025

Last updated on November 24, 2025

Many people who suffer from borderline personality disorder, or BPD, also struggle with major depressive disorder. In fact, it’s uncommon not to see the two disorders co-existing.

That coexistence makes treatment more complicated. 

What Is Borderline Personality Disorder

Borderline personality disorder involves intense and rapidly shifting emotions, impulsive behavior and difficulty managing anger and relationships. It is often associated with acute emotional sensitivity, with small things eliciting big reactions and difficulty calming down afterward.

Because it’s characterized by a fear of abandonment or being left alone, people with BPD also exhibit a pattern of volatility in interpersonal relationships. They may swing from believing someone is perfect one moment to thinking they don’t care the next, and they often push others away through impulsivity and self-injury.

Triggers can include criticism, rejection or prolonged stress.

Other symptoms of BPD include: 

• Brief episodes of stress-related paranoia and disconnection with reality
• Self-destructive, impulsive behavior, such as gambling, drug use, spending sprees or engaging in unsafe sex
• Bouts of intense and inappropriate anger, including loss of temper, physically fighting or self-harm
• Chronic feelings of emptiness

Borderline personality disorder usually begins in late adolescence or early adulthood, when it is often most severe. It also frequently occurs with other mental health disorders such as depression, anxiety or bipolar disorder, which makes accurately diagnosing it challenging.

Similarities With Major Depressive Disorders

Many of the symptoms of BPD are the same as those of major depressive disorder, including: 

• Feeling mentally withdrawn or having a lack of energy or excitement
• Feeling a sense of emptiness
• Loss of interest in things you once enjoyed
• Disrupted sleep patterns
• A sense of worthlessness
• Difficulty concentrating
• Intense guilt or shame

Borderline personality disorder and depression are often confused with one another. Yet experts have noted that depression presents differently in patients with BPD, and treatment is more challenging for those who suffer from both disorders. 

Evidence suggests that when patients with these comorbidities are treated specifically for BPD, their depressive symptoms improve.

How is Borderline Personality Disorder Treated?

Unfortunately, there are no drugs approved by the FDA specifically to treat BPD. But several drugs have been found to help alleviate symptoms, including many used to treat major depressive disorder, and often alongside cognitive behavioral therapy or dialectical behavior therapy.

There is also hope in transcranial magnetic stimulation (TMS), which uses short magnetic pulses from a head-mounted coil to activate neurons in areas of the brain associated with mood disorders. Studies have shown that TMS is effective at reducing symptoms of BPD — particularly at stabilizing patients’ emotional and impulsive behaviors.

If you struggle with BPD, it’s important to seek help as early as possible — and TMS may be a way to provide relief, especially if traditional treatments have proven insufficient.

To make an appointment with a licensed healthcare professional at Madison Avenue TMS & Psychiatry, contact us online or call (212) 731-2033.

Madison Avenue TMS & Psychiatry