Emotionally Unstable Personality Disorder: Living With EUPD

Emotionally Unstable Personality Disorder (EUPD) is a serious and often misunderstood mental health condition that affects many people across the globe. While experiences vary, EUPD can generally impact your emotional well-being, relationships, and daily functioning.

The complexity of this condition means that many people live with it for years before receiving a diagnosis or accessing the right kind of support. As more people learn about EUPD, it becomes more important to offer compassionate and understanding care that meets their needs. 

In this blog post, read on as our experts from the PROMIS Clinic share with you what EUPD is, what signs you need to watch out for, some risk factors, and the treatment options to achieve long-term recovery. 

What is Emotionally Unstable Personality Disorder (EUPD)?

EUPD, also known as Borderline Personality Disorder (BPD), is a psychological disorder characterised by problems in emotion regulation, self-image, and interpersonal functioning. 

If you have EUPD, you may experience difficulties in managing overwhelming emotions, which can affect your relationships and daily life. Contrary to the beliefs of many, this condition isn’t simply a matter of being overly emotional or reactive, it reflects underlying psychological patterns that may be shaped by your adverse childhood experiences or a long-standing emotional distress. It’s a complex condition that requires careful assessment and understanding.

Prevalence of EUPD

Data shows that an estimated 1% of the general population in the United Kingdom (UK) is struggling with EUPD, a figure consistent with global estimates that range between 0.5% and 1.4% worldwide. However, the prevalence is much higher in clinical settings. Studies show that around 12% of psychiatric outpatients and 22% of inpatients globally meet the diagnostic criteria for EUPD. 

In the UK, similar trends are observed, with EUPD accounting for a significant proportion of people who are receiving mental health care. In addition, it’s also more frequently diagnosed among women, which is a pattern that appears across many countries. 

Signs and Symptoms of EUPD

Understanding the signs and symptoms can help you make sense of what you’re going through and can improve overall treatment outcomes. Here are some of the common symptoms you need to watch out for:

Emotional Instability

If you have EUPD, your emotions can shift quickly and feel overwhelmingly intense. For example, you might go from feeling okay to deeply sad, angry, or anxious within a short period of time, even without a clear reason. These emotional surges can be difficult to control, and they don’t always match the situation at hand. It’s important to note that this emotional instability is more than a change in mood; it’s an exhausting cycle that can interfere with your day-to-day functioning. 

Fear of Abandonment

You often carry an ongoing fear of being abandoned, even though there’s no actual threat that exists. For instance, small changes in someone’s routine, like a partner being late or your friend cancelling plans, can trigger your intense anxiety. This fear can lead to desperate efforts to avoid being alone, like clinging to others, withdrawing suddenly, or reacting strongly to perceived rejection.

Unstable Relationship

Your relationships may also feel intense, unpredictable, and fragile. You might see a person as perfect one day and feel disappointed by them the next day. This all-or-nothing way of seeing others can cause a lot of tension and misunderstanding in your relationships. Another example is that you might want to be close but also feel scared of getting hurt. This can lead to arguments or sudden breakups even when you don’t really want that distance.

Impulsive Behaviors

Impulsivity is very common among EUPD, and it can take many forms. For example, you may spend money recklessly, use substances, binge eat, or engage in risky sex. These behaviours usually come from your need to escape emotional distress or feel something when numbness sets in. While the relief may be temporary, the consequences can bring more distress and reinforce a cycle that’s difficult to break without support.

Distorted Self-Image

If you have EUPD, you may also experience a shifting of your sense of self, which can be disorienting. You might frequently change how you view yourself, unsure of who you are, what you value, or what you want from life. This distorted self-image reflects the emotional turbulence within, where your identity feels unstable or even non-existent at times. 

Chronic Feelings of Emptiness

Chronic emptiness isn’t the same as boredom. It’s a persistent feeling of being disconnected from yourself or the world. Some people may describe it as a hollow or aching void that nothing seems to fill. This internal feeling can be difficult to explain and can lead to unhealthy coping strategies.

Intense Anger

Chronic emptiness isn’t the same as boredom. It’s a persistent feeling of being disconnected from yourself or the world. Some people may describe it as a hollow or aching void that nothing seems to fill. This internal feeling can be difficult to explain and can lead to unhealthy coping strategies.

Self-Harm or Suicidal Behaviours

For most people with EUPD, in moments of emotional crisis, self-harm or suicidal thoughts can feel like the only way to cope, as these behaviours are often a desperate attempt to manage unbearable emotional pain. While these self-injurious behaviours may bring temporary relief, the underlying distress remains.

Paranoia or Dissociation

Under a certain period of stress, some people with EUPD can experience a short episode of paranoia, like believing others are judging them or plotting against them. Furthermore, they may also experience dissociation, where they feel detached from reality or from their own body. This dissociation may create a sense of numbness or being in a dream-like state, which can make it difficult for you to connect with others or trust what’s happening in the moment.

Risk Factors of EUP?

The exact cause of EUPD remains unclear, but many people diagnosed with this condition have experienced some form of trauma during their lives, difficult or unstable family environments, such as growing up with a parent who struggled with addiction, or losing a caregiver at an early age. In addition, being left alone for long periods or enduring physical, emotional, or relational abuse can also contribute to the development of EUPD.

However, it’s also possible for someone to develop EUPD without a history of trauma or post-traumatic stress disorder. In some cases, genetic or biological factors may increase your vulnerability, especially when there’s someone in your family who has a history of EUPD.

How is EUPD Diagnosed?

Diagnosing EUPD can be challenging because its symptoms often overlap with other mental health conditions. This means that misdiagnosis is not uncommon, especially if the healthcare provider is unfamiliar with the nuances of the disorder. In addition, there are also differing views on how EUPD should be defined, diagnosed, and treated, which can add to the confusion.

Another factor that contributes to its complexity is that emotional instability can be hard to describe, which can make it difficult for some people to clearly express what they’re going through. This can complicate the diagnostic process, especially when symptoms are dismissed or misunderstood.

Some people may feel they’ve been misdiagnosed or overlooked entirely, while others question whether a diagnosis of EUPD fully explains their experiences. If your diagnosis doesn’t feel accurate, seeking a second opinion from a qualified mental health professional is a vital step toward clarity and appropriate support.

How Does EUPD Affect Daily Life?

On a daily basis, the symptoms of EUPD can be distressing and have a serious impact on your occupational and personal relationships. The mood swings and sudden outbursts of anger may make it difficult for you to hold down a job or complete an education. An impulsive decision can lead to instability in career paths, frequent job changes, or even legal problems.

In addition, the emotional toll it can take on your relationships, whether with your family, partners, or friends, is also a major concern. For instance, your outbursts of anger and unpredictable mood shifts can be exhausting for your loved ones.

There’s no doubt that living with EUPD is difficult, but with the right support and treatment, long-term recovery is achievable. 

What is the Prognosis of EUPD?

The long-term outlook for individuals with this condition can vary, but research shows that many experience improvement over time. While EUPD is often a persistent illness, the intensity and frequency of symptoms may reduce as you gain a better understanding of your emotional patterns and behavioural responses.

It’s also essential to note that the prognosis of EUPD can also be influenced by several factors such as the severity of symptoms, the presence of co-occurring conditions, social support, and early intervention. In fact, some people may continue to experience difficulties with emotional regulation and relationships, while others may reach a more stable level of functioning.

Treatment Programme 

Psychotherapy remains the cornerstone of treatment for EUPD. Data from research and clinical practice have shown that various therapies are effective in helping people understand and manage the symptoms of EUPD. Among these is the Dialectical Behaviour Therapy (DBT), a widely recognised treatment for EUPD or BPD, which focuses on teaching you how to regulate emotions, improve relationships, and reduce self-harming behaviours.

While there is currently no medication specifically for EUPD, pharmacological support may be considered when symptoms such as anxiety, depression, or severe emotional distress are present. In such cases, medication is used to address co-occurring symptoms rather than the core features of the disorder.

Treatment for EUPD often extends over several months and requires consistent involvement from mental health professionals. A carefully structured plan that includes regular therapy and clinical oversight is important for lasting improvements in functioning and quality of life.

Living With EUPD: Your Recovery Begins at PROMIS

We understand that unexplained mood shifts, persistent emptiness, or emotional overwhelm can leave you questioning what’s really going on. These experiences can disrupt your daily life in ways that are difficult to explain, and even harder to face without the right kind of help.

At PROMIS Clinic, we recognise the complexity of what you’re feeling, and our mental health team is here to guide you in reconnecting back to yourself and reclaiming your wellbeing.

Always remember that reaching out is not a sign of weakness but a courageous step in overcoming this extraordinary condition.