Illustrated Doctor and patient sitting at a table talking about sex
Illustration by Marta Pucci

Understanding BPD and Sex

Photo of Dr Katherine Hertlein
Reviewed by Dr Katherine Hertlein,
created by Blueheart
created by Josh Green
created by Sophie Browness
Date published:
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Photo of Dr Katherine Hertlein
Reviewed by Dr Laura Vowels,
created by Blueheart
created by Josh Green
created by Sophie Browness
Date published:
Last updated:

Living with borderline personality disorder brings its own set of challenges in regard to libido. BPD and sex can complicate even the longest-standing relationships.

Those diagnosed with borderline tend to be sexually impulsive or sexually avoidant. Sexual impulsivity can lead to an increased rate of risky behaviors such as unprotected sex and sexual avoidance can negatively impact romantic relationships.

What is BPD?

BPD stands for borderline personality disorder. The nine symptoms of BPD are fear of abandonment, unstable relationships, identity disturbance (unstable sense of self), impulsive or self-destructive behaviors, intense emotional swings, chronic feelings of emptiness, explosive anger, and feeling suspicious of real or perceived abandonment, or stress-induced paranoia. While these are the 9 symptoms of BPD, you only need to exhibit 5 or more of them to receive a diagnosis.

People with BPD are highly sensitive to rejection, with some describing it as being like a raw nerve. This sensitivity brings about positive attributes like compassion but also brings about the aforementioned negative traits.

Some symptoms like not being clear in who you are and feelings of emptiness can lead to engaging in relationships to find a sense of self and to avoid feeling empty. One potential consequence of this is increased engagement in sexual activity to find oneself and feel connected.  At the root of this behavior is the desire to fill a void or feel wanted. People with BPD may seek out sex more often but have great difficulty maintaining healthy relationships.

BPD can also co-occur with other psychiatric disorders such as bipolar, anxiety, or substance abuse. People with BPD tend to be impulsive and then experience extreme anxiety or regret around the decisions they made while experiencing an episode. This cyclical nature of thinking, feeling, and behaving can make it difficult to cope with day-to-day interactions.

If you identify with any of the above symptoms, you may have BPD. Of course, it's best to speak with a mental health professional to receive a proper diagnosis.

BPD and sex

Borderline personality disorder is notoriously difficult to diagnose because it coexists alongside mood disorders, either of which can affect sexual functioning. When it comes to libido, the range of effects is significant.

If you have BPD, you may feel you want sex constantly, often feeling like you can't get enough of it no matter how much you have or with how many partners because you are looking to feel fulfilled emotionally. Being unable to initiate sex is another experience that those with BPD have. In a relationship, waiting for a partner to always initiate sex can cause tension.

BPD also can be associated with low self-worth. Feelings of unworthiness or insecurity can creep up during sex when a person is most vulnerable. You may feel like you're unable to please your partner no matter what you do, even if your partner has shown no outward signs of discomfort or disapproval.

Borderline personality disorder relationships

Relationships with a borderline partner tend to be tumultuous. If you have BPD, you could be highly sensitive to rejection and harbor a fear of abandonment that may lead to subconsciously or consciously sabotaging your relationship. 

BPD is a disorder of proportionality.Your partner may feel like they are walking on eggshells at times, because the relationship becomes very up-and-down, where things are good and then bad, and then good and then bad, over a short period of time. It may be difficult to express your emotions when you're in the middle of a depressive or angry episode. Be gentle with yourself.

Obsessive thoughts may lead to the development of making your partner your FP (favorite person). You may struggle with having them on your mind all the time which can lead to feeling abandoned when they don't answer phone calls, texts, or messages right away. You may want to be physical with them at all times.

Because BPD can affect your libido, it might be difficult for you to match your partner's drive. If your partner doesn't want to have sex, you may take this as a sign of rejection on a deeply personal level. 

BPD and loss of interest in sex

Losing interest in sex or having low libido can also happen to people with BPD. So what can you do? Don't be afraid to voice your needs. Do things that make you and your partner feel relaxed before engaging in sexual activity. It might be helpful to engage your partner in foreplay. Try to ask your partner for verbal feedback. Talking to your partner about sex can be tough, but it's necessary for building a healthy relationship. You'll both feel stronger and more confident. It can build a stronger bond.

It can be difficult to know how much sex is normal. The answer is different for everyone, but if you feel like you're having more or less sex than what makes you comfortable, it might be necessary to examine your sexual needs through journaling and therapy.

It's not your fault

The first step is recognizing that there's nothing fundamentally wrong with you or your partner if sex doesn't always happen as planned. The reasons people have sex vary widely from wanting to procreate to a desire to feel needed.

All of these symptoms can make it incredibly tough to maintain a relationship, but it isn't impossible. Recognizing that your FP has their own desires, goals, hopes, dreams, and motivations can bring things into perspective. Communicate with your partner about your needs and expectations, especially when it comes to sex.

Coping, finding the right therapist, and medication

BPD is usually comorbid with other conditions such as depression but SSRIs alone can be ineffective. Your psychiatrist may prescribe antipsychotics along with mood stabilizers because BPD's effects on your mood can affect your work, studies, and relationships in such a profound way. Medication like antipsychotics can decrease libido so try to focus more on therapy.

Dialectal behavior therapy (DBT) can help you develop necessary skills to help you control your behavior which can alleviate mental suffering and help with negative feelings surrounding sex. DBT can also lay the foundation for the formation of healthier, happier relationships with friends, partners, and family.

There are also self-help techniques to cope with the windstorm of emotions that come with BPD and feelings of unworthiness that may come from low libido. Observe your emotions as if you're outside of your body. You can record yourself and rewatch the video to identify your emotional state. Some people with BPD find making a video diary is an effective tool to identify and combat negative emotions.

When you feel sexually impulsive, take a few moments to stimulate your other senses. See if there's an underlying feeling that can be accessed. Write down those feelings as they come and go.

It's also important to avoid drugs, eat well, get enough sleep, and exercise. You can also practice guided meditation and other relaxation techniques, and seek out individual, family-based or couple therapy.  

The bottom line

BPD is a serious diagnosis that can affect all aspects of your life – including your libido. It can cause tension in relationships with your partner because your emotional state can be unstable at times.

Managing your sexual impulses, using coping skills and DBT therapy, and finding the right medication can improve your mood and your sex life. With the right support system from family, friends, mental health professionals, and even a partner, healthy relationships are possible.

Want more information about mental health and libido-related issues? Check out our other articles.

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