Borderline Schizophrenia: Causes, Symptoms and Treatment

Borderline Schizophrenia: Causes, Symptoms and Treatment

Written by :

Arooj Anjum

Arooj Anjum

Biomedical Engineer


Mental illness can sometimes co-occur, although a rare phenomenon, it is possible for individuals to tackle multiple mental health disorders at once. One such condition is borderline schizophrenia. The development might be the result of ongoing anxiety, depression, post-traumatic stress disorder, and substance abuse.


If you or a family member is suffering from any mental health illness, don’t hesitate to contact Therapy Fleet, an online mental health consultation center. We take pride in our work; our mental health professionals are the best. Book an appointment now.


What is Borderline Schizophrenia?


There is a significant chance that borderline schizophrenia is misdiagnosed, so the best way to understand it is to look at both conditions separately. As the name suggests, borderline schizophrenia is the co-occurrence of two different mental health conditions, namely, borderline personality disorder and schizophrenia spectrum disorder The name comes from the fact that both share some common causes, features, and symptoms.


Individuals who have borderline schizophrenia suffer from social difficulties, distorted thoughts, and odd behaviors. All these factors affect their personal lives drastically. Unfortunately, not much is known about this disorder, and it is no longer a psychiatric diagnosis as of now.


This blog will help cover the key elements of borderline schizophrenia, its symptoms, causes, treatments, and much more. Seeking help from healthcare professionals is recommended in all cases. We will look at both BPD and schizophrenia separately as well.

Can You Have BPD and Schizophrenia Together?


As mentioned earlier, BPD and schizophrenia can co-occur together. The exact percentage of borderline schizophrenia is not clear. In 2010, a study found that 17.6% of the people diagnosed with schizophrenia also had BPD. But, in 2018, another study showed that only 2% of females with BPD have schizophrenia. 


People suffering from BPD find it difficult to 

  • regulate their emotions, 
  • behaviors, and 
  • thoughts. 

This affects their relationships and identity as a person. BPD impacts the lives of individuals in all areas of life, socially and at work.


In contrast, schizophrenia affects the way people behave, feel, and think. It also removes the person’s ability to function in their daily lives. Although a rare condition, Schizophrenia is a serious mental health problem that disconnects individuals from reality. They build their perception of reality and get wrapped around it, not knowing what’s true and what’s not.


Now, when we say the term borderline schizophrenia, we simply mean people who decipt the symptoms of both mental health disorders. Although, this is not a medically accepted term. If you know someone who needs mental health support, don’t hesitate to get help. Therapy Fleet offers a wide array of psychotherapy programs customized for each individual.

How Are Borderline Personality and Schizophrenia Similar?


Both these conditions alter the individual’s thinking, perception of reality, and, thus, behavior. Common symptoms of borderline schizophrenia are impulsive behavior, excessive anger, delusions, paranoia, and hallucinations. Both disorders can make social interactions difficult to maintain.


In contrast, BPD individuals have brief psychotic periods under extreme stress where they become delusional and hear and see things that are not there. Whereas, in schizophrenia, these symptoms and moments of psychosis are ongoing and more common.


The similarity in cause also occurs as the exact cause for both is unknown. Various factors do play a role in the development of the disease.


Note- it is important to understand that borderline schizophrenia requires medical attention. If you are struggling with signs and symptoms of BPD or schizophrenia, seek help!

Differences between Borderline Personality Disorder and Schizophrenia


Borderline schizophrenia is also known as schizotypal personality disorder SPD because it is a part of the spectrum of schizophrenia. Although an outdated term, now, SPD patients are real loners because, in their map of the world, people around them are harboring negative thoughts and feelings about them.


Let’s look at BPD and Schizophrenia separately now!

Borderline Personality Disorder


BPD, or borderline personality disorder, is a personality disorder that affects the thoughts, emotions, and, thus, behavior of an individual. People with BPD symptoms often find it tough to maintain their relationships with others; they lack self-worth and, therefore, are unable to keep their self-image, which, in the end, affects their identity as a person. BPD patients also have extreme mood swings and show impulsivity out of the blue.


It is developed during early adulthood and is more common in females. BPD can be managed with therapy and medications. 



In contrast, individuals with schizophrenia are often delusional. They live in their perception of reality, frequently hallucinating things that aren’t true. This distorts their thinking and affects their behaviors, making it difficult to attain communication and social interactions. 


Schizophrenia is developed in the late teenage years and can affect both men and women. Antipsychotic medications are the first treatment options, with or without therapy.

Causes of BPD & Schizophrenia


At the moment, the possible causes of BPD and schizophrenia are not clear, and more research is required to clarify and unveil the truth. 


However, experts believe it could be genetics, physiology, and our environment. It cannot be only a single factor but rather a combination of different sources that aid in developing BPD and schizophrenia.

1. Genetics

No single gene was identified that could lead to the development of BPD or schizophrenia symptoms. However, it is guaranteed that family history plays a role. How? 


A study conducted in 2017 of twins showed that if one of the identical twins develops traits of schizophrenia, then the chances of schizophrenia traits developing in the other twin increases. 


Another research from 2021 showed that individuals who have family members with BPD have a higher chance of developing the condition. However, that does not guarantee anything.

2. Environment

Individuals who experienced trauma in the early years were more at risk of developing BPD. According to  a 2021 review, 90% of individuals with BPD experienced one of the following trauma in their childhood,

  • Neglect
  • Bullying 
  • And physical, verbal, or sexual abuse

A 2021 review suggested that almost 15 to 40% of the environmental factors contributed to developing schizophrenia. 


Environmental factors contributing to schizophrenia

  • Season of birth
  • Complications at birth
  • Infections during pregnancy
  • Drug use
  • Social factors

3. Physiology

Physiology plays an important role here. Huge difference in levels of serotonin and dopamine impacts the development of BPD and schizophrenia. Plus, it’s not just that. Some regions of your brain that are in charge of regulating emotions and controlling impulsivity ( amygdala and hippocampus) also appear and function differently in individuals with borderline personality disorder.


Research from 2018 neuroimaging shows that people with schizophrenia showed visible differences in activity and size of temporal and frontal lobes that regulate emotions, memory, and language functioning.

Borderline Schizophrenia Symptoms


Although a rare condition, borderline schizophrenia can occur at once, and some symptoms overlap. It is important to know the difference between the symptoms for both conditions.

Symptoms of Schizophrenia


The symptoms of schizophrenia are divided into three categories;

  1. Positive symptoms- psychosis ( hallucinations and delusions), distorted thinking and speech, and altered sensations
  2. Negative symptoms- decreased motivation, suppressed emotions, difficulty in planning, and social withdrawal.
  3. Cognitive symptoms- unable to concentrate or focus, memory loss, and difficulty in absorbing information and making decisions

Symptoms of BPD


Some common BPD symptoms include

  • Depression & Anxiety
  • Emotionally unstable
  • Shifting moods and behavior
  • Impulsivity 
  • Lack of purpose
  • Instability to maintain relations
  • Self-harm 
  • And suicidal ideation

Suicide Prevention


If you or a loved one is suffering from suicidal thoughts or a risk to others, please ask them, ‘Are you considering suicide?’


Be all ears, do not judge me, and call 911 immediately. Stay close to them until a professional is at the doorstep.


In the meantime, get rid of any weapons or medications. Look out for any sharp and harmful objects from their sight.


Remember, the 988 Suicide and Crisis Lifeline is 24* 7 at your service.



A small percentage of BPD individuals also notice;

  • Delusions
  • Paranoia
  • Hallucinations
  • dissociation

Note- if you or a family member are suicidal and behaving differently, seek professional help right away.

Common Symptoms of Borderline Schizophrenia


Let’s look at the similar symptoms of borderline schizophrenia;

  • Chronic feelings of lack of motivation
  • Empty feeling
  • Cognitive distortions
  • Unable to regulate emotions
  • Delusional
  • Disorganized thinking and behavior
  • Impulsivity
  • Anosognosia
  • Hallucinations
  • Rapidly changing emotions
  • Feeling disconnected.

Borderline Schizophrenia Treatment Plan


BPD and schizophrenia can only be managed professionally. Managing the symptoms becomes more tough when an accurate diagnosis is not made.


Work with your mental healthcare provider closely so that they can customize a complete treatment plan for you.


Treatment of Borderline schizophrenia is a combination of the following;

  1. Medication
  2. Psychotherapy and 
  3. Self-care

A. Effective Therapy Plan

Usually, the first option plan for borderline schizophrenia, psychotherapy, consists of different therapies.

Therapy for managing BPD symptoms;

  1. Transference-focused therapy
  2. DBT or dialectical behavioral therapy
  3. And cognitive-behavioral therapy or CBT

Research shows mixed reviews on the performance of transference-focused therapy.

Therapy for managing schizophrenia symptoms;

  1. acceptance and commitment therapy 
  2. assertive community treatment 
  3. cognitive behavioral therapy (CBT)
  4. social skills training

B. Medication for Borderline Schizophrenia


Presently, the FDA has not approved any drug for treating BPD. However, BPD comes with other mental health conditions, and medications for those are prescribed.


The following medicines are given for managing other mental health conditions developed due to BPD;

In contrast, for individuals with schizophrenia, antipsychotic medicines are given to manage delusions and hallucinations;

  1. Clozapine (Clozaril)
  2. Haloperidol (Haldol) 
  3. Quetiapine (Seroquel)
  4. Aripiprazole (Abilify)

DBT is usually used to manage behaviors, while CBT is used to reframe and manage thoughts. The antipsychotic drugs, plus the mood stabilizers, are used for both BPD and schizophrenia symptoms.


However, research shows that schizophrenic patients need more therapeutic care in comparison to BPD individuals.

C. Self-Care


People with borderline schizophrenia are more prone to everyday stress, which is why incorporating changes in their daily routines is mandatory.


Some common examples that need to be strategized are;

  • Regular exercise
  • Healthy diet
  • Mindfulness and meditation
  • Building a sleep routine
  • Journaling
  • Joining support groups and 
  • Building a support network

Support for Borderline Personality Disorder and Schizophrenia at Therapy Fleet


Getting an accurate diagnosis is important. Ensure that the mental health provider understands your symptoms and treats you accordingly. Borderline schizophrenia is rare but possible; don’t wait to get better without help. Please visit a mental health doctor and get yourself treated. Don’t live your life in vain. You, too, can lead a normal life.


If you or a family member is dealing with borderline personality disorder, schizophrenia, or both, contact us at Therapy Fleet. We offer online mental health treatment for people of all ages. We deal with all types of mental health conditions, including mood disorders, depression, and much more.



Borderline schizophrenia is not a recognized clinical term. Schizophrenia is a distinct disorder characterized by hallucinations, delusions, and disorganized thinking.


1. Can BPD convert into schizophrenia?


No, but do occurrence of BPD and schizophrenia is possible. Symptoms like psychosis dissociation and mood swings are seen in both; therefore, it may seem like BPD has changed into schizophrenia while, in reality, it does not.

2. What are the symptoms of borderline schizophrenia?


Some common symptoms include identity disruption and feeling empty and alone. Cognitive impairments and delusions.

3. Is there anything like mildly schizophrenic?


Yes, some people have mild schizophrenia, commonly known as residual schizophrenia. It consists of positive symptoms such as delusions and hallucinations.

4. Which is one of the biggest signs of schizophrenia?


Hallucinations involve hearing or seeing things that aren’t true. Hallucinations can occur with any of the five senses, but hearing voices is the most common.

5. Does borderline schizophrenia have its diagnosis?


No, but in the 1970s, the experts campaigned that borderline schizophrenia should have its diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition DSM-3.

6. At what age does borderline schizophrenia develop?


The symptoms often develop in the late teenage years or early twenties, but the condition can develop at any time.

7. What should I do if I have borderline schizophrenia?


If your loved one poses a threat to themselves or others, call 911 right away. If you are the one experiencing the symptoms, take care of yourself. Make sure you recognize the symptoms and call for help immediately in an emergency.


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