Co-occurring Disorders


Cutting • SuicideAnxietyADHDBipolar DisorderDepression


Depression, or major depressive disorder, is a mood disorder that is characterized by loss of interest and persistent sadness. It affects all areas of your life, keeps you from your daily activities, and affects how you feel, think and behave. Depression is not something you can just “get over.” It sometimes requires long-term medical treatment, including medication and psychotherapy. Approximately 80-percent of people with Borderline Disorder also have major depressive disorder at some time. 

Symptoms of major depressive disorder include:

  • Feelings of emptiness, hopelessness and sadness 
  • Outbursts of anger, frustration and irritability
  • Loss of pleasure and interest in normal activities
  • Either insomnia or sleeping too much
  • Weight loss or gain
  • Lack of energy
  • Restlessness and anxiety
  • Slowed speaking and thinking
  • Trouble thinking, making decisions and concentrating
  • Thinking of death, suicidal thoughts, and attempts at suicide 


Approximately 40-percent of people with Borderline Disorder develop Dysthymia. Dysthymia is characterized by similar symptoms as major depressive disorder, but there are fewer symptoms. The symptoms of Dysthymia are not as severe, but for a diagnosis of Dysthymia you must have been depressed for at least two years and not without at least two of its symptoms for at least two consecutive months, and the symptoms need to have had a significant impact on your daily life. There are other parameters for the diagnosis that your clinician can help you understand through actual diagnosis and a treatment plan. 

For a diagnosis of Dysthymia, while depressed your symptoms may include two or more of the following:

  • Trouble thinking, making decisions and concentrating
  • Feelings of emptiness, hopelessness and sadness
  • Lack of energy
  • Lowered self-esteem
  • Either insomnia or sleeping too much
  • Fatigue and low energy

The symptoms of Borderline Disorder, Major Depressive DIsorder and Dysthymia all overlap, making the diagnosis difficult. For example, Borderline Disorder is marked by feelings of loneliness and sadness that are triggered by events and occur soon after, resulting in episodes of depression that do not last for years or weeks and can be turned around if a situation changes. In Borderline sufferers, self-harming behaviors and suicidal thoughts are often the result of personal problems they are experiencing. If you think you have any of these disorders, a clinician can help you find the correct diagnosis and treatment path. There is hope and a way forward for all of these conditions. 

If you feel you are at risk for suicide, or your loved one is at risk, make sure someone stays with that person. Call your local emergency room, 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).


Sources Cited:

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. American Psychiatric Publishing, 2014.
  • Friedel, Robert O. “Borderline Personality Disorder Demystified |.” Borderline Personality Disorder Demystified, 10 Feb. 2018,
  • “Depression (Major Depressive Disorder).” Mayo Clinic,