Psychosis is a complex symptom of several mental health disorders, including borderline personality disorder. Not every person with BPD will have psychosis, but on this page we will look at the nature of psychosis, it’s common symptoms and available treatment options.

What is psychosis?

Psychosis is a state in which an individual experiences a disconnection from reality, which affects their thoughts,  feelings, perceptions, and behaviours.

People undergoing a psychotic episode may struggle to distinguish between what is real and what is not, leading to distorted beliefs and perceptions.

While psychosis is commonly associated with severe mental illnesses, such as schizophrenia, it can also manifest in personality disorders such as BPD, mood disorders such as bipolar disorder, and certain medical  (physical) conditions.

What are the symptoms?

The most common symptoms of psychosis are:


These are false beliefs that persist despite seeing evidence to the contrary. These beliefs can be strange or bizarre, such as the person thinking they have super powers, or persecutory, where the person believes they are being target by others (this can be one person, an organisation, the government, etc).


Individuals with symptoms of psychosis may experience hallucinations, which is seeing or hearing things that aren’t present. Hallucinations can take several forms:

  • auditory (hearing things)
  • visual (seeing things)
  • olfactory (smelling things)
  • gustatory (tasting things)
  • tactile (feeling sensations on the skin

Disorganised thinking

Psychosis often disrupts the individuals thought processes, leading to incoherent or illogical thinking. Conversations may become disjointed, and it may be challenging for the individual to communicate effectively.

Impaired insight

Individuals experiencing psychosis may have difficulty recognizing that their thoughts or behaviours are abnormal, which can hinder their willingness to seek or accept help.

What is the treatment?

Psychosis is a challenging and intricate aspect of borderline personality disorder that requires a comprehensive approach leading to the correct diagnosis and treatment for the individual.

Effective treatment for psychosis often involves a combination of medication, psychotherapy and support from mental health professionals.

Antipsychotic medications may help manage symptoms by modulating activity in parts of the brain, while psychotherapy can help people understand and cope with their distorted thoughts.

By fostering awareness and reducing the stigma surrounding psychosis, we can contribute to creating a more compassionate and inclusive society for those living with complex mental health challenges.