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Understanding Borderline Schizophrenia: Symptoms, Causes and Treatment

Understanding Borderline Schizophrenia: Symptoms, Causes and Treatment

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Borderline schizophrenia is a term used to describe that there are two co-occurring conditions: borderline personality disorder (BPD) and schizophrenia. It is no longer a formal diagnosis, but there are similarities and differences between borderline personality disorder and schizophrenia. Borderline schizophrenia can appear anytime in a person’s lifetime, but symptoms usually occur in the teenage and early 20s. It is important to manage the co-occurring condition early before it develops. In this blog, we will see what is borderline schizophrenia, its symptoms, causes, and the treatment for this mental disorder.

What is Borderline Schizophrenia?

Borderline schizophrenia is diagnosed the same way as many of the other mental illnesses. So to avoid confusion, it is better if we discuss its components, schizophrenia and borderline personality disorder, before talking about borderline schizoaffective disorder. There are some differences in these disorders, patients with BPD have fewer delusions. People with schizophrenia tend to have symptoms of psychosis because of hallucinations and paranoia.

Schizophrenia is a rare disorder and it usually affects the way we behave by disturbing thinking patterns and brain activity. It is a psychotic disorder led by hallucinations, delusions, paranoia, and disordered thoughts.

A borderline personality disorder is a mental health condition in which a person cares too much about their self-image, shows impulsive behavior, and has a fear of abandonment. This impulsive behavior may cause ADHD.

So we can say that people with schizophrenia often struggle with their relationship with people, and people with borderline personality disorder struggle with their relationship with themselves. This makes it clear that those who suffer from borderline schizophrenia struggle with both things to some extent.

A borderline personality disorder is also known as schizotypal personality disorder, as it was considered to be a part of the spectrum of schizophrenia. This term is outdated today and no one uses it.

Read More: Schizophrenia in Children: Causes, Symptoms, and Treatment

Borderline Schizophrenia Symptoms

Both Borderline Personality Disorder and Schizophrenia are mental health conditions outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. But there is no mention of borderline schizophrenia in it. So there is no diagnosis for this disease, but we do it by combining both BPD and schizophrenia diagnosis. Let’s discuss the symptoms of schizophrenia and borderline personality disorder to get borderline schizo symptoms.

Borderline Personality Disorder Symptoms

These are the indications for borderline personality disorder.

  • A sequence of unstable relationships
  • Frequent suicidality because of anxiety disorders, specifically GAD
  • Recurrent outbursts of inappropriate anger
  • Avoidance of real or perceived abandonment
  • A constant unstable image or sense of self
  • Stress-related dissociation or paranoid thoughts
  • Reckless behaviors and impulsivity
  • Stress-related psychosis
  • Mood disorders
  • Chronic feelings of emptiness
  • Self-destructive behaviors

Read More: Causes of Schizophrenia: Is Schizophrenia Genetic?

Schizophrenia Symptoms

Symptoms of schizophrenia include:

  • hallucinations or delusions
  • disorganized thoughts and speech related to a specific phobia
  • disorganized motor function causing depression
  • negative symptoms, including reduced emotional expression, decreased speech output, and social withdrawal, leading to MDD (major depressive disorder)
  • active and inactive periods of psychotic symptoms, including acute stress and anxiety disorders
  • psychosis not related to mood
  • impaired concentration, memory, and decision-making
  • mood episodes, particularly depressive episodes

There are some overlapping symptoms

  • Mood changes
  • Psychosis
  • Relationship challenges
  • Anger and Anxiety
  • Depression
  • Paranoid ideation

Read More: A Guide To Understand Catatonic Schizophrenia

Causes of Borderline Personality Disorder and Schizophrenia

There is no specific cause for both of these diseases, but there are some factors that can be the possible reasons for borderline personality disorder and schizophrenia. It has been observed that genetics, physiology, and environment all play a role in the development of these illnesses.

Genetics

No single gene is responsible for the development of schizophrenia, but a combination of genes can cause schizophrenia. A study has shown that BPD can also be hereditary, if a person in the family has BPD, then you might have it.

Environment

Childhood trauma can be the cause of the development of BPD and schizophrenia. Childhood trauma may cause any specific phobia, which might lead to disorganized thinking, and cause borderline schizophrenia.

Other factors include birth complications, infections during pregnancy, season of birth, and major lifestyle changes like migration.

Physiology

Changes in neurotransmitter levels like serotonin and dopamine can cause the development of schizophrenia and borderline personality disorder. It can also affect emotions, memory, and language functioning.

Read More: Understanding the Stages of Psychosis

Treatment for Borderline Schizophrenia 

Borderline personality disorder and schizophrenia can be treated at the same time, it is known as comorbidity. But because these conditions are not so common, that is why comorbidity is rare. Just as symptoms for both of them overlap, so are the treatment options.

Medication Management

The first solution for borderline schizophrenic disorder is medication. However, without proper medication management, it is too difficult to deal with both of them. There is no approved medicine for BPD but medical professionals prescribe some drugs to manage the co-occurring symptoms.

Talk Therapy

Therapy is also used for the treatment of borderline schizophrenia. Different types of psychotherapy are used to deal with borderline schizophrenia.

Cognitive-behavioral therapy (CBT) is specifically used for the treatment of borderline personality disorder and is effective in handling mood swings and enhancing personal growth. Other therapies used for the treatment of BPD are dialectical behavioral therapy (DBT) and transference-focused therapy.

Read More: What’s The Difference Between A Mood Disorder And A Personality Disorder?

For the treatment of schizophrenia, therapies that are commonly used include cognitive behavioral therapy (CBT), social skills training, assertive community treatment, and acceptance and commitment therapy.

It implies that the best therapy for borderline schizophrenic disorder is cognitive-behavioral therapy.

Self-Care

Acute stress can impact both BPD and schizophrenia and lifestyle modifications focused on self-care can be essential for dealing with symptoms of these conditions. Some examples of coping strategies include exercising daily, eating nutritious foods, maintaining a consistent sleep routine, journaling, making time for hobbies and activities you love, creating a support network, and joining support groups.

Read More: Defining Undifferentiated Schizophrenia

Conclusion

Borderline Schizophrenia is used to describe the presence of both illnesses, borderline personality disorder and schizophrenia. It cannot be diagnosed directly as one disease. It is considered as two separate conditions occurring together. They also have similarities and dissimilarities.

If you feel the symptoms of borderline schizophrenia, get in touch with Orange Coast Psychiatry now and get the diagnosis. If you cannot come to the clinic, we offer telehealth services. Schedule your consultation now!

Frequently Asked Questions

Both BPS and schizophrenia cause disturbances in a person’s thinking, behavior, and perception. There is no specific cause for both of them, and they can be treated in the same way. 

Research shows that both can co-occur, but there is not enough research to confirm definite comorbidity. Most of the symptoms are the same, but they are different illnesses. 

BPD is not considered an early stage of schizophrenia. So, BPD would not turn into schizophrenia and neither would schizophrenia turn to BPD.

Reference and Footnotes
  1. French, M. (2023b, June 6). What to know about borderline schizophrenia. https://www.medicalnewstoday.com/articles/borderline-schizophrenia
  2. Blaine, E. (2024, October 11). What even is borderline schizophrenia? Charlie Health. https://www.charliehealth.com/post/borderline-schizophrenia
  3. Doe, E. (2024, August 15). Borderline schizophrenia: Definition, symptoms, treatment. MentalHealth.com. https://www.mentalhealth.com/library/borderline-schizophrenia
  4. Gillette, H. (2023b, September 18). Your guide to Borderline Personality Disorder (BPD) and schizophrenia. Healthline. https://www.healthline.com/health/schizophrenia/borderline-personality-disorder-and-schizophrenia#takeaway

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Jackson Tea

MSN, PMHNP-BC

Administrative Director and Psychiatric Mental Health Nurse Practitioner

Jackson Tea, MSN, PMHNP-BC, serves as the Administrative Director and a board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP-BC) at Orange Coast Psychiatry. Dedicated to breaking the stigma surrounding mental health, Jackson is passionate about providing compassionate, evidence-based care that empowers individuals to take charge of their mental well-being. His expertise includes comprehensive psychiatric assessments, personalized medication management, and behavioral health interventions designed to help patients achieve the best possible outcomes in their mental health journey.
Jackson’s approach to care is rooted in the belief that mental health is just as vital as physical health. He focuses on creating a supportive, judgment-free environment where patients feel heard, valued, and understood. By offering individualized treatment plans tailored to each person’s unique needs and goals, Jackson helps clients overcome obstacles such as anxiety, depression, mood disorders, and other mental health challenges.
He holds a Post-Master’s Certificate as a Psychiatric Mental Health Nurse Practitioner from National University, a Master of Science in Nursing in Nursing Administration from the University of Phoenix, and a Bachelor of Science in Nursing from California State University, Los Angeles, where he earned Dean’s List honors. As a member of the Sigma Theta Tau Honor Society of Nursing, Jackson remains committed to advancing mental health awareness and promoting high standards of care in the field.
In his role at Orange Coast Psychiatry, Jackson leads clinical operations while ensuring regulatory compliance and delivering high-quality care. His core competencies include psychiatric assessment, evidence-based interventions, crisis management, clinical leadership, and risk mitigation. Above all, Jackson strives to make mental health care accessible and effective for everyone, supporting individuals in making meaningful progress, improving their quality of life, and achieving lasting well-being.

May Faustino

Board-Certified Psychiatric-Mental Health Nurse Practitioner

May Faustino, PMHNP-BC, is a compassionate and highly skilled psychiatric provider with over four years of nursing experience, including three years specializing in psychiatric care. She holds a Master of Science in Nursing from West Coast University, where she received extensive training in managing the psychiatric needs of pediatric, adult, and geriatric populations, as well as providing therapy and counseling services.
May has worked in diverse mental health settings, including forensic psychiatry at the Department of State Hospitals and behavioral health services at Aliso Ridge Behavioral Health. Her clinical expertise spans psychiatric assessments, medication management, and trauma-informed care, with a strong focus on treating anxiety, depression, and trauma-related disorders.
Bilingual in English and Tagalog, May is dedicated to serving diverse patient populations with a culturally sensitive approach. She is trained in evidence-based therapeutic modalities such as cognitive behavioral therapy (CBT) and motivational interviewing and is well-versed in trauma-informed care and suicide prevention strategies.
May is passionate about promoting resilience and recovery through preventive mental health care and individualized, holistic treatment plans. Her commitment to excellence is reflected in her memberships in the American Psychiatric Nurses Association and Sigma Theta Tau International Honor Society of Nursing.
In her personal time, May enjoys fostering mindfulness and well-being through activities she loves, such as spending time with her husband and their two beloved cats, Pippy and Eva.

Dr. Montgomery

M.D. – Psychiatrist

Dr. Torri Montgomery, M.D., is a board-certified psychiatrist with the American Board of Psychiatry and Neurology, with a subspecialty board certification in forensic psychiatry. Dr. Montgomery is an integral part of our Management Team as a Psychiatrist and Supervising Psychiatrist for our Psychiatric-Mental Health Nurse Practitioners here at Orange Coast psychiatry.
Dr. Montgomery earned her Bachelor of Science (Magna Cum Laude) from Arizona State University and her Doctor of Medicine (M.D.) from The University of Arizona, College of Medicine. She completed her psychiatry residency at Los Angeles County Harbor-UCLA Medical Center. During her psychiatry residency, Dr. Montgomery completed a year-long certification in Electro-Convulsive Therapy (ECT), earned a certificate from the Drug Enforcement Agency (DEA) to prescribe medication for the treatment of substance use disorders, and worked in a Medication Assisted Treatment (MAT) clinic for substance use disorders. Additionally, she was appointed Chief Resident and received an Excellence in Teaching award.
After psychiatry residency, she completed her Forensic Psychiatry Fellowship at the University of Southern California, Keck School of Medicine. After completing her fellowship, Dr. Montgomery has worked in public psychiatry for the Los Angeles County Department of Health Services. She teaches, consults, and treats individuals with depressive disorders, anxiety disorders, trauma-related disorders, and serious mental illness (SMI), such as schizophrenia spectrum and bipolar disorders. Her experience includes outpatient, inpatient, emergency, consult liaison, addiction, dual-diagnosis, and forensic psychiatry. She is an expert evaluator on the Superior Court of California Panel of Expert Psychiatrists and Psychologists. Dr. Montgomery is an attending physician for the Harbor-UCLA Department of Psychiatry and serves as a psychiatrist with Orange Coast psychiatry.

Dr. Ravi

M.D. – Psychiatrist

Dr. Dave Ravi, M.D., is a Board Certified Psychiatrist with additional qualifications in geriatric psychiatry. Dr. Ravi is an integral part of our Management Team as a Psychiatrist and Supervising Psychiatrist for our Psychiatric-Mental Health Nurse Practitioners here at Orange Coast psychiatry.
Dr. Ravi graduated from Virginia Commonwealth University (B.S., Magna Cum Laude), VCU School of Medicine (M.D.), Dartmouth Hitchcock Medical Center (Residency in Psychiatry), and John. A. Burns School of Medicine (Fellowship in Geriatric Psychiatry). He currently is a clinical assistant professor of psychiatry at John A. Burns School of Medicine in Honolulu, HI and serves as a psychiatrist with Orange Coast psychiatry.
Dr. Ravi is a dedicated community psychiatrist with extensive experience in public, correctional, inpatient and outpatient settings, and an experienced tele-psychiatrist. He consults on topics in general psychiatry, including quality improvement, treatment planning, and crisis management, and in correctional psychiatry, including recovery-oriented treatment for individuals with serious mental illness and dual diagnosis. His current and future interests focus on understanding the various approaches in managing the suffering and disturbance of complex psychiatric disorders, particularly in the use, misuse, overuse, and misrepresentation of psychotropic medications.

Dr. Irwin

M.D. , Ph.D – Psychiatrist

Dr. Scott Irwin, M.D., Ph.D., is Board Certified Psychiatrist. Dr. Irwin is an integral part of our Management Team as a Psychiatrist and Supervising Psychiatrist for our Psychiatric-Mental Health Nurse Practitioners here at Orange Coast psychiatry.
His career mostly focuses on improving outcomes for those with cancer or other progressive, potentially life-limiting illnesses, and their families, through leading-edge clinical services, ongoing research, as well as program development, improvement, and implementation.
He is widely published, has been recognized at many levels for his research, teaching, consulting, and clinical endeavors, and has received research funding from the NCI, NIMH, the National Palliative Care Research Center, the Archstone Foundation, and industry.
Dr. Irwin earned his Bachelor of Science from the University of California, Los Angeles, and both his MD and PhD (neuroscience) at the University of Illinois, Urbana-Champaign. He successfully completed his psychiatry residency at UC San Diego as chief resident of Outpatient Psychiatric Services, as well as a two-year elective in hospice and palliative care at San Diego Hospice and The Institute for Palliative Medicine. He is a diplomate of the American Board of Psychiatry and Neurology, with subspecialty certification in psychosomatic medicine.

Richard Samedra.

Psychiatric-Mental Health Nurse Practitioner-BC

Richard Samedra, PMHNP-BC, is a Board Certified Psychiatric-Mental Health Nurse Practitioner. He brings over 12 years of experience in the mental health field, working with clients facing a wide range of acute and chronic mental health conditions. His journey began as a Licensed Vocational Nurse and Charge Nurse at Westminster Therapeutic Residential Treatment, where he supported clients dealing with anxiety, depression, schizophrenia, bipolar disorder, and substance use disorders. Richard’s dedication was centered on helping these individuals improve their mental health and transition to a lower level of care, whether that meant returning to their families, a board and care facility, or a sober-living environment.
Motivated by a growing passion for mental health care, Richard pursued his Registered Nurse (RN) education at Saddleback Community College and later transitioned to La Palma Intercommunity Hospital Behavioral Health. In this role, he specialized in geriatric psychiatry, working with older adults experiencing conditions such as Parkinson’s disease, dementia, depression, and anxiety. This experience solidified his commitment to mental health, leading him to work at Bellflower Community Hospital, where he provided care for patients experiencing severe psychiatric crises, including suicidal ideation, manic and depressive episodes, substance use disorders, and exacerbated schizophrenia symptoms.
Inspired by the impactful work of PMHNPs at Bellflower, Richard enrolled in the Psychiatric-Mental Health Nurse Practitioner program at Azusa Pacific University. To broaden his expertise, he worked full-time at College Hospital Costa Mesa while completing his studies. There, he gained comprehensive experience across various units, including adolescent, acute men’s and women’s, stabilization, and detox/med-surg. Now, as a PMHNP, Richard is committed to leveraging his diverse background and knowledge to provide compassionate, comprehensive care to those in need.
Richard currently practices as a Nurse Psychiatric-Mental Health Nurse Practitioner at Orange Coast Psychiatry, where he is supervised by Dr. Montgomery.

Shaheena Gazipura

Psychiatric-Mental Health Nurse Practitioner-BC

Shaheena Gazipura is a board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP-BC) with over 9 years of dedicated experience in both inpatient and outpatient mental health care. She earned her Master of Science in Nursing from Western University of Health Sciences in Pomona, California.
Shaheena began her career working on an adult psychiatric inpatient unit before transitioning to the geriatric psychiatric inpatient unit at USC Verdugo Hills Hospital. In addition to her clinical work, Shaheena also serves as a Nursing Clinical Instructor, guiding the next generation of nurses through their mental health rotations at a large community college.
Shaheena is a passionate advocate for mental health, believing that it is a fundamental pillar of overall well-being. She is committed to reducing the stigma surrounding mental illness and strives to provide comprehensive, compassionate care that honors each individual’s unique experiences and challenges. Her goal is to create a supportive, nonjudgmental environment where patients feel empowered to work alongside her in achieving their mental health goals.
Outside of her professional life, Shaheena enjoys exploring new culinary experiences, staying active through exercise, and planning her next travel adventures.
Shaheena currently practices as a Nurse Psychiatric-Mental Health Nurse Practitioner at Orange Coast Psychiatry, where she is supervised by Dr. Barrios.

Clint Nacar

Psychiatric-Mental Health Nurse Practitioner -BC

Clint Nacar, PMHNP-BC is a Board Certified Psychiatric-Mental Health Nurse Practitioner. Mr. Nacar graduated from Charles R. Drew University of Medicine and Science. Currently Mr. Nacar works in an inpatient psychiatry unit at a leading academic medical center in Los Angeles, Renewed Mental Health Group, and Orange Coast Psychiatry
Mr. Nacar brings over 7+ years of experience with the mental health population. He works to help patients take control of their mental health through patient education, psychotherapy and medication management. Mr. Nacar’s areas of focus include: Depression, Anxiety, Adjustment Disorder, Bipolar disorder, Attention Deficit Hyperactivity Disorder (ADHD), and Post-Traumatic Stress Disorder (PTSD). Mr. Nacar treats children ages 6+, adolescents, and adults, offering both in-person services and telehealth at Renewed Mental Health Group.
With the collaboration of each patient, Mr. Nacar strives to develop individualized plans of care addressing each patient’s unique situation and concerns. He also encourages each patient to take charge of their mental health through a holistic approach while also employing the latest evidence based practices in treatment.

Clint is one of our most experienced Psychiatric-Mental Health Nurse Practitioners at Orange Coast Psychiatry and is 103NP Licensed in the State of California.

Cristian Cuevas

Psychiatric-Mental Health Nurse Practitioner-BC (Fluent in Spanish)

Cristian Cuevas, PMHNP-BC, is a highly skilled board-certified psychiatric mental health nurse practitioner with over seven years of experience in inpatient psychiatry and mental health.
A California State University Long Beach graduate, Cristian also earned recognition as a board-certified psychiatric mental health registered nurse. With a wealth of expertise in adult psychiatric care across the lifespan, Cristian has successfully diagnosed and treated a diverse range of mental health disorders.
Additionally, his specialized experience in child and adolescent inpatient populations further enhances his ability to provide comprehensive and compassionate mental health care.
Cristian Cuevas is the Lead Nurse Psychiatric-Mental Health Nurse Practitioner at Orange Coast Psychiatry and is supervised by Dr Barrios.

Griselda Hernandez

Psychiatric-Mental Health Nurse Practitioner-BC (Fluent in Spanish)

As a licensed Psychiatric-Mental Health Nurse Practitioner (PMHNP) with a robust background in psychiatric and substance abuse nursing, Griselda provides compassionate, evidence-based care to individuals facing mental health and addiction challenges. The core of her practice focuses on promoting holistic wellness, fostering resilience, and empowering patients in their recovery journey. Specializing in the assessment, diagnosis, and treatment of adolescents with various mental health disorders, Griselda strives to create a therapeutic environment where patients feel valued, respected, and supported.

“My approach is grounded in years of diverse experience, including work in psychiatric units and medical detox units for both adults and adolescents. This extensive background has equipped me with the skills and knowledge to manage complex psychiatric and substance abuse conditions effectively. I am committed to staying updated with the latest advancements in psychiatric care, integrating cutting-edge therapies and best practices into my treatment plans. Collaboration is key to my practice; I work closely with multidisciplinary teams, families, and community resources to provide coordinated and comprehensive care tailored to each individual’s unique needs.”

Griselda holds a Master of Science in Nursing with a specialization in Psychiatric-Mental Health from West Coast University, and a Bachelor of Science in Nursing from The University of Alabama, Tuscaloosa. Additionally, she is fluent in the English and Spanish language, enhancing her ability to connect with a diverse patient population.

Griselda currently practices as a Nurse Psychiatric-Mental Health Nurse Practitioner at Orange Coast Psychiatry, where she is supervised by Dr. Barrios.

Dr Barrios

Board-Certified Child and Adolescent Psychiatrist

Dr. Carlos Barrios is a Board-Certified Child and Adolescent Psychiatrist with over two decades of experience in mental health care. His expertise in telepsychiatry has allowed him to serve patients across California and beyond. In his practice, Dr Barrios integrates metabolic and functional methodologies, focusing on guiding patients toward medication independence and emphasizing the connection between physical and mental health.
Outside of his professional life, Dr Barrios is passionate about kettlebell training, which helps him maintain my physical and mental wellness. He cherishes visiting his family in Guatemala, to reconnecting with his cultural roots and rejuvenating his spirit. Dr Barrios is also deeply involved in transcendental meditation and rucking, practices that not only provide him with tranquility but also keep him grounded and connected to nature. These hobbies reflect his commitment to a holistic approach to health, both personally and professionally.