Borderline Personality Disorder (BPD) is a serious mental health condition in which a person has significant difficulty managing their emotions and behavior.

Men and women with BPD often experience fear of rejection or separation, unstable self-image, anxiety, and mood changes. These inner feelings may result in impulsive actions including self-harm, and dangerous and/or suicidal behavior. Heightened emotional sensitivity is common, and people with BPD typically respond angrily to perceived slights. Personal relationships are commonly turbulent. External environmental stressors intensify these symptoms.

While this condition is serious, it is important to note that BPD is highly treatable. With compassionate, evidence based treatment, frequency and intensity of these symptoms are typically reduced. The condition is still underdiagnosed and misdiagnosed, however awareness, research, and treatment availability are rapidly advancing each year.

The borderline individual is faced with an apparently irreconcilable dilemma. On the one hand, she [he] has tremendous difficulties with self-regulation of affect and subsequent behavioral competence. She frequently but somewhat unpredictably needs a great deal of assistance, often feels helpless and hopeless, and is afraid of being left alone to fend for herself in a world where she has failed over and over again. Without the ability to predict and control her own well-being, she depends on her social environment to regulate her affect and her behavior. On the other hand, she experiences intense shame at behaving dependently in a society that cannot tolerate dependency, and has learned to inhibit expressions of negative affect and helplessness whenever the affect is within controllable limits. Indeed, when in a positive mood, she may be exceptionally competent across a variety of situations. However, in the positive mood state she has difficulty predicting her own behavioral capabilities in a different mood, and thus communicates to others an ability to cope beyond her capabilities. Thus, the borderline individual, even though at times desperate for help, has great difficulty asking for help appropriately or communicating her needs.

Marsha Linehan, PhD

Characteristics of BPD

In order to be diagnosed with BPD, one must show signs of at least five of the following symptoms:

  1. Fear of abandonment. People with BPD are often terrified of being abandoned or left alone. Even something as innocuous as a loved one arriving home late from work or going away for the weekend may trigger intense fear. This can prompt frantic efforts to keep the other person close.
  2. Unstable relationships. People with BPD tend to have relationships that are intense and short-lived. Relationships either seem perfect or horrible, without any middle ground.
  3. Unclear or shifting self-image. With BPD, one’s sense of self can be unstable. People may not have a clear idea of who they are or what they want in life. As a result, they may frequently change jobs, friends, lovers, religion, values, goals, or even sexual identity.
  4. Impulsive, self-destructive behaviors. People BPD may engage in harmful, sensation-seeking behaviors, especially when emotionally upset. One may impulsively spend money he/she can’t afford, binge eat, drive recklessly, shoplift, engage in risky sex, or over indulge in drugs or alcohol.
  5. Self-harm. Suicidal behavior and deliberate self-harm are common in people with BPD. Suicidal behavior includes thinking about suicide, making suicidal gestures or threats, or actually carrying out a suicide attempt. Self-harm encompasses all other attempts to hurt yourself without suicidal intent.
  6. Extreme emotional swings. Unstable emotions and moods are common with BPD. Mood swings can be intense, but they tend to pass fairly quickly (unlike the emotional swings of depression or bipolar disorder), usually lasting just a few minutes or hours.
  7. Chronic feelings of emptiness. People with BPD often talk about feeling empty, as if there’s a hole or a void inside them. At the extreme, they may feel as if they’re “nothing”.
  8. Explosive anger. With BPD, one may struggle with intense anger and/or a short temper. This anger can be extremely difficult to manage, and it can often result in yelling, throwing things, or becoming completely consumed by rage. It’s important to note that this anger isn’t always directed outwards, and can be focused on inward on one’s self.
  9. Feeling suspicious or out of touch with reality. People with BPD often struggle with paranoia or suspicious thoughts about others’ motives. When under stress, one may even lose touch with reality—an experience known as dissociation. Sensations of feeling foggy, spaced out, or as if outside one’s own body may occur.

For more information, please visit the National Educational Alliance for Borderline Personality (NEABPD) website.