Symptoms & Signs of Borderline Personality Disorder
Borderline personality disorder (BPD) is a serious mental health condition with an official definition that comes from an organization called the American Psychiatric Association. However, you or your loved one can have symptoms or show signs of the disorder without actually meeting all of the criteria needed to make an official diagnosis. In either situation, it’s important to recognize BPD’s effects and seek help as soon as possible.
A Broad Picture of the Condition
Before we look at the official definition of BPD, let’s take a broader look at all of the condition’s potential symptoms and signs. The three main problems present in people with borderline personality disorder are:
- Frequent involvement in unusually reckless or impulsive conduct
- Difficulty maintaining solid relationships with others
- Difficulty maintaining control over one’s thought processes and emotions
A broad range of symptoms can point to the existence of these problems. For example, common forms of impulsive conduct in people with BPD include binging on food, driving recklessly, going on major shopping binges, participating in risky sexual behavior and abusing drugs, alcohol or prescription medications. On the relationship front, you or your loved one may tend to fall into volatile relationships that swing back and forth between extreme affection and blatant hostility.
People with BPD may experience a wide variety of thought- or emotion-related problems. Relatively common examples of these problems include angry outbursts that seem to come out of nowhere, serious and unpredictable mood changes, strong fear of being abandoned by others and a sense of emptiness that occurs repeatedly over time, or never seems to go away at all. During stressful situations, a person with borderline personality disorder may experience bouts of paranoia. At the extreme end of possible symptoms, the condition may lead to loss of a sense of self or a complete break with reality. In addition, significant numbers of people with BPD physically injure themselves without planning to commit suicide, make actual suicidal plans or take active steps to commit suicide.
The Official BPD Definition
When doctors in the U.S. diagnosis borderline personality disorder, they use the American Psychiatric Association’s official criteria. According to the standards currently in place, you or your loved one must have extensive problems with emotions, self-image and interpersonal relationships, as well as exhibit reckless/impulsive behavior. These problems must occur in a range of situations; in addition, they must first appear in the early stages of adulthood. A person who qualifies for a BPD diagnosis must also have at least five out of nine specific symptoms. These symptoms are:
- “Frantic” attempts to avoid being abandoned, even in situations where there is no realistic threat of abandonment
- A clear pattern of volatile relationships that swing between extremes of love and hatred
- A clear and ongoing inability to create a stable identity
- Involvement in at least two forms of impulsive behavior that can lead to self-harm
- Repeated episodes of non-suicidal self-harming behavior, suicidal thinking or actual suicide attempts
- A sense of emptiness that lingers for extended periods of time
- Bouts of emotional instability that last for anywhere from several hours to several days
- Generally poor temper control or bouts of anger that don’t fit the current situation
- Bouts of paranoid thinking, disconnection from the self or disconnection from reality that occur in stressful situations
Why Do Doctors Look for Specific Symptoms?
There are some important reasons for counting the number of symptoms in people who show signs of borderline personality disorder. First, some of the disorder’s symptoms also occur in individuals affected by other mental health problems. If doctors only looked for a couple of signs of the illness, they could easily mistake other conditions for BPD (or vice versa). In turn, this could lead to an incorrect diagnosis and a course of treatment that doesn’t have any positive effects. Doctors can also use the number of symptoms present to tell the difference between relatively mild and severe cases of the disorder: A person with all nine BPD symptoms almost certainly has problems that are more serious than a person who only has five symptoms.
Doctors also pay close attention the specific symptoms experienced by you or your loved one. That’s because some of these symptoms are extremely serious even in people who don’t qualify for an official diagnosis. For example, whether or not you have borderline personality disorder, suicidal thinking and suicidal behavior are life-threatening issues that require immediate attention from a trained mental health professional.
National Institute of Mental Health: Borderline Personality Disorder http://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml#part_145389
Medscape: Borderline Personality Disorder