Have you ever wonder what are the symptoms of Borderline Personality Disorder - BPD?
The symptoms of BPD can show up in all aspects of your life — especially in your mood, behaviour, and self-image. But with the right treatment, they can become much easier to manage.
Each person’s experience with BPD is unique, but there are some common experiences many people with BPD can relate to — like having difficult feelings toward yourself and others, instability in your relationships and your view of yourself (self-image), and periods of anger, depression, or anxiety that can last for hours to days.
When considering the symptoms of Borderline Personality Disorder, Is also common to view things in extremes, such as only good or only bad. Many feelings and behaviours in BPD are based in a fear of abandonment or an effort to avoid being abandoned.
There’s a lot of misinformation and stigma around BPD, partly because of a historic idea that it’s untreatable — but this is not the case.
The truth is that BPD is treatable, and many people reach a point of “remission” with the help of therapy, especially dialectical behavioural therapy (DBT). This means they experience few to no BPD symptoms and may even no longer meet the criteria for BPD diagnosis.
Symptoms of BPD
The diagnostic criteria for BPD are listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to the DSM-5, you must have five or more of the following symptoms to receive a BPD diagnosis:
Frantic efforts to avoid abandonment, whether real or imagined.
A pattern of unstable and intense interpersonal relationships, which can include a tendency to see others as “all good” (idealization) or “all bad” (devaluation).
Identity disturbance, such as a significant and persistent unstable self-image or sense of self. You might feel like you don’t know who you really are, and your likes and dislikes might change often.
Impulsivity in at least two areas that are potentially self-damaging (such as spending, sex, substance use, reckless driving, or binge eating).
Recurrent suicidal ideation, suicidal actions, or self-harm behaviors.
Emotional instability, or turbulent, quickly changing emotions. Periods of intense anger, depression, or anxiety can last for hours to days.
Chronic feelings of emptiness.
Inappropriate, intense anger or difficulty controlling anger, which might lead to frequent displays of temper, arguments, or physical fights.
Transient, stress-related paranoid thoughts or severe symptoms of dissociation.
Many people use coping methods such as substance use or self-harm to deal with difficult emotions. Treatment plans aim to help you manage intense feelings and reduce distress so you resort to these methods less often.
Although people with BPD usually receive a diagnosis in early adulthood, they will likely have experienced certain BPD symptoms for years. This is partly because diagnosing a personality disorder requires medical professionals to look back at patterns that have formed over a long period.
It’s not common to receive a personality disorder diagnosis in childhood or adolescence because children and teens are still developing, maturing, and experiencing personality changes. For a diagnosis to occur in early life, the features must have been present for at least a year.
Like those of most personality disorders, BPD symptoms typically decrease in intensity with age. Many people with BPD might find that they have fewer symptoms by the time they’re in their 40s or 50s.
Note that the term “personality disorder” is controversial, and many people (clinicians included) reject this label because the term itself can be stigmatising.
Efforts to avoid abandonment
People with BPD are often very sensitive to what’s happening around them and to them. Many of the feelings and behaviours in people with this diagnosis result from an intense fear of abandonment. Even if you’re not truly being abandoned, the feeling is so strong that you can become very upset, angry, or distressed.
For example, you might feel very angry with a friend who is a few minutes late to a lunch date. If a loved one moves away, you might feel a strong sense of loss and personal rejection.
When something like this happens, your self-image might take a hit. You might automatically interpret the real or imagined abandonment to mean that you are worthless, bad, or even evil.
These abandonment fears are related to difficulty tolerating being alone and a need to have other people with you. Frantic efforts to avoid abandonment may include impulsive actions such as self-harm or suicidal behaviour.
Instability in your relationships
Unstable and intense personal relationships are a common experience in BPD and are the source of many challenges for people living with this diagnosis and their loved ones.
You might idealise potential friends, lovers, or caregivers at the first or second meeting, demand or insist on spending a lot of time with them, and share the most intimate details early in a relationship. However, you may switch quickly from idealising people to devaluing them and feeling like they don’t care enough, don’t give enough, or are not “there” enough.
You might experience sudden and dramatic shifts in your view of others, alternately seeing people as kindly supportive or cruelly punitive. These shifts reflect disillusionment with a caregiver whose nurturing qualities you had idealised or whose rejection or abandonment you expected.
Instability in your identity
Many people with a BPD diagnosis report feeling unstable in their identity. You might experience sudden and dramatic shifts in your self-image and frequent changes in your goals, opinions, values, career plans, sexual identity, or friends.
It’s common to have a self-image based around being bad, not good enough, or evil. You may also have periods when you feel very excited and positive. You might sometimes feel like you don’t exist at all.
What are the treatments for BPD?
While BPD can’t exactly be “cured,” there are many effective treatments and ways to manage the symptoms and reduce distress.
Psychotherapy
BPD treatment usually includes long-term psychotherapy with a therapist who has experience in treating people with symptoms like yours.
The most common type of psychotherapy suggested for people with BPD is DBT. This type of therapy is one of the most commonly prescribed treatments for BPD. It teaches you skills like self-awareness, mindfulness, distress tolerance, emotional regulation, and healthy relationship skills. It could include both one-on-one and group therapy.
Your therapist might also recommend cognitive behavioral therapy (CBT), a type of therapy that helps you become aware of patterns in your life, including harmful behaviour and thought patterns. CBT teaches you how to address those thoughts and feelings and react in a less harmful way.
Psychodynamic therapy uses principles of psychoanalysis to help you and your therapist identify and better understand certain patterns in your life that affect your relationships, emotions, thoughts, and behaviour.
Depending on your situation, another type of therapy might also be helpful for you. For more information about treatment, you can read Psych Central’s article on borderline personality disorder treatment.
Medication
There are no medications specifically made for BPD. However, other medications, such as antidepressants, may be helpful in managing some BPD symptoms. Mood stabilisers and low-dose antipsychotic medications may also help. However, not everyone who has BPD needs to use medication.
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