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Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic, mental health disorder. It is a complex psychological condition that is characterized by pervasive instability in moods, emotions, behaviors, and interpersonal relationships which interfere with one’s ability to function in everyday life. It can be difficult to determine who will develop borderline personality disorder as the cause of BPD remains unknown. The National Institute of Mental Health (NIH) alludes to research that “suggests that genetics, brain structure and function, and environmental, cultural, and social factors play a role, or may increase the risk for developing borderline personality disorder.” BPD typically develops in early adulthood, often with more severe symptoms occurring in the early stages of onset.

Symptoms & Diagnostic Criteria

Borderline personality disorder directly affects how one feels about him or herself, one’s behavior as well as how an individual can relate to others. It is not uncommon for people with BPD to feel extremely intense emotions for extended periods of time. This makes returning to a stable emotional baseline far more challenging, especially after experiencing an emotionally triggering event. According to the DSM-5 key signs and symptoms of BPD may include:  

  • Unstable personal relationships that alternate between idealization and devaluation, sometimes referred to as splitting
  • Frantic efforts to avoid real or imagined abandonment by family and friends
  • Impulsive behaviors resulting in dangerous outcomes (e.g., engaging in unsafe sex, reckless driving, abuse of drugs, etc.)
  • Distorted and unstable self-image, affecting one’s moods, relationships, goals, values, and/ or opinions
  • Self-harming behavior (e.g., suicidal threats)
  • Chronic feelings of emptiness and/ or boredom
  • Periods of intense depressed mood, irritability and/ or anxiety lasting anywhere from a few hours to a few days long
  • Dissociative feelings
  • Intense, inappropriate, and/ or uncontrollable anger, typically followed by feelings of guilt and/ or shame

More specifically, the diagnostic criteria outlined in the DSM-5, indicates that to be clinically diagnosed with BPD an individual must experience five or more of the following symptoms, in a variety of contexts,

  1. Emotional instability
  2. Feelings of emptiness
  3. Efforts to avoid abandonment
  4. Impulsive behaviors
  5. Identity disturbances
  6. Inappropriate, irrational and/ or intense bouts of anger
  7. Transient paranoid and/ or dissociative symptoms
  8. Unstable interpersonal relationships
  9. Suicidal and/ or self-harming behaviors

Due to the quick changing nature of signs and symptoms associated with borderline personality disorder, it is notoriously known as a difficult to diagnose illness. The treatment for BPD often includes long-term participation in psychodynamic models of psychotherapy such as dialectical behavior therapy (DBT). DBT was developed by Marsha M. Linehan in the late 1980s, as a means to more effectively treat chronically suicidal individuals diagnosed with borderline personality disorder. It is an evidence-based psychotherapy that combines techniques from western cognitive behavioral therapy (CBT), psycho-educational modules, and eastern mindfulness-based practices to foster the systematic learning of new emotional coping skills. Since its inception, dialectical behavior therapy has been and remains the gold standard method of treatment for individuals diagnosed with BPD.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

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