Borderline personality disorder (BPD) manifests in many different ways, but for the purposes of diagnosis, mental health professionals group the symptoms into nine major categories. In order to be diagnosed with BPD, you must show signs of at least five of these symptoms. Furthermore, these symptoms must be long-standing (usually beginning in adolescence) and pervasive across many areas of your life.
The 9 symptoms of BPD
Fear of abandonment. People with BPD are often terrified of being abandoned or left alone. Even something as innocuous as a loved one getting home late from work or going away for the weekend can trigger intense fear. This leads to frantic efforts to keep the other person close. You may beg, cling, start fights, jealously track your loved one’s movements, or even physically block the other person from leaving. Unfortunately, this behavior tends to have the opposite effect—driving others away.
Unstable relationships. People with BPD tend to have relationships that are intense and short-lived. You may fall in love quickly, believing each new person is the one who will make you feel whole, only to be quickly disappointed. Your relationships either seem perfect or horrible, with nothing in between. Your lovers, friends, or family members may feel like they have emotional whiplash from your rapid swings between idealization and devaluation, anger, and hate.
Unclear or unstable self-image. When you have BPD, your sense of self is typically unstable. Sometimes you may feel good about yourself, but other times you hate yourself, or even view yourself as evil. You probably don’t have a clear idea of who you are or what you want in life. As a result, you may frequently change jobs, friends, lovers, religion, values, goals, and even sexual identity.
Impulsive, self-destructive behaviors. If you have BPD, you may engage in harmful, sensation-seeking behaviors, especially when you’re upset. You may impulsively spend money you can’t afford, binge eat, drive recklessly, shoplift, engage in risky sex, or overdo it with drugs or alcohol. These risky behaviors may help you feel better in the moment, but they hurt you and those around you over the long-term.
Self-harm. Suicidal behavior and deliberate self-harm is 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 includes all other attempts to hurt yourself without suicidal intent. Common forms of self-harm include cutting and burning.
Extreme emotional swings. Unstable emotions and moods are common with BPD. One moment, you may feel happy, and the next, despondent. Little things that other people brush off can send you into an emotional tailspin. These mood swings are 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.
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, you may feel as if you’re “nothing” or “nobody.” This feeling is uncomfortable, so you may try to fill the hole with things like drugs, food, or sex. But nothing feels truly satisfying.
Explosive anger. If you have BPD, you may struggle with intense anger and a short temper. You may also have trouble controlling yourself once the fuse is lit—yelling, throwing things, or becoming completely consumed by rage. It’s important to note that this anger isn’t always directed outwards. You may spend a lot of time being angry at yourself.
Feeling suspicious or out of touch with reality. People with BPD often struggle with paranoia or suspicious thoughts about others’ motives. When under stress, you may even lose touch with reality—an experience known as dissociation. You may feel foggy, spaced out, or as if you’re outside your own body.
Common co-occurring disorders
Borderline personality disorder is rarely diagnosed on its own. Common co-occurring disorders include:
- depression or bipolar disorder
- substance abuse
- eating disorders
- anxiety disorders
When BPD is successfully treated, the other disorders often get better, too. But the reverse isn’t always true. For example, you may successfully treat symptoms of depression and still struggle with BPD.
Causes—and hope
Most mental health professionals believe that borderline personality disorder (BPD) is caused by a combination of inherited or internal biological factors and external environmental factors, such as traumatic experiences in childhood.
Brain differences
There are many complex things happening in the BPD brain, and researchers are still untangling what it all means. But in essence, if you have BPD, your brain is on high alert. Things feel more scary and stressful to you than they do to other people. Your fight-or-flight switch is easily tripped, and once it’s on, it hijacks your rational brain, triggering primitive survival instincts that aren’t always appropriate to the situation at hand.
This may make it sound as if there’s nothing you can do. After all, what can you do if your brain is different? But the truth is that you can change your brain. Every time you practice a new coping response or self-soothing technique you are creating new neural pathways. Some treatments, such as mindfulness meditation, can even grow your brain matter. And the more you practice, the stronger and more automatic these pathways will become. So don’t give up! With time and dedication, you can change the way you think, feel, and act.
Not all people with BPD are exactly alike and having BPD does not mean you are sick, unlikable,flawed or have some kind of illness or a bad personality.
