5 Common Symptoms Of Borderline Personality Disorder

What are the nine main symptoms of BPD?

Symptoms of bipolar disorder (BPD) vary in intensity and frequency. Some people may not experience all of them and some might. Despite these fluctuations between individuals, there are some primary symptoms common to BPD:

1. Intense fear of isolation/abandonment. 

People with BPD may experience extreme fear when left alone unexpectedly. This can result in problematic behaviors such as begging, inconsolable crying, and starting fights or physically preventing the individual from leaving. 

2. Tumultuous relationships. 

Intense and unstable relationships are common for people with BPD. They may fall in love quickly and form attachments early, but it typically doesn’t take long before their rapid mood swings affect the relationship. They may experience “all-or-nothing” feelings that oscillate between idealization and depreciation, eventually leading to resentment and anger—often from both parties. 

3. Unstable identity/sense of self.

Dramatic fluctuations in how they feel about themselves can be a problematic symptom for people with BPD. For example, one minute, the individual feels confident and good about themselves; the next, they may experience inner disdain and worthlessness. This instability of self may cause individuals to cycle quickly through jobs, religions, goals, friendships, and romantic partners. 

4. Self-destructive, erratic behaviors. 

People with BPD may engage in risky behaviors such as binge eating, excessive substance use, theft, risky sex, or reckless driving. Often, these behaviors accompany tumultuous mood swings. 

5. Self-harming behavior/suicidal ideation. 

Suicidal behavior or deliberate self-harm is also somewhat common for people with BPD. They may think about suicide, make threats of suicide, or attempt suicide. These behaviors may include intentional self-harm, such as cutting or self-mutilation without suicidal intent. 

If you or someone you know is having thoughts of suicide, reach out to the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) immediately for help. 

6. Dramatic mood swings. 

People with BPD may feel elated one minute and then depressed the next. They typically have difficulty controlling their emotions triggered by an unpleasant event (or an event perceived as unpleasant), such as a contentious conversation or social slight. These types of mood swings often pass pretty quickly and usually last for anywhere from a few minutes to a few hours.

7. Chronic feelings of existential emptiness. 

People with BPD may have feelings of self-deprecation and emptiness as if they have a “hole” inside them. As a result, they may engage in self-destructive, sensation-driven behaviors such as drug and alcohol use, casual sex, or overeating. 

8. Rage or intense feelings of anger and irritability.

A short temper is a common trait of someone with BPD. They may struggle with controlling their feelings of intense anger and, as a result, engage in rage-driven behaviors like shouting and destroying things. The anger can be directed outwardly at someone else or inwardly at oneself. 

9. Paranoid delusions and dissociation.  

In extreme cases of BPD, people may experience paranoia and become suspicious of other people’s motives. They may also experience dissociation characterized by sensations of disconnection from reality and feeling as if they’re outside of their bodies during times of stress. 

What are the main early signs of borderline personality disorder?

Early signs of borderline personality disorder typically manifest differently depending on the individual, but many people encounter them in late adolescence or the early 20s. Borderline personality disorder diagnosed early can reduce some of the long-term symptoms associated with the condition.

One may have dramatic mood swings, including intense anxiety, happiness, irritability, and shame. Some may experience uncontrolled anger or irritation, physical fighting, and verbal altercations. Feelings of emptiness and extreme sadness may emerge as well. 

Is borderline personality a mental illness?

Yes, borderline personality disorder is classified as a cluster B personality disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Cluster B disorders are characterized by erratic, self-destructive behaviors and intense shifts in emotional state. One with a cluster B disorder may behave dramatically and impulsively and experience paranoia and delusions. 

Why do people get BPD?

BPD is likely caused by a combination of risk factors such as neurological dysfunction, chemical imbalance, abnormal brain development, or genetic predisposition. Environmental factors may also play a part-- such as severe neglect during childhood, abuse, exposure to chronic distress and fear as a child, or growing up with another family member/caregiver with a severe mental health condition or substance use disorder. 

How does someone with BPD think?

People with BPD often have multiple forms of distorted thinking and perceptions of the world around them. These may include paranoia, dissociation, and intense “black-or-white” thinking. They may think they’ll be abandoned by loved ones and have difficulty coping with the intense emotions that usually accompany those beliefs. 

What is a BPD favorite person?

A BPD’s favorite person is usually a close partner, friend, or family member. They can also be an advocate like a coach, teacher, or someone in mental health services like a counselor or therapist. They often rely on this individual for emotional support, comfort, and security, and they feel happiest when they’re with this person. 

The relationship with the favorite person may be healthy at first but become unstable due to the problematic behaviors expressed by some with BPD. For example, they may require constant attention and validation from their favorite person to the point of “neediness” due to feelings of insecurity and fear of abandonment. 

Other favorite person relationships can be toxic from the beginning if the individual already has difficulty handling stress, a tendency towards interpersonal dysfunction, an unhealthy attachment style, or a substance use disorder.

When do borderline symptoms start?

Borderline symptoms typically emerge in late adolescence or early adulthood, but there are cases when BPD appears in early childhood. 

Does BPD go away?

BPD is a chronic condition without a cure. While it won’t “go away,” symptoms aren’t always lifelong and can be significantly managed with psychotherapy and medication if necessary. A combination of therapeutic techniques may be required to treat borderline personality disorder, including, but not limited to, group and individual dialectical behavior therapy (DBT), cognitive behavioral therapy (CBT), and mentalization-based therapy (MBT). 

It’s prudent to note that borderline personality disorder treated through therapy and medication may take one year or longer for some individuals. 

How do you get tested for BPD?

Testing for BPD typically requires a thorough assessment by a licensed mental health professional. The process may include

• An in-depth interview using the Diagnostic Interview for Borderlines (DIB) and other tools to assess the patient’s cognitive symptoms, affect, interpersonal functioning, and impulse control. 
• A review of the patient’s medical history, including family medical history.
• A physiological exam to rule out potential physical causes of symptoms.
• Interviews with friends, family, and loved ones if necessary. Interviews like these are often used to obtain information about the patient’s symptoms from the perspective of someone who knows them intimately. 

After the assessment period, the mental health provider will typically review the criteria set forth by the DSM-V. According to the DSM-V, the patient must experience at least five of the nine symptoms common to BPD. 

People developing borderline personality disorder may also experience comorbidities such as eating disorders, other types of personality disorder, post-traumatic stress disorder, and substance use disorder. These co-occurrences are typically discovered during the testing and diagnostic process and factored into the treatment plan accordingly.

Does someone with BPD have empathy?

Despite symptoms that may indicate otherwise, people with BPD do have emotional and cognitive empathy— in fact, studies suggest that some may experience an enhanced sense of empathy. The ability to feel and express empathy differs between individuals and may fluctuate depending on symptoms.