Borderline Personality Disorder

Borderline personality disorder is a personality disorder that is characterized by a recurring, long-standing pattern of having unstable relationships with others — romantic, friendships and with family members. It’s marked by impulsivity in decision-making. People with borderline personality disorder often swing from one emotion to another easily and quickly, and their self-image changes just as often.

If there’s an overarching defining characteristic of someone who suffers from borderline personality disorder, it’s that they often seem like they are ping-ponging back and forth between everything in their life. Relationships, emotions, and self-image change as often as the weather, in reaction to something happening around them, such as stress, bad news, or a perceived slight. They rarely feel satisfaction or happiness in life, are often bored and filled with feelings of emptiness.

The term “borderline” means in-between one thing and another. Originally, this term was used when the clinician was unsure of the correct diagnosis because the client manifested a mixture of neurotic and psychotic symptoms. Many clinicians thought of these clients as being on the border between neurotic and psychotic, and thus the term “borderline” came into use.

The term “borderline” has sometimes been used in a number of ways in society that are quite different from the formal diagnostic criteria for borderline personality disorder (BPD). In some circles, “borderline” is still used as a “catch-all” diagnosis for individuals who are hard to diagnose or is interpreted as meaning “nearly psychotic,” despite a lack of empirical support for this conceptualization of the disorder.

Additionally, with the recent popularity of “borderline” as a diagnostic category and the reputation of these clients as being difficult to treat, “borderline” is often used as a generic label for difficult clients — or as a reason (or excuse) for a patient’s psychotherapy going badly.

Symptoms of Borderline Personality Disorder

There are nine primary symptoms associated with borderline personality disorder (a person needs to have at least 5 of these to qualify for a diagnosis):

  • Frantic efforts to avoid real or imagined abandonment
  • A pattern of unstable, intense interpersonal relationships characterized by alternating between extremes of idealizing others, to de-valuing them.
  • A disturbance in their identity, such as a significant and persistent unstable self-image or sense of self
  • Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
  • Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
  • Emotional instability due to an ever-changing mood (e.g., intense episodes of depression, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
  • Chronic feelings of emptiness
  • Inappropriate, intense anger, or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
  • Transient, stress-related paranoid thoughts or severe dissociative symptoms

You can learn more details about these symptoms of borderline personality disorder now.

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