consistently intense and unstable relationships with other people, alternating between idealising them and devaluing them. persistently distorted self-image or sense of self. at least 2 impulsive behaviours that are potentially self-damaging. ongoing self-harming behaviour, suicidal behaviour or threats.
Personality disorders, including borderline personality disorder, are diagnosed based on a: Detailed interview with your doctor or mental health provider. Psychological evaluation that may include completing questionnaires. Medical history and exam.
Signs and symptoms
An unstable sense of self with poor ability for self-direction and impaired ability to pursue meaningful short-term goals with satisfaction. Marked instability in functioning, affect, mood, interpersonal relationships, and, at times, reality testing. Disturbances in empathy and intimacy.
Impulsive and risky behavior, such as gambling, reckless driving, unsafe sex, spending sprees, binge eating or drug abuse, or sabotaging success by suddenly quitting a good job or ending a positive relationship. Suicidal threats or behavior or self-injury, often in response to fear of separation or rejection.
BPD, Depression, and Dysthymia
One argument in favor of BPD as a form of major depression was based on the frequency of family history of depression in BPD patients. However, impulsive disorders, such as substance abuse and antisocial personality, are actually more common in families than mood disorders.
If left untreated, the person suffering from BPD may find themselves involved with extravagant spending, substance abuse, binge eating, reckless driving, and indiscriminate sex, Hooper says. The reckless behavior is usually linked to the poor self-image many BPD patients struggle with.
Borderline personality disorder (BPD) can be hard to diagnose because the symptoms of this disorder overlap with many other conditions, such as bipolar disorder, depression, anxiety, and even eating disorders.
You might also experience BPD without having any history of traumatic or stressful life events. Or you might have had other types of difficult experiences. If you already experience some of these difficulties, then experiencing stress or trauma as an adult could make things worse.
According to the DSM-5, BPD can be diagnosed as early as at 12 years old if symptoms persist for at least one year. However, most diagnoses are made during late adolescence or early adulthood.
Separations, disagreements, and rejections—real or perceived—are the most common triggers for symptoms. A person with BPD is highly sensitive to abandonment and being alone, which brings about intense feelings of anger, fear, suicidal thoughts and self-harm, and very impulsive decisions.
If your doctor suspects BPD, they may refer you to a psychiatrist or psychologist for diagnosis and treatment – this may be through your local public mental health service. There are no specific tests that can help confirm the diagnosis of BPD.
Antipsychotics are widely used in BPD, as they are believed to be effective in improving impulsivity, aggression, anxiety and psychotic symptoms [Nose et al. 2006; American Psychiatric Association, 2001].
BPD has been linked to the amygdala and limbic systems of the brain, the centres that control emotion and, particularly, rage, fear and impulsive automatic reactions.
That's not true! Although it is not caused by a chemical imbalance in the brain, such as what happens during a depressive episode, BPD does have biological foundations. BPD develops partly from having a highly sensitive nervous system.
People with BPD score low on cognitive empathy but high on emotional empathy. This suggests that they do not easily understand other peoples' perspectives, but their own emotions are very sensitive. This is important because it could align BPD with other neurodiverse conditions.
Key points. Mental health providers can be reluctant to diagnose BPD and other personality disorders due to diagnosis criteria, insurance, and stigma. Not diagnosing BPD, where appropriate, can adversely affect treatment. Traits of BPD can be communicated without formally diagnosing the full personality disorder.
Many mental health professionals offer a brief free consultation over the phone, though these calls typically needed to be scheduled in advance. Let the therapist know that you are interested in an assessment and treatment. Describe some of your symptoms. You can even mention that you think you may have BPD.
Additionally, relationship instability is a feature of BPD, and clinicians may be wary of patients with whom establishing a therapeutic bond could be difficult. They may also hold the mistaken belief that treatment is ineffective for BPD patients.
Researchers have used MRI to study the brains of people with BPD. MRI scans use strong magnetic fields and radio waves to produce a detailed image of the inside of the body. The scans revealed that in many people with BPD, 3 parts of the brain were either smaller than expected or had unusual levels of activity.
Borderline personality disorder (BPD) is a serious, long-lasting and complex mental health problem. People with BPD have difficulty regulating or handling their emotions or controlling their impulses.
Many people still believe that those living with it can be manipulative or dangerous due to their symptoms. While this can be the case in a very small minority of people, most people with BPD are just struggling with their sense of self and their relationships. It's important to note that we're not dangerous people.
It can be distressing for the person with borderline personality disorder and the people around them, and it is often misunderstood. It is the most common personality disorder in Australia, affecting about 1 to 4 in every 100 people at some time in their lives.
Many mental health professionals do not have a lot exposure or education on BPD, so it's easy for BPD to be misdiagnosed as something else such as bipolar disorder since both disorders involve shifting moods and periods of depression.