Borderline Personality Disorder For Dummies
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Knowing whether you or someone you know has borderline personality disorder (BPD) requires careful scrutiny and input from a trained mental health professional. However, even professionals struggle with making this diagnosis because the symptoms of BPD vary dramatically from person to person.

In a way, BPD is similar to the countless breeds of dogs that exist today. For example, cocker spaniels, terriers, Bernese mountain dogs, pit bulls, Russian wolfhounds, golden doodles, mutts, and Chihuahuas differ strikingly from each other, but they’re all dogs. Likewise, people with BPD don’t share all the same symptoms, but they do all have the same disorder.

BPD symptoms © Xandra R /

People who suffer from BPD experience a range of symptoms, which mental health professionals group into nine major categories. Currently, to be diagnosed with BPD, you must show signs of at least five of these nine symptoms.

1. Sensation seeking (impulsivity)

To count as a sign of BPD, this sensation-seeking symptom has to involve a minimum of two types of impulsive, self-destructive behaviors. Impulsive people tend to act without thinking of the consequences. These impulsive behaviors trigger adrenaline rushes and intense excitement and include the following:
  • Sexual acting out
  • Substance abuse
  • Uncontrolled spending sprees
  • Binge eating
  • Reckless behavior, including
    • Highly aggressive driving
    • Extreme sports
    • Shoplifting
    • Destruction of property
The impulsive behaviors we’re talking about here are both risky and self-damaging. They often endanger the lives and well-being of the people who exhibit them. For instance, sexual acting out may consist of frequent, casual, unprotected sexual encounters with complete strangers, which can lead to STDs or unwanted pregnancies.

Uncontrolled spending sprees can involve numerous, unnecessary purchases that max out credit cards and pile up debt. Shoplifting often involves stealing items strictly for excitement and can lead to jail time.

The tendency to act impulsively is thought to be predisposed by inherited influences. Impulsivity often shows up early in life and continues throughout childhood, adolescence, and adulthood. However, it can be influenced by experiences and learning. In addition, some impulsivity can be treated with medication.

2. Self-harm

Self-harm is a particularly common and conspicuous symptom in people with BPD. People who exhibit this symptom may threaten or attempt suicide and do so often. Others may deliberately burn themselves with cigarettes, slice their arms with sharp blades, bang their heads, mutilate their skin, or even break bones in their hands or bodies. Although this symptom is separate from sensation seeking, it also involves a certain level of impulsivity. People who exhibit this symptom have to be impulsive enough to try to kill themselves again and again.

A common misperception is that suicidal threats rarely lead to real suicide attempts. You should take any threat of suicide by a person (whether he’s suffering from BPD or not) seriously and seek professional help immediately.

3. Roller coaster emotions

People with BPD experience extreme emotional swings. They may feel on top of the world one moment and plunge into deep despair the next. These mood swings are intense but usually transient, lasting only a few minutes or hours. The emotional flip-flops often occur in response to seemingly trivial triggers.

For example, a co-worker passes by someone with BPD in the hallway without acknowledging her. This unintentional and misinterpreted slight can spark powerful anxiety and distress in the person with BPD. That emotional distress can lead someone with BPD to overreact. Most people who are in a relationship with someone who has BPD find these mood swings quite difficult to understand or accept.

4. Explosiveness

Dramatic bouts of anger and rage frequently plague people with BPD. Again, the events that trigger these rages may seem inconsequential to other people. As you can imagine, these explosions often wreak havoc in relationships and may even result in physical confrontations. People with BPD sometimes end up in legal entanglements because of their outrageous behavior. Road rage is a good example of this symptom of BPD, although not everyone who exhibits road rage has BPD.

5. Worries about abandonment

People who exhibit this symptom obsess over the fear that a loved one will leave them. Their terror over abandonment may cause them to appear clingy, dependent, and outrageously jealous. For example, a husband with BPD may check his wife’s cellphone logs, e-mails, and car odometer readings daily, always looking for evidence of infidelity. Paradoxically, the obsession with keeping loved ones close usually drives them away.

To reduce anxiety over the possibility of abandonment, those with BPD often seek reassurance from their friends and loved ones. They may ask, “Do you still love me?” numerous times per day. They may feel terror over perceived criticism or slights, assuming it means they’re no longer cared about. If it’s even possible that some action could imply rejection, they’re likely to perceive it as such. This constant fear leads to much unwanted suffering on the part of the person with BPD.

6. Unclear and unstable self-concept

This symptom describes a failure to find a stable, clear sense of identity. People who exhibit this symptom may view themselves highly favorably at times, yet, at other times, they exude self-disdain. They often have little idea of what they want in life and lack a clear sense of values or purpose. Frequent changes in jobs, religion, or sexual identity may reflect shifting values and goals. Navigating life without a clear self-concept is like trying to find your way across the ocean with no compass.

7. Emptiness

Many people with BPD report feeling painfully empty inside. They have overwhelming cravings for something more, but can’t identify what that something more is. They feel bored, lonely, and unfulfilled. They hunger for something that could give them a sense of purpose or direction. They may attempt to fill their needs with superficial sex, drugs, or food, but nothing ever seems truly satisfying—they feel like they’re trying to fill a black hole.

8. Up-and-down relationships

Relationships involving people with BPD resemble revolving doors. People with BPD often see other people as either all good or all bad, and these judgments can flip from day to day or even from hour to hour.

People afflicted with BPD often fall in love quickly and intensely. They place new loves on pedestals, but their pedestals collapse when the slightest disappointments (whether real or imagined) inevitably occur. People in relationships with people who have BPD (whether they’re lovers, co-workers, or friends) experience emotional whiplash from the frequent changes from idolization to demonization. As a result, many people find difficulty in maintaining meaningful relationships with those who have BPD.

People with BPD can be highly interesting, exciting, creative, and fun to be with. We’re not implying that long-term relationships with them never work out. With work, patience, and understanding, relationships can sometimes be maintained and enjoyed.

9. Dissociation: Feeling out of touch with reality

Professionals describe dissociation as a sense of unrealness. People who feel dissociated or out of touch with reality say they feel like they’re looking down at themselves and watching their lives unfold without being a real part of them.

When people with BPD lose touch with reality, they usually don’t do so for long periods of time. But sometimes when they lose touch with reality, they hear voices telling them what to do. At other times, they may suffer from intense, unwarranted mistrust of others.

As you can no doubt see, these signs and symptoms overlap and feed on each other. Thus, if someone explodes with little or no provocation, demonstrates unusual moodiness, and clings excessively to his loved ones, you can understand why that person’s relationships suffer. And when relationships go poorly, self-concept can plummet.

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