Like most mental health issues, there are no lab tests or medical assessments that can effectively identify borderline personality disorder. Instead, BPD is diagnosed through a clinical and psychological evaluation. Since BPD shares some traits with dissociative and mood disorders, diagnosing it can be difficult. If you’re struggling with a mental health issue, it’s important to work with your doctor or therapist to get the best diagnosis for your needs. It may take several visits with a therapist to identify complex issues like BPD. To help identify BPD, the DSM-5 outlines nine signs that are common in the disorder. In order to definitely qualify as having BPD, you need to have experienced five of the nine traits. Personality disorder symptoms are usually present for long periods of time and may occur from childhood. They don’t usually start for the first time after a recent event.
Avoiding abandonment. BPD can cause an extreme fear of abandonment that causes people with the disorder to experience anxiety and take extreme steps to avoid abandonment.
Unstable and intense personal relationships. With this disorder, you may experience a string of unstable relationships. You may idealize and devalue the people around you and switch between the two quickly. Relationships often feel like rollercoasters of intense passion and anger.
Unstable self-image. This can affect your self-worth or your sense of who you are. You may alter your image by changing your style of dress or hair. This is referred to as an identity disturbance.
Impulsivity. You may act quickly without thinking about what you’re doing or the potential consequences. This can cause dangerous consequences like overspending, substance misuse, binge eating, and risky sexual behavior.
Suicidal or self-harm behavior. Self-harm and suicidal behavior are common in BPD. It often manifests as a cry for help or as an extreme measure to avoid abandonment. Even when self-harm is meant to get the attention of someone else, it may unintentionally lead to a fatality.
Unstable moods. Moods may shift from intense sadness to anger or another emotion very quickly and intensely.
A lasting feeling of emptiness. Emptiness is characterized by feelings of sadness, boredom, or a lack of fulfillment. It may contribute to impulsive attempts to fill up the feeling of emptiness.
Inappropriate emotional expression. BPD can cause extreme expressions of mood and emotions that are inappropriate to the situation. For instance, small problems can cause an angry outburst or bitter tears.
Stress-induced paranoia. High-stress situations can cause brief periods of paranoid delusions. Paranoia is often centered on the fear of abandonment. It can also cause dissociative episodes.