It is important to note that those with BPD are likely to have several, but not all the following symptoms. It is critical that self-diagnosis is not made, but instead a medical professional should be consulted if you have any concerns that you have BPD or any other mental health concern. Also note that many people who live with BPD are not aware they have (yet if affects up to 1 in 20 people) it and may not realize there’s a healthier way to behave and relate to others. Many people with this disorder get better over time with treatment and can learn to live satisfying lives.

• An intense fear of abandonment, even going to extreme or even frantic measures to avoid real or imagined separation or rejection by friends, family or loved ones.  It’s common for people with BPD to feel uncomfortable being alone. When people with BPD feel that they’re being abandoned or neglected, they feel intense fear or anger. They might track someone close to them or try to prevent them from leaving. In other cases, they may preemptively push people away to reduce the chances of rejection.
• Wide mood swings lasting from a few hours to a few days, which can include intense depression, happiness, irritability, shame, anxiety, fear, hatred, sadness and love.
• Inappropriate, intense or uncontrollable anger, such as frequently losing your temper, being sarcastic or bitter, or having physical fights, often followed by shame and guilt.
• Unstable personal relationships that alternate between idealization (“I’m so in love!”) and devaluation (“I hate her”). This is also sometimes known as “splitting.” Strong, up-and-down relationships with family and friends often can go quickly from very close to anger and hatred.
• Black and white thinking.  If most of your thoughts break down to black or white, good or bad, and all or nothing, then it is possible that you have a strong tendency towards dichotomous thinking.
• Rapid changes in self-identity which affects moods, values, opinions, relationships, and seeing yourself as bad or as if you don’t exist at all. A distorted or unclear self-image is common. People with BPD often feel guilty or ashamed and see themselves as “bad.”
• Impulsive behaviors that can have dangerous outcomes, such as excessive spending, gambling, unsafe sex, reckless driving, or misuse or overuse of substances, binge eating, fighting, drug abuse, or sabotaging success by suddenly quitting or getting fired from a good job, ending a positive relationship, or fail a test on purpose.
• Chronic feelings of boredom or emptiness. Feeling sad, bored, unfulfilled or “empty” is common, as well as feelings of worthlessness and self-loathing are common, too.
• Dissociative feelings—disconnecting from your thoughts or sense of identity or “out of body” type of feelings—and stress-related paranoid thoughts. Severe cases of stress can also lead to brief psychotic episodes.
• Periods of stress-related paranoia and loss of contact with reality, lasting from a few minutes to a few hours, sometimes even resulting in hallucinations, usually the result of extreme stress or leaving by a loved one.
• Suicidal threats or behavior, self-injury, or self-harming behaviors such as cutting, hair pulling, or burning, often in response to fear of separation or rejection by a caregiver or loved one.

Risk Factors for BPD

• Abuse: The person has suffered from physical abuse, emotional abuse, sexual abuse, or neglect usually as a child.
• Attachment: Experienced an early loss or attachment of a caregiver, usually maternal, such as:
  • losing one’s birth parents via adoption,
  • experienced the death of a parent,
  • a parent leaving home (due to divorce, job, etc…) or other separation
  • poor maternal attachment
  • inappropriate family boundaries
  • parental substance use disorder
• Genetics: There is a higher tendency of BPD to run in families.
• Brain changes: In people with BPD, the parts of their brain that control emotion and behavior don’t communicate properly

Common Therapeutic Treatments

Studies of effectiveness of treatment have been researched, and the body of evidence indicates an increasing successful recovery rate of borderline personality disorder.

• Cognitive behavioral therapy. This gives you tools to help change your thoughts and actions.
• Dialectical behavior therapy. This helps you to be more aware of the current moment. It teaches you how to reduce extreme emotions and actions.
• Schema-focused therapy. This helps you change how you see yourself. It helps you turn negative views into more positive ones.
• Systems Training for Emotional Predictability and Problem Solving, or STEPPS. This trains you to use tools to manage your reactions to certain situations. Family and friends are also trained.
• Transference-Focused Therapy for Borderline Personality Disorder
• Mentalization-Based Treatment for Borderline Personality Disorder