What Is Borderline Personality Disorder (BPD)? Symptoms, Causes, Diagnosis, Treatment, and Prevention

BPD causes people to experience intense emotions, which can make them feel insecure and cause them to act irrationally. This behavior is often seen in their relationships: Someone could be considered a close friend one day and an enemy the next day. (6)

“It’s really a relationship disorder — relationships can’t be functional, and that’s the trigger and pinpoint,” says Bethany Kassar, a licensed clinical social worker and addiction counselor based in Ambler, Pennsylvania.

Signs and symptoms include: (2,3)

• An extreme, often irrational fear of abandonment and extreme efforts to avoid experiencing it
• Intense, unstable relationships (going from extremely loving someone to despising them completely)
• A negative self-image (thinking they’re bad or worthless) and an unstable sense of self
• Risky or impulsive behavior (drug abuse, unsafe sex, reckless spending, gambling)
• Self-harm through injury (for example cutting) or suicide attempts
• Severe mood swings that can last a few hours or a few days
• Having problems controlling anger and outbursts
• Chronic feelings of emptiness
• Feeling disconnected from thoughts or feelings
• Experiencing paranoia or loss of reality caused by stress
• Having a lack of direction (constantly changing goals)

Anyone experiencing signs and symptoms of BPD should talk to a doctor about it. There isn’t a test or screening for BPD, so getting a diagnosis can take time and a careful evaluation. A doctor will meet with you to discuss symptoms and may also talk to your previous doctors or ask to interview friends and family about your behavior in relationships. (2)

BPD isn’t usually diagnosed in children because young people’s personalities and traits are still developing, although experts do watch for signs early in adolescence. (7) Many people get a diagnosis in young adulthood, around age 18.

To diagnose BPD, a mental health professional (such as a psychiatrist, a psychologist, a therapist, or a licensed clinical social worker) will do the following: (6)

• Interview you and ask about your symptoms
• Discuss your family medical history (specifically if there’s a history of mental illness)
• Perform a medical exam to make sure your symptoms aren’t due to another medical condition

Learn More About the Symptoms of BPD and How It’s Diagnosed