Signs and Symptoms of Borderline Personality Disorder

Are You Worried That You or a Loved One Have BPD?

Depressed woman sitting on steps
Learn about the signs and symptoms of borderline personality disorder. Angelika Schwarz/E+/Getty Images

If you are worried that you or a loved one may have borderline personality disorder (BPD), it's important to be informed about the illness and its symptoms. While some of the symptoms of BPD are not easily identified, others are associated with observable behaviors.

Borderline personality disorder symptoms include instability in interpersonal relationships, self-image, and emotion, as well as a pattern of impulsive behaviors.

Individuals with BPD often first experience these symptoms in young adulthood, and the symptoms tend to continue for many years. BPD may occur in both men and women.

Here are some signs and symptoms that may indicate you or your loved one need to be evaluated by a healthcare professional:

Fear of Abandonment

People with BPD tend to have difficulties in their relationships. In particular, people with BPD can be very sensitive to abandonment. They may believe they are being left by someone when that is not actually the case at all.

Since the fear of abandonment can be so strong and pervasive, people with BPD often engage in behaviors meant to provide reassurance that the other person still cares about them. For example, they may call someone on the telephone repeatedly asking for confirmation that the relationship is still intact or physically cling to others when they attempt to leave. Unfortunately, this scenario can be a double edged sword.

The more a person seeks reassurance that their relationship with another is "safe," the more likely they are to push that person away, sabotaging themselves in the process.

Unstable Relationships

BPD is often associated with patterns of very unstable and intense interpersonal relationships. A pattern of alternating between idealization and devaluation in relationships is common, a process referred to as "splitting." A relationship may start in the idealization phase with the person with BPD feeling intensely connected to and positive about the other person and wanting to spend a lot of time with this person.

When the devaluation phase emerges, however, the person with BPD may see the other person as worthless, mean or uncaring, and may attempt to distance herself from him or her.

In addition, a relationship with someone with BPD is commonly characterized by lots of conflict, ups and downs, mistrust, neediness, and frequent arguments. In fact, a person with BPD often feels disappointment in or even hatred towards loved ones. They also have difficult recognizing the feelings of others or empathizing with others. 

Impairment in Identity 

The same instability in relationships can also apply to self-image or sense of self. A person with BPD may seem to believe that she is successful one moment, but the next may be extremely self-denigrating or hard on herself. Her sense of self may also be unstable, which may lead her to behave differently in different contexts, such as behaving one way around one group of friends but another way entirely around another group.

In addition, a person with BPD may feel nonexistent or unsure about their identity or role (for example, feeling like you don't know who you really are as a person, or what you believe in.)

Impulsivity

Many people with BPD exhibit risky impulsive behaviors, such as:

  • Spending sprees
  • Having promiscuous sex
  • Driving recklessly
  • Abusing drugs or alcohol
  • Binge eating
  • Breaking the law (for example, shop lifting)

These impulsive behaviors, in turn, often lead to problems with relationships, physical health, or legal issues.

Self-Harm or Suicide Behaviors

Some individuals with BPD may engage in self-harming behaviors and some make suicidal gestures or attempts.

Self-harming behaviors and suicidal gestures are actually separate issues—self-harming behaviors are not attempts to commit suicide. Self-harming behaviors (self-mutilation) are attempts to get rid of emotional pain or intensely uncomfortable feelings.

People who self-harm rarely do so when others are present. Yet you may see signs of self-harm, including scarring or wounds from cutting, burning, or other forms of self-injury.

People with BPD may also threaten suicide and may make suicide attempts. Such threats or attempts should be taken very seriously. It's thought that roughly 70 percent of people with borderline personality disorder will make at least one suicide attempt during their life, and for nearly 10 percent of people with BPD, the attempt will be successful. If you are thinking that you or a loved one may have BPD, write down the number for the National Suicide Prevention Hotline before you leave this page.

Emotional Instability

Although this is not always something that can be observed from the outside, people with BPD tend to have intense and frequent mood changes that usually occur in response to something happening in the environment. A person with BPD may go from seemingly content to feeling upset in a matter of minutes or even seconds. She (or he, as men may have BPD as well) may also experience intense negative feelings in reaction to day-to-day situations and/or intense sadness or irritability that can last for hours.

 Feelings of Emptiness

A person with BPD often feels a chronic sense of emptiness, like there is nothing inside or that they are emotionally dead. This chronic feeling that life is of little worth can lead to behaviors marked by emotional drama (such as hysteria, raging, and more) in order to attract attention through a crisis. It's important for loved ones to understand the origins of these behaviors, as common reactions only serve to increase these feelings of hollowness for a person with BPD.

Intense Anger and Aggressive Behavior

People with BPD tend to feel intense anger that is stronger than the situation warrants. Some people with BPD experience intense anger that they rarely or never express outwardly. Others express anger openly, sometimes in the form of physical aggression. Angry behavior, ranging from sarcastic comments to physical violence against other people, is a common sign of BPD. 

A Word From Verywell

It is important to remember that some of the symptoms described above are experienced by many people from time to time. However, people with BPD experience several of these symptoms daily or almost every day for years.

Also, people with BPD experience these symptoms across different contexts. For example, they will experience instability in many relationships, not just one or two or even three.

If you think you may have BPD, it is important to see a licensed mental health professional who can listen to your concerns and make an accurate diagnosis. You may feel discouraged after reading about the signs and symptoms and how they affect nearly every aspect of a person's life. Treatment with a good mental health professional, however, can help both those suffering with BPD and their family and friends manage the symptoms and underlying basis of the condition.

If You are Concerned About Yourself

If you are concerned that you may have BPD yourself, please understand that we realize where the behaviors that are signs and symptoms of BPD originate. Those who are educated in BPD understand that annoying actions like repeated phone calls are your attempt to cope with a fear of abandonment. Going from seeing someone as wonderful to despising them may leave friends confused, yet it is a protective mechanism your mind enacts to try and keep you from being hurt. Finding a good therapist can make a world of difference for people living with this condition. Many of the issues that now make you see red can be coped with much more easily when you recognize them for what they are. A good therapist can help you discover and learn to cope with your triggers and help you develop healthy coping skills.

If You are Concerned About a Family Member or Friend

If you landed on this page because you are wondering whether a friend or family member may have BPD, keep in mind that help is available. That said, if you have watched your friend value and then devalue other friends, you may be wondering when it will be your turn. You may be worried that if you open your mouth, you will be the next one to be "devalued" and labeled the black sheep. Take a moment to learn about how to cope when a loved one with BPD is "splitting." Family therapy can be very helpful. The important point to make is that BPD can affect anyone involved, and it's important to care for yourself as well as your loved one.

Sources:

Crowell, S. Biting the Hand That Feeds: Current Opinion on the Interpersonal Causes, Correlates, and Consequences of Borderline Personality Disorder. F1000Research. 2016. 5:2796.

Diagnostic and statistical manual of mental disorders DSM-5. Arlington, VA, American Psychiatric Association, 2013.

Scott, L., Wright, A., Beeney, J. et al. Borderline Personality Disorder Symptoms and Aggression: A Within-Person Process Model. Journal of Abnormal Psycholgoy. 2017 Apr 6. (Epub ahead of print).

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