Signs of Borderline Personality Disorder

What Signs of BPD Should Friends and Family Look For?

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If you are worried that a friend or 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.

Here are some signs that may indicate your loved one needs to be evaluated by a healthcare professional:

Symptoms and Signs of Borderline Personality Disorder

  • Intense Anger and Aggressive Behavior: 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 one common sign of BPD. 
  • Abandonment Sensitivity: 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. They may also 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. 
  • Unstable and Intense Relationships: BPD is associated with patterns of very unstable and intense interpersonal relationships. These relationships can be characterized by alternating between idealization and devaluation. The 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, the person with BPD may see the other person as worthless, mean or uncaring, and may attempt to distance herself from them.
  • Unstable Self-image or Sense of Self: The same instability in relationships can also apply to self-image or sense of self. A person with BPD may seem to believe that they are successful one moment, but the next may be extremely self-denigrating or hard on themselves. Their sense of self may also be unstable, which may lead them to behave differently in different contexts, such behaving one way around one group of friends but another way entirely around another group.
  • Engaging in Risky Impulsive Behaviors: Many people with BPD exhibit risky impulsive behaviors, such as shopliftings, abusing drugs or alcohol, promiscuity or driving recklessly.
  • Emotional Ups and Downs: 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. They may go from seeming content to feeling upset in a matter of moments.
  • Self-Harm: Some individuals with BPD engage in self-harming behaviors and some make suicidal gestures or attempts. These are actually separate issues; self-harming behaviors are not attempts to commit suicide. They are attempts to get rid of emotional pain or intensely uncomfortable feelings. People who self-harm rarely do it when others are present. But you may see signs of self-harm, including scarring or wounds from cutting, burning, or other forms of self-injury.
  • Suicide Gestures or Attempts: People with BPD may also threaten suicide and may make suicide attempts. Such threats or attempts should be taken very seriously.

    What You Can Do to Help

    If you have observed one or more of these signs of BPD in your loved one, it may make sense to encourage him to see a professional for an evaluation. Referrals are available from a variety of online sources, including Ucompare Healthcare and the American Psychological Association. Although you cannot force your loved one to get treatment, you can let him know about your concerns, encourage him to get the help he needs, and let him know that excellent treatments are available when he is ready to reach out for help. By showing that you care for his well-being, you are helping him get on the path to recovery. 

    Sources:

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed, text revision. Washington, DC, Author, 2013.

    Zanarini, MC, Frankenburg, FR, Sickel, AE, & Yong, L. Diagnostic interview for DSM-IV Personality Disorders. McLean Hospital, Belmont MA, and the Department of Psychiatry, Harvard Medical School, 1996.

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