Borderline Personality Disorder
Symptoms
A person with borderline personality disorder often has unstable relationships, low self-esteem, and problems with impulsive behavior, all of which begin by early adulthood.2
A common feature of this disorder is fear of being left alone (abandoned), even if the threat of being abandoned is not real. This fear may lead to frantic attempts to hold on to those around you and may cause you to become too dependent on others. Sometimes you may react to the fear of being abandoned by rejecting others first before they can reject you. This erratic behavior can lead to troubled relationships in every area of your life.
People who are diagnosed with borderline personality disorder have at least five of the following symptoms. They may:4
- Make frantic efforts to avoid real or imagined abandonment.
- Have a pattern of difficult relationships caused by alternating between extremes of intense admiration and hatred of others.
- Have an unstable self-image or be unsure of his or her own identity.
- Act impulsively in ways that are self-damaging, such as extravagant spending, frequent and unprotected sex with many partners, substance abuse, binge eating, or reckless driving.
- Have recurring suicidal thoughts, make repeated suicide attempts, or cause self-injury through mutilation, such as cutting or burning himself or herself.
- Have frequent emotional overreactions or intense mood swings, including feeling depressed, irritable, or anxious. These mood swings usually only last a few hours at a time. In rare cases, they may last a day or two.
- Have long-term feelings of emptiness.
- Have inappropriate, fierce anger or problems controlling anger. The person may often display temper tantrums or get into physical fights.
- Have temporary episodes of feeling suspicious of others without reason (paranoia) or losing a sense of reality.
Not everyone who has five or more of these symptoms is diagnosed with borderline personality disorder. For a person to be diagnosed with any personality disorder, the symptoms must be severe and must go on long enough to cause significant emotional distress or problems functioning in relationships or at work.4
You may have temporary episodes of psychosis (paranoia and a loss of a sense of reality) with borderline personality disorder, especially when you are going through a personal crisis. This psychosis usually does not last very long. But if it continues, your doctor may consider another condition, such as schizophrenia.
Symptoms of borderline personality disorder are not caused by another medical condition or by medicines, and they are not a result of long-term substance abuse problems. Borderline personality disorder may be confused with other conditions with similar symptoms, such as other personality disorders, including antisocial personality disorder and histrionic personality disorder.
Suicidal behavior
Suicidal behavior is common in people with borderline personality disorder, with close to 10% of those with the disorder completing suicide.6 Your risk of suicidal thoughts or attempts increases if you have depression along with borderline personality disorder.7 But you can reduce your risk for suicide by treating symptoms of both conditions.
Other conditions that commonly occur with borderline personality disorder
Other mental health conditions commonly occur with borderline personality disorder and need treatment also. These additional conditions can make it difficult to distinguish borderline personality and can complicate treatment. Conditions that frequently occur with borderline personality disorder include:3, 4
- Depression or other mood disorders (for example, dysthymic disorder).
- Eating disorders, especially bulimia nervosa.
- Substance abuse problems.
- Bipolar disorder, which is depression with episodes of mania.
- Panic attacks or panic disorder.
- Attention deficit hyperactivity disorder (ADHD).
Other personality disorders can occur in addition to borderline personality disorder. A few of these conditions include:
- Histrionic personality disorder, which causes excessive emotional reactions, attention-seeking behavior, and dramatic behavior.
- Avoidant personality disorder, which causes a person to avoid interaction with other people, especially if the interaction involves a new activity that may prove embarrassing.
- Antisocial personality disorder, a condition that involves a pattern of disregard for or violation of the rights of others.
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| Author: | Jeannette Curtis | Last Updated: March 26, 2007 |
| Medical Review: | Kathleen Romito, MD - Family Medicine Lisa S. Weinstock, MD - Psychiatry | |
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