Signs and Symptoms of Borderline Personality Disorder

Borderline personality disorder (BPD) is a chronic (long-term) mental health condition that makes it difficult for you to regulate your emotions and behaviors. People with BPD may experience symptoms such as difficulty maintaining stable relationships and a having a fear of abandonment. 

BPD is categorized as a cluster B personality disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). People with cluster B personality disorders have chronic, ongoing problems with relating to others and functioning well at work or school due to impulsivity, turbulent emotions, and unstable moods.

An estimated 1.4% of U.S. adults have borderline personality disorder. Knowing the symptoms can help you or a loved one get the help they need.

Fear of Abandonment

An overwhelming fear of abandonment is one of the most common symptoms of borderline personality disorder. With BPD, you may have difficulty spending time alone or feel hypersensitive to the threat of abandonment or rejection from those you love. 

Many people with BPD may try to “test” or even sabotage their relationships to see if their partner will leave them. If you're worried about being abandoned, it can sometimes be common to lash out, panic, or make desperate efforts to please others.

Intense and Unstable Relationships

BPD is associated with a pattern of intense, all-consuming, and unstable relationships. You may notice behaviors of frequently breaking up with romantic partners, rushing into relationships, or having conflicts with your significant others, family, and friends. 

The condition can often cause black-and-white thinking, making it difficult for you to control your emotions. Some people with BPD often engage in “splitting.” Splitting refers to switching between idealization and devaluation of others. For example, you might go from thinking your partner is perfect and feeling head over heels in love with them to wanting nothing to do with them at all.

Angry Outbursts

People with BPD have a hard time regulating their emotions, which can make it easy to feel uncontrollable anger, frustration, or irritability. You may lash out at others with harsh comments, especially if you're afraid of being abandoned by them. In the aftermath, it's likely that you also feel very guilty after these incidents and try to make amends.

Feelings of Emptiness

Feelings of emptiness and boredom are common with BPD. In addition to feeling “empty inside,” you may feel numb, alienated, lonely, hopeless, or disconnected from others. 

Some people with BPD attempt to fill this void by finding other people to “rescue” or want to take care of them. Others may act out impulsively in an attempt to feel more present in the moment or experience more excitement.

Dissociation

People with BPD sometimes experience dissociation, which refers to a feeling of being disconnected from reality. Some people with BPD feel like they don’t truly exist or that their thoughts are not truly their own. With dissociation, you may have a feeling like you're living outside of your body or are cut off from the rest of the world. 

While psychosis is not typically a symptom of BPD, you might experience brief, temporary episodes of paranoia or a need to dissociate from reality. This is especially common during times of intense stress.

Unstable Sense of Self

Borderline personality disorder is often linked to an unstable sense of self. With this condition, you may commonly look to others to create your sense of self-image and build your self-esteem. Your goals, values, dreams, and desires are perpetually in flux, as you may feel reliant on others to influence your decisions.

In an attempt to find yourself or to conform to the people around you, it's common to feel the need to adopt new beliefs, lifestyles, or religions often. You may also switch jobs, schools, locations, interests, or partners regularly as your perception of self and the world around you changes.

This BPD symptom is sometimes read by others as a sign of “flakiness” or deceitfulness, but it is often actually an attempt to develop a more coherent identity.

Intense Mood Swings

Having BPD may cause you to experience intense, rapid mood swings. You might quickly cycle through a variety of strong emotions—from sadness and irritability to excitement and anxiety in just a few hours or days. It may also be common to feel depressed in the morning but feel “recovered” or better by the evening (or vice versa). These shifts in mood are typically unpredictable.

Self-Harming and Impulsive Behaviors

Many people with BPD engage in impulsive, self-sabotaging, and/or reckless behavior. You might participate in actions such as:

• Binge eating 
• Heavy drinking
• Drug use
• Dangerous driving
• Unprotected sex
• Excessive spending

Suicidal ideation and self-harm are also common among people with BPD. Unfortunately, research suggests that up to 10% of people with borderline personality disorder die by suicide.

When to See a Healthcare Provider

If you think you have any of the above signs of BPD, you’re not alone—and support is available. While symptoms of the condition can be difficult to experience or witness, it's important to note that there are effective treatments that can help you better manage your condition.

Your healthcare provider can help you get a diagnosis for BPD and recommend treatments such as psychotherapy, medication, or both. The first-line treatment for BPD is dialectical behavior therapy (DBT), a targeted type of therapy that can help you build coping skills, stay more present in the moment, and learn to regulate your emotions in healthier ways.

Experiencing intense emotions, undergoing distress, or noticing changes in your relationships, work, or school can be difficult. Now is a good time to reach out to your provider for the care you need.

A Quick Review

Borderline personality disorder (BPD) is a mental health condition that makes it challenging for you to regulate your emotions. As a result, you may have difficulty with your self-esteem, relationships, and work.

The signs of BPD include fear of abandonment, turbulent relationships, displays of inappropriate anger, ongoing feelings of boredom and emptiness, dissociation, an inconsistent sense of self, rapid mood swings, and impulsive, self-sabotaging behaviors. Not everyone with BPD has all of these symptoms and the condition can affect each person differently. Regardless, if you or a loved one are experiencing these symptoms, it's good practice to talk to a healthcare provider for support.