The hallmark symptoms of Borderline Personality Disorder (BPD) revolve around a pervasive pattern of instability in moods, relationships, self-image, and behaviors. The official diagnosis, as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), requires a persistent pattern including at least five of nine specific criteria.
Commonly-prescribed mood stabilizers and anticonvulsants for those with BPD include:
People with Borderline Personality Disorder (BPD) "split" (use black-and-white thinking) as a defense mechanism to manage overwhelming, conflicting emotions, especially fear of abandonment, by seeing people or situations as entirely "good" or "bad" rather than integrating complex realities, providing temporary relief from intense anxiety and emotional pain. It's a way to simplify a confusing world and protect themselves from perceived threats, but it often leads to unstable relationships and self-image.
If Borderline Personality Disorder (BPD) is left untreated, symptoms worsen, leading to severe emotional instability, chaotic relationships, chronic emptiness, and a significantly higher risk of self-harm and suicide, alongside developing co-occurring mental health issues like depression, anxiety, and substance abuse, severely impacting daily functioning and overall quality of life.
Those with BPD often cannot rein in their emotions and therefore struggle to rein in their behavior. Saying "Stop over-reacting" or "I don't understand you" invalidates a complex inner experience and can create more defensive volatility in BPD.
Conflicts and disagreements are difficult for people with BPD, as they interpret these as signals of uncaring or relationship termination, generating feelings of anger and shame.
People with BPD often experience intense fears of abandonment, rapid mood shifts, and struggles to maintain stable connections. These challenges can sometimes result in behaviors that come across as manipulative, but in reality, they're usually a cry for help rather than an attempt to control others.
BPD symptoms often start to emerge in early adolescence. 5 Symptoms may worsen through adolescence, particularly if risk factors like low socioeconomic status, stressful life events, family adversity, and exposure to abuse are present.
People with Borderline Personality Disorder (BPD) are triggered by intense emotions, particularly fear of abandonment, rejection, and invalidation, often stemming from past trauma, leading to reactions like sudden anger or self-harm when feeling criticized, alone, or facing instability, sudden changes, or perceived neglect, according to sources like Borderline in the ACT. Common triggers include relationship conflicts, cancelled plans, perceived or real abandonment, reminders of trauma, or unmet needs like sleep, disrupting their fragile sense of self and emotional regulation.
Symptoms - Borderline personality disorder
Jobs that draw on empathy, communication, and understanding, traits often strengthened by lived experience with BPD, can also be deeply rewarding. Examples include: Teaching assistant or education support worker. Counsellor, peer support, or mental health worker.
Being married to someone with BPD can make you feel like you're being left alone with your worries and stresses. The stress and uncertainty associated with caring for the individual through their mood swings can take an emotional toll on a spouse.
Due to high comorbidity of BPD with addictive disorders, use of substances with high dependence potential should be avoided if possible. The use of unsafe drugs with risk of overdose (tricyclic antidepressants [TCAs], monoamine oxidase inhibitors [MAOIs]) should be avoided.
A “Favorite Person” is someone with whom a person with BPD forms an intense emotional attachment. This relationship is often marked by a combination of deep admiration, dependence and fear of abandonment. The FP becomes a central figure in the individual's life, often absorbing much of their emotional energy and focus.
Objectively measured sleep continuity is also disturbed in BPD, with patients having longer sleep onset latency and wakefulness after sleep onset, more awakenings, shorter total sleep time, and lower sleep efficiency than healthy controls [15,28].
The "3 C's of BPD" typically refer to advice for loved ones of someone with Borderline Personality Disorder, reminding them: "I didn't cause it, I can't cure it, I can't control it," to help set boundaries and avoid taking on undue responsibility for the person's actions or illness. Another set of "C's" describes core BPD traits for individuals: Clinginess (fear of abandonment), Conflict (intense relationships/moods), and Confusion (unstable self-image).
How can I help myself in the longer term?
Borderline personality disorder (BPD) is a mental health condition. You may have extreme mood swings, unstable relationships and trouble controlling your emotions. You have a higher risk of suicide and self-destructive behaviors.
Up to 50% of people with Borderline Personality Disorder (BPD) experience psychotic symptoms like hallucinations and paranoid thoughts. BPD-related psychosis typically differs from other psychotic disorders as symptoms are usually brief, stress-triggered, and the person often maintains some reality testing.
Fear of Abandonment & Being Alone
For many with BPD, the fear of abandonment represents one of the most challenging aspects of living alone. This core symptom can trigger intense emotional responses when physically separated from others for extended periods.
Several investigations suggested that generally BPD symptoms have their onset in adolescence, reach a peak in early adulthood, and then decline during the course of life (83, 93).
If Borderline Personality Disorder (BPD) is left untreated, symptoms worsen, leading to severe emotional instability, chaotic relationships, chronic emptiness, and a significantly higher risk of self-harm and suicide, alongside developing co-occurring mental health issues like depression, anxiety, and substance abuse, severely impacting daily functioning and overall quality of life.
Things like impulsively spending money you don't have, binge eating, driving recklessly, stealing, having random sex, or overdoing drugs and/or alcohol. Having suicidal behavior, cutting yourself, or intentionally burning yourself is a common symptom of BPD.
As a Harvard-trained psychologist, I've found that there are seven phrases you'll hear from highly narcissistic people:
Manipulative movements such as throwing, catching, kicking, trapping, striking, volleying, bouncing, and ball rolling are considered to be fundamental manipulative skills. These skills are essential to purposeful and controlled interaction with objects in our environment.