Unstable self-image or sense of self: People with BPD often have a distorted or unclear self-image and often feel guilty or ashamed and see themselves as “bad.” They may also abruptly and dramatically change their self-image, shown by suddenly changing their goals, opinions, careers or friends. They also tend to sabotage their own progress. For instance, they may fail a test on purpose, ruin relationships or get fired from a job.
Rapid mood changes: People with BPD may experience sudden changes in how they feel about others, themselves and the world around them. Irrational emotions — including uncontrollable anger, fear, anxiety, hatred, sadness and love — change frequently and suddenly. These swings usually only last a few hours and rarely more than a few days.
Impulsive and dangerous behavior: Episodes of reckless driving, fighting, gambling, substance use, binge eating and/or unsafe sexual activity are common among people with BPD.
Repeated self-harm or suicidal behavior: People with BPD may cut, burn or injure themselves (self-injury) or threaten to do so. They may also have suicidal thoughts. These self-destructive acts are usually triggered by rejection, possible abandonment or disappointment in a caregiver or lover.
Persistent feelings of emptiness: Many people with BPD feel sad, bored, unfulfilled or “empty.” Feelings of worthlessness and self-loathing are common, too.
Anger management issues: People with BPD have difficulty controlling their anger and often become intensely angry. They may express their anger with biting sarcasm, bitterness or angry tirades. These episodes are often followed by shame and guilt.
Temporary paranoid thoughts: Dissociative episodes, paranoid thoughts and sometimes hallucinations may be triggered by extreme stress, usually fear of abandonment. These symptoms are temporary and usually not severe enough to be considered a separate disorder.
Not everyone with borderline personality disorder experiences all of these symptoms. The severity, frequency and duration of symptoms are unique to each person.
What causes borderline personality disorder?
Healthcare providers believe BPD results from a combination of factors, including: symptoms of Borderline Personality Disorder
Childhood abuse and trauma: Up to 70% of people with BPD have experienced sexual, emotional or physical abuse as a child. Maternal separation, poor maternal attachment, inappropriate family boundaries and parental substance use disorder are also associated with BPD.
Genetics: Studies show that borderline personality disorder runs in families. If you have a family history of BPD, you’re more likely — but not guaranteed — to develop the condition.
Brain changes: In people with BPD, the parts of their brain that control emotion and behavior don’t communicate properly. These problems affect the way their brain works.
DIAGNOSIS AND TESTS
How is borderline personality disorder diagnosed?
Personality continues to evolve throughout child and adolescent development. Because of this, healthcare providers don’t typically diagnose someone with borderline personality disorder until after the age of 18. Occasionally, a person younger than 18 may be diagnosed with BPD if symptoms are significant and last at least a year.
Personality disorders, including borderline personality disorder, can be difficult to diagnose, as most people with a personality disorder lack insight into their disruptive behavior and thought patterns.