BPD Symptoms Explained
Understanding the 9 DSM-5 criteria for borderline personality disorder and how these symptoms manifest in everyday life.
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The 9 DSM-5 Criteria for BPD
A diagnosis of BPD requires meeting at least 5 of these 9 criteria. Each criterion represents a pattern of behavior that is pervasive and persistent.
Fear of Abandonment
Frantic efforts to avoid real or imagined abandonment. This doesn't include suicidal or self-mutilating behavior covered in criterion 5.
Examples in daily life:
- • Panic when someone is late or doesn't respond to texts immediately
- • Clinging to relationships even when they're unhealthy
- • Reading abandonment into neutral situations
- • Going to extreme lengths to keep people from leaving
Unstable Relationships
A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
Examples in daily life:
- • Seeing people as either all good or all bad
- • Intense, passionate relationships that quickly turn sour
- • Putting people on pedestals, then knocking them down
- • Difficulty maintaining stable friendships or romantic relationships
Identity Disturbance
Markedly and persistently unstable self-image or sense of self.
Examples in daily life:
- • Frequent changes in goals, values, or career plans
- • Feeling like you don't know who you really are
- • Adopting the personality traits of people around you
- • Dramatic shifts in self-perception and life direction
Impulsivity
Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
Examples in daily life:
- • Impulsive spending sprees or financial decisions
- • Risky sexual behavior or substance use
- • Binge eating or other eating-related impulsivity
- • Quitting jobs or ending relationships suddenly
Suicidal or Self-Harm Behavior
Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
⚠️ If you're experiencing these symptoms, seek immediate help:
- • Thoughts of suicide or self-harm
- • Cutting, burning, or other self-injury
- • Suicide attempts or gestures
- • Using self-harm to cope with emotions
Crisis Resources: Call 988 (US) or visit your local emergency room
Emotional Instability
Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
Examples in daily life:
- • Rapid mood swings throughout the day
- • Intense emotional reactions to minor events
- • Difficulty returning to emotional baseline
- • Feeling overwhelmed by emotions regularly
Chronic Emptiness
Chronic feelings of emptiness.
Examples in daily life:
- • Feeling hollow or void inside most of the time
- • Difficulty finding meaning or purpose
- • Feeling disconnected from yourself and others
- • Constantly seeking something to fill the emptiness
Inappropriate Anger
Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
Examples in daily life:
- • Explosive outbursts over minor issues
- • Difficulty calming down once angry
- • Anger that seems disproportionate to the situation
- • Frequent arguments or conflicts with others
Dissociation or Paranoia
Transient, stress-related paranoid ideation or severe dissociative symptoms.
Examples in daily life:
- • Feeling disconnected from your body or surroundings
- • Temporary paranoid thoughts during stress
- • Feeling like you're watching yourself from outside
- • Brief episodes of feeling unreal or detached
Understanding Emotional Dysregulation
What is Emotional Dysregulation?
Emotional dysregulation is the inability to manage emotional responses or keep them within an acceptable range. For people with BPD, emotions are often more intense, last longer, and interfere with daily functioning.
Emotional Dysregulation Looks Like:
- • Emotions feel overwhelming and uncontrollable
- • Mood changes happen rapidly and unpredictably
- • Difficulty returning to emotional baseline
- • Emotions interfere with relationships and work
- • Using unhealthy coping mechanisms
Healthy Emotional Regulation Looks Like:
- • Emotions are manageable and temporary
- • Ability to calm down within a reasonable time
- • Emotions match the situation appropriately
- • Can function despite experiencing emotions
- • Using healthy coping strategies
💡 The Good News About Emotional Dysregulation
Emotional regulation is a skill that can be learned and improved with practice. Therapies like DBT specifically teach these skills, and many people with BPD see significant improvement in their ability to manage emotions.
How BPD Symptoms Impact Daily Life
🏠 At Home and in Relationships
- • Difficulty maintaining stable, long-term relationships
- • Intense fear when partners are away or seem distant
- • Frequent arguments or emotional outbursts
- • Feeling misunderstood by family members
- • Struggling with boundaries and personal space
💼 At Work or School
- • Difficulty concentrating when emotionally distressed
- • Challenges with authority figures or criticism
- • Frequent job or major changes
- • Interpersonal conflicts with colleagues or classmates
- • Perfectionism or fear of failure affecting performance
🧠 Internal Experience
- • Constant emotional turmoil and exhaustion
- • Feeling like you're "too much" for others
- • Chronic sense of emptiness or boredom
- • Difficulty trusting your own perceptions
- • Feeling fundamentally different from others
When to Seek Professional Help
🚨 Seek Immediate Help If:
- • You have thoughts of suicide or self-harm
- • You've made a suicide attempt
- • You're engaging in self-injurious behavior
- • You feel you might hurt yourself or others
- • You're experiencing severe dissociation or paranoia
Crisis Resources:
• Call 988 (Suicide & Crisis Lifeline)
• Text HOME to 741741 (Crisis Text Line)
• Go to your nearest emergency room
💙 Consider Professional Help If:
- • Your emotions feel unmanageable most days
- • Relationships are consistently difficult
- • You're struggling at work or school
- • You identify with 5 or more BPD criteria
- • Your coping strategies aren't working
- • You want to improve your quality of life