Borderline Personality Disorder: Diagnostic Criteria
The term “borderline personality disorder” is often bandied
about by the media and laymen alike. Many of the behaviors that constitute
the disorder are common to other disorders and indeed, normal human
However for an accurate diagnosis to be made, a person must exhibit
a pervasive pattern of instability in personal relationships, self esteem,
and moods, in addition to marked impulsivity in behavior which typically
begins in early adulthood.
For a decisive diagnosis to be made at least five
of the following characteristics must be present:
1. Frantic efforts to avoid real or imagined abandonment.
The sufferer reports feelings of “emptiness” and
needs the constant reassurance and love of others to fill that sense
of emptiness. When signs of imminent abandonment are present, the
sufferer becomes increasingly agitated and unstable, leading to impulsive
behaviors, even suicidal gestures.
2. An ongoing pattern of unstable and intense personal relationships
characterized by alternating idealization of the person concerned
or devaluation. The person could be male or female.
The sufferer moves rapidly between thinking that an acquaintance
or love interest is “fantastic” or a “loser”
or some other derogatory term. Most people come in shades of black
and white for the borderline sufferer; there is little room in their
minds for grey. However, one of the characteristics of the disorder
so that the sufferer frequently cycles quickly through these likes
and dislikes, and having debased a particular person on one occasion
does not mean that by the following week they cannot be the best of
friends again. The key is the rate at which these cycles manifest.
3. Marked and persistent unstable self-image or sense of self.
The sufferer doesn’t merely have a “down” day
where they are hard on themselves. The lack of self love is continuous
4. Impulsivity in at least two areas that may lead to self harm:
These include sex, substance abuse, spending, reckless driving, binge
5. Recurrent suicidal thoughts, gestures, threats, or self-mutilating
behavior such as slashing.
6. Intense mood swings including sadness, anxiety, or irritability
that last for several hours but rarely more than a few days.
7. Chronic feelings of emptiness.
8. Anger management problems associated with mood instability and
9. Transient, stress-related paranoid thoughts or dissociation symptoms
(where the sufferer feels unreal and/or detached from the world around
Next blog, we’ll look at causes and treatment options for this
our forum on Borderline Personality Disorder
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