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 behavior.

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 and relentless.

4. Impulsivity in at least two areas that may lead to self harm:

These include sex, substance abuse, spending, reckless driving, binge eating.

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 impulsivity.

9. Transient, stress-related paranoid thoughts or dissociation symptoms (where the sufferer feels unreal and/or detached from the world around them.

Next blog, we’ll look at causes and treatment options for this disorder.

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