What are the signs of Borderline Personality Disorder (BPD)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Article Review Status
Submitted
Under Review
Approved

Last updated: April 18, 2025 • View editorial policy

From the Research

Borderline Personality Disorder (BPD) is characterized by several key signs including intense mood swings, fear of abandonment, unstable relationships, unclear or shifting self-image, impulsive behaviors, self-harm, suicidal thoughts, intense anger, feelings of emptiness, and paranoia or dissociation during stress. People with BPD often experience emotions very intensely and have difficulty regulating them, leading to rapid shifts between extreme emotional states. Their relationships typically fluctuate between idealization and devaluation of others. Impulsive behaviors may include substance abuse, reckless driving, binge eating, or excessive spending. Self-harm behaviors such as cutting or burning are common coping mechanisms. BPD is typically diagnosed through psychological evaluation by mental health professionals using criteria from diagnostic manuals.

Key Signs and Symptoms

  • Intense mood swings
  • Fear of abandonment
  • Unstable relationships
  • Unclear or shifting self-image
  • Impulsive behaviors
  • Self-harm
  • Suicidal thoughts
  • Intense anger
  • Feelings of emptiness
  • Paranoia or dissociation during stress

Treatment usually involves psychotherapy approaches like Dialectical Behavior Therapy (DBT) or Mentalization-Based Therapy (MBT), sometimes supplemented with medications to address specific symptoms like depression or anxiety, as noted in a comprehensive review of current diagnostic practices and treatment modalities 1. While there's no specific medication for BPD itself, antidepressants, mood stabilizers, or antipsychotics may be prescribed as part of a comprehensive treatment plan. The effectiveness of psychotherapeutic approaches and the role of pharmacological interventions are evaluated in the context of BPD treatment, highlighting the importance of personalized medicine approaches, such as those suggested by studies examining the moderators of differential treatment response 2.

Treatment Approaches

  • Psychotherapy: DBT, MBT
  • Medications: Antidepressants, mood stabilizers, antipsychotics for specific symptoms
  • Personalized medicine approaches to tailor treatment to individual patient needs

It's essential to consider the most recent and highest quality studies when making treatment decisions for BPD, prioritizing approaches that have demonstrated efficacy in improving patient outcomes, such as reducing symptoms and enhancing quality of life, as discussed in the context of dialectical behavior therapy and its components 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.