9 Essential Borderline Personality Disorder Symptoms You Need to Know

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) is the text that guides mental health clinicians in diagnosing and assessing patients. This manual allows us to delve into the 9 key borderline personality disorder symptoms.

Although I mentioned some major flaws and issues of the DSM-V in my previous article, the diagnosis still helps clinicians communicate their specialty to clients. However, that is primarily the extent to which the diagnosis is used. It’s advisable to read the previous article before this one.

It’s time to explore the nine symptoms. To meet the label’s criteria, one must have at least five of the nine indicators.

The Fear of Abandonment

People with Borderline Personality Disorder often experience a deep fear of abandonment, like a child lost in a crowd. This fear is one of the key borderline personality disorder symptoms and can lead to behaviors aimed at keeping others close. They might seek constant reassurance or change plans abruptly to avoid solitude. Even small delays, like a friend being late, can trigger anxiety, causing significant stress in relationships.

Unstable Relationships

Relationships for those experiencing borderline personality disorder symptoms can be like a rollercoaster ride. They may idealize someone one moment and feel deeply disappointed the next. This pattern of intense and unstable relationships is a hallmark of borderline personality disorder symptoms, making it hard to maintain long-lasting connections. One day, a person might be their best friend, and the next, they feel betrayed, leading to isolation.

Shifting Self-Image

A core aspect of borderline personality disorder symptoms is an unclear or shifting self-image. Individuals often feel like a chameleon changing colors, with their sense of self varying based on who they are with or what they are doing. This confusion can cause a lack of direction and a perpetual search for identity.

Impulsive Behaviors

Impulsive behaviors are another common borderline personality disorder symptom. These actions can lead to trouble, like jumping into a pool without checking the water. People may spend money recklessly, engage in risky activities, or make hasty decisions to cope with emotional pain. These choices often result in personal and professional challenges.

Self-Harm

Self-harm is a significant borderline personality disorder symptom, bringing temporary relief, like scratching an itch. It’s a way to manage overwhelming emotions or feel something when numb. This behavior signals a need for help, akin to a flare sent up from a ship in distress.

Emotional Instability

Emotional instability, a key borderline personality disorder symptom, causes emotions to shift rapidly, like a storm passing through. Minor events can trigger intense feelings of happiness, anger, or sadness. These mood swings can last minutes or hours, affecting both the individual and those around them.

Chronic Emptiness

Chronic feelings of emptiness, another borderline personality disorder symptom, are like a hollow drum resonating with nothing inside. People often feel empty or numb, constantly seeking new experiences or relationships to fill the void, yet the emptiness remains.

Intense Anger

Intense anger, a frequent borderline personality disorder symptom, can flare up like a match catching fire. This anger often seems out of proportion and can result in shouting or physical conflicts. It acts as a defense against feelings of hurt or rejection, leaving regret in its wake.

Paranoia and Dissociation

Paranoia or dissociation under stress is another borderline personality disorder symptom, making individuals feel detached, like watching life through a window. It can cause doubt in others’ motives, while dissociation can create a sense of floating above their own body. These experiences aim to manage overwhelming emotions but can lead to further isolation.

Overlapping of Symptoms

These symptoms may appear distinct and relatable to some. I can share with you that many disorders have similar symptoms. This is the major criticism of the DSM-V.

1. Fear of Abandonment
   Similar to: Dependent Personality Disorder
   Also seen in: Attachment disorders
2. Unstable Relationships
   Similar to: Histrionic Personality Disorder
   Also seen in: Cyclothymia
3. Shifting Self-Image
   Similar to: Identity Disorder
   Also seen in: Dissociative disorders
4. Impulsive Behaviors
   Similar to: Bipolar Disorder (during manic episodes)
   Also seen in: ADHD, Substance Use Disorders
5. Self-Harm
   Similar to: Major Depressive Disorder
   Also seen in: Eating disorders, PTSD
6. Emotional Instability
   Similar to: Cyclothymic Disorder
   Also seen in: Bipolar Disorder, PMDD
7. Chronic Emptiness
   Similar to: Persistent Depressive Disorder (Dysthymia)
   Also seen in: Major Depressive Disorder
8. Intense Anger
   Similar to: Intermittent Explosive Disorder
   Also seen in: PTSD, Bipolar Disorder
9. Paranoia and Dissociation
   Similar to: Schizotypal Personality Disorder
   Also seen in: PTSD, Schizophrenia

This overlapping issue is the reason approximately 40% of people with borderline personality disorder (BPD) receive an initial misdiagnosis of bipolar disorder because of similarities in mood-related symptoms. The major problem I see among clinicians is that many professional hyper-focuses on one particular symptom.

When counselors observe clients engaging in self-harm activities, they often diagnose borderline personality disorder. Although that behavior is one criterion, one engaging in such a behavior is not enough. It’s a recurring thing to hear, “Oh, she is self-harming. Must be borderline.”

Understanding these borderline personality disorder symptoms is essential for providing effective support and treatment. Each symptom reflects the complexity of living with this condition and highlights the need for compassionate care. However, it’s critical to not hold the label to close where it defines who you are as a person. There’s a high probability that it’s incorrect.

In a separate article, I explore the three contemporary and powerful therapeutic approaches that clinicians can use to tackle the borderline personality disorder symptoms. Click here to read more how they can assist you. The approaches I mentioned are relevant for misdiagnosis situations.

To succeed, focus on practicing and applying the coping strategies recommended by your counselor. The coherence of your experiences won’t aid you in living a worthwhile life. Being aware of symptoms or getting a diagnosis won’t make a difference in your life.