Borderline Personality Disorder (BPD) is diagnosed when an individual experiences a prolonged disturbance of her or his personality function. Characteristic symptoms of the disorder include: unstable moods and emotions, continual difficulty in interpersonal relationships, and pervasive problems with self-image and behavior.
BPD accounts for roughly one out of five psychiatric hospitalizations. Although BPD symptoms may first appear during adolescence, diagnosis is rarely made before the age of 18. Persistence of symptoms over time is an essential indicator of BPD.
BPD is typically diagnosed in young adults of both sexes. However, females exhibit borderline personalities at a ratio of 3:1 to males.
Criteria for BPD Diagnosis
BPD is a complex disorder, and mental health professionals consider many factors and assess multiple symptoms before arriving at a diagnosis. To make a diagnosis of BPD, clinicians and therapists rely on the Diagnostic and Statistical Manual of Mental Disorders (DSM), which defines nine criteria to look for when diagnosing BPD.
A patient must meet at least five of the following nine criteria to be diagnosed with BPD:
- Extreme fear of abandonment
- A series of unstable relationships
- Persistent instability in self-image
- Poor impulse control and self-damaging behavior
- Suicidal thoughts and self-injurious behavior
- Unusually wide mood fluctuations
- Chronic feelings of emptiness
- Inappropriate and uncontrollable anger
- Paranoid episodes and periods of dissociation
While all of the symptoms listed above represent issues that are best addressed in a therapeutic or clinical setting, it is the occurrence of five or more together that define a borderline personality.
Once a patient has been diagnosed with BPD, a holistic course of treatment that deals with the person as a whole, rather than as an array of pathologic symptoms and behavioral issues, offers the greatest hope of long-term recovery.