What are the signs and symptoms of borderline personality disorder (BPD)?

What are the signs and symptoms of borderline personality disorder (BPD)?

Signs and symptoms of borderline personality disorder usually appear in your late teenage years or early adulthood. A troubling event or stressful experience can trigger symptoms or make them worse.

Over time, symptoms usually decrease and may go away completely.

Symptoms can range from manageable to very severe and can include any combination of the following:

• Fear of abandonment: It’s common for people with BPD to feel uncomfortable being alone. When people with BPD feel that they’re being abandoned or neglected, they feel intense fear or anger. They might track their loved ones’ whereabouts or stop them from leaving. Or they might push people away before getting too close to avoid rejection.
• Unstable, intense relationships: People with BPD find it challenging to keep healthy personal relationships because they tend to change their views of others abruptly and dramatically. They can go from idealizing others to devaluing them quickly and vice versa. Their friendships, marriages and relationships with family members are often chaotic and unstable.
• Unstable self-image or sense of self: People with BPD often have a distorted or unclear self-image and often feel guilty or ashamed and see themselves as “bad.” They may also abruptly and dramatically change their self-image, shown by suddenly changing their goals, opinions, careers or friends. They also tend to sabotage their own progress. For instance, they may fail a test on purpose, ruin relationships or get fired from a job.
• Rapid mood changes: People with BPD may experience sudden changes in how they feel about others, themselves and the world around them. Irrational emotions — including uncontrollable anger, fear, anxiety, hatred, sadness and love — change frequently and suddenly. These swings usually only last a few hours and rarely more than a few days.
• Impulsive and dangerous behavior: Episodes of reckless driving, fighting, gambling, substance use, binge eating and/or unsafe sexual activity are common among people with BPD.
• Repeated self-harm or suicidal behavior: People with BPD may cut, burn or injure themselves (self-injury) or threaten to do so. They may also have suicidal thoughts. These self-destructive acts are usually triggered by rejection, possible abandonment or disappointment in a caregiver or lover.
• Persistent feelings of emptiness: Many people with BPD feel sad, bored, unfulfilled or “empty.” Feelings of worthlessness and self-loathing are common, too.
• Anger management issues: People with BPD have difficulty controlling their anger and often become intensely angry. They may express their anger with biting sarcasm, bitterness or angry tirades. These episodes are often followed by shame and guilt.
• Temporary paranoid thoughts: Dissociative episodes, paranoid thoughts and sometimes hallucinations may be triggered by extreme stress, usually fear of abandonment. These symptoms are temporary and usually not severe enough to be considered a separate disorder.

Not everyone with borderline personality disorder experiences all of these symptoms. The severity, frequency and duration of symptoms are unique to each person.