Sometimes called Emotionally Unstable Personality Disorder, Borderline Personality Disorder (BPD) is characterized by intense emotional experiences, unstable relationships, impulsive behaviors, and identity disturbances.
People with BPD often struggle with regulating their emotions and managing their reactions to various situations, leading to frequent mood swings and interpersonal difficulties.
A pervasive pattern of instability of interpersonal relationships, self image, and affects beginning by early adulthood and present in a variety of contexts- indicated by at least 5 out of 9 of the following symptoms:
This isn’t just the occasional worry that a partner will leave, but more so a full blown paranoia/belief that people are destined to leave the Borderline’s life. This fear can be triggered by even minor events, such as a partner arriving home late, a friend canceling plans, or someone being less responsive than usual. The perceived threat of abandonment, whether real or imagined, can cause intense emotional distress.
In response, an individual with BPD might act impulsively or desperately to pull the other person back in (begging them to stay, threatening self-harm, accusing them of not caring, or clinging tightly) in ways that can feel overwhelming to others. These reactions are often driven by an internal belief that they are unlovable or destined to be left.
Many people with BPD hold a black and white view of relationships. Either that person is amazing, or they’re the worst and the relationship is doomed. This is known as "splitting." They tend to change their view of others quickly and dramatically- whether it be friendships, romance or family.
During idealization, they may see an individual as perfect, creating an intense emotional bond. They may share intimate details quickly. However, if this person makes a mistake or disappoints them, they may quickly shift to devaluation, viewing the individual as wholly negative or hurtful. They’re not there enough, they don’t give enough attention, they don’t care enough. This cycle can be confusing and painful for both parties, making the relationship feel unstable.
People with BPD may engage in a range of impulsive and sometimes self-damaging behaviors. This can include substance abuse, binge eating, reckless spending, unsafe sex, or even reckless driving. These behaviors aren’t just bad decisions made without thinking, they often happen in the midst of emotional distress or inner turmoil.
When emotions spike quickly and intensely, the urge to act can feel overwhelming. Many describe knowing they’ll regret their actions but doing them anyway because the emotional need is too intense. After the fact, these behaviors frequently lead to feelings of shame, guilt, or even further emotional distress, creating a painful cycle.
Their self-image can shift dramatically depending on the situation, who they’re around, or how they’re feeling in the moment. One day, they might feel confident and passionate about a goal or relationship, and the next day, they might feel completely disconnected from it, questioning whether it ever truly mattered to them. This can extend to values, career goals, sexual identity, and even personal style or interests. It’s not just being indecisive, it’s a sense that the self is fluid, hard to grasp, or even nonexistent at times.
These identity disturbances can create a strong dependence on others to define who they are so much so that when a relationship shifts or ends, it can feel like the Borderline's entire world and sense of self collapse.
Let's break this one down simply:
Behavior: An active suicide attempt, even if non-lethal.
Gestures: Actions that look like a suicide attempt but may not have lethal intent (e.g., taking a small number of pills, or holding a knife to oneself but not using it).
Threats: Saying things like "I wish I were dead," "If you leave me, I’ll kill myself," or "I can’t go on."
"Recurrent" means that this happens more than once, not just a one-time crisis. These thoughts or behaviors tend to be ongoing, especially during emotional distress. Borderlines usually engage in some form of self harm via: cutting, burning, scratching, hitting themselves or other ways of intentionally bringing harm to their body. Oftentimes this symptom is the main reason they go to therapy.
People with BPD struggle to control their emotions, and some may self harm compulsively to cope with their uncomfortable inner moods. Suicidal ideation is another common one, which means people with this condition can passively contemplate suicide for days, weeks, months or even years. Borderlines can also engage in suicidal behaviors on impulse without considering the consequences. These are often cries for help, ways to express deep emotional pain, or attempts to manage abandonment fears.
Someone with BPD can experience very intense emotional shifts, and those shifts are usually triggered by something external like a perceived slight, argument, or feeling abandoned. In short, Borderline's emotions are rapidly shifting and extreme. These mood swings can last for a few hours to a few days at most.
Since BPD is associated with intense negative experiences, their emotions can be severely painful. An emotionally neutral situation can quickly spiral into shame, emptiness, or intense anxiety. These emotions can feel almost impossible to control as if being hijacked by them. Their main mood is despair, panic, anger or numbness. This mood is usually not relived by periods of well being or satisfaction.
For someone with Borderline Personality Disorder, this refers to a persistent, internal sense of being hollow, numb, or like nothing inside them feels real and meaningful. They might constantly seek ways to fill the void: through relationships, impulsive behaviors (e.g., spending, sex, drugs), or even self-harm.
This symptom can drive a lot of the other BPD behaviors, like intense relationships or mood swings, because the person is trying to feel something or find meaning. Even when things are “fine,” this emptiness can still be there. It’s chronic, meaning it sticks around long-term, not just during a crisis.
This refers to episodes of rage that feel disproportionate to the situation and Borderlines may lash out verbally, act impulsively, or become physically agitated. It's a type of anger can flare up quickly and be overwhelming, especially in close relationships where emotional stakes feel high. Small misunderstandings or neutral comments may be interpreted as personal attacks, leading to explosive reactions that seem sudden or confusing to others.
After the anger passes, many people with BPD experience deep regret, guilt, and shame. They might not fully understand why they reacted so strongly, which can lead to feelings of self-loathing and fear that they’ve pushed others away. This cycle of emotional intensity, outburst, and remorse can be painful and exhausting, both for the person with BPD and those close to them.
Intense emotional stress can temporarily affect the Borderline's perception of reality. When this personality is hypervigilant, even subtle cues (like a tone of voice, a delay in a text, or a look from someone) can feel like red flags. This state of emotional “over-attunement” can lead to misinterpretations, which can quickly spiral into paranoid thoughts.
For example, a small change in a loved one’s behavior might trigger intense worry: “They’re mad at me,” or “They’re going to leave,” even if there’s no real evidence. That fear, paired with hypervigilance, can grow into beliefs like “They’re hiding something” or “They’re trying to hurt me,” which is where the transient paranoid ideation comes in. It's not paranoia in the psychotic sense — it’s often fear-driven, based on heightened sensitivity to cues that others might overlook.
Hypervigilance can also tie into dissociation. When someone becomes overwhelmed by perceived danger (emotional or otherwise), their mind might shut down or disconnect as a form of protection — leading to dissociative symptoms like feeling numb, foggy, or detached from reality.
Sarah is a 26-year-old woman who was referred to outpatient psychiatric services by her primary care physician after a recent breakup that led to self-harm and suicidal ideation. Sarah feels out of control with her emotions, especially in her relationships. She expresses frustration that she pushes people away when she fears they might leave her.
Her childhood was chaotic. Sarah's father frequently engaged in substance abuse and was even physical at times. Her mother was emotionally distant and neglectful. She had a few close friends in school but these relationships were marked by intense highs and lows, and they often ended abruptly due to conflicts. Sarah dropped out of college after one semester, feeling overwhelmed and inadequate. Her job history is inconsistent.
Despite her current partner's reassurance, Sarah worries about being abandoned and asks if she's still loved. She has frequent panic attacks and needs constant validation. Oftentimes Sarah feels unsure about her identity and what she wants out of life. She changes her goals and career aspirations frequently, feeling deeply conflicted about who she is. She also has a history of binge eating, making impulsive purchases and driving recklessly.
After a thorough assessment, Sarah is diagnosed with Borderline Personality Disorder (BPD).
The following statements are based on traits often associated with BPD. Note: this is not a diagnostic tool and should not be used as one- for yourself or others around you. A proper diagnosis should only be made by a qualified mental health professional. These statements may, however, help an individual reflect on their thoughts, feelings and behaviors. This inventory is provided for educational and entertainment use only.
When in a relationship, I repeatedly ask my significant other if they still love me, if they’re going to leave, or other questions of reassurance.
I have often perceived innocent remarks that people have made as personal attacks against me, misjudging the intentions of others.
I sometimes idealize people one moment and then feel they are cruel or uncaring the next.
Often times, I feel unsure about who I am or what I want in life.
I often feel overwhelmed by intense emotions, even in situations that might not seem to warrant such a strong reaction and I have trouble calming down when I'm upset.
When I’m upset, I might do things that I later regret, such as overspending, substance use, or unsafe sex.
I may have brief episodes where I feel paranoid or suspicious of others without clear reason.
