Borderline personality disorder (BPD) presents as a distinctive pattern of emotional intensity, unstable relationships, and challenges with self-identity and impulse control. The symptoms typically cluster around strong emotions that shift quickly, urgent relationship dynamics, and impulsive actions that can feel overwhelming. Understanding these nine diagnostic symptoms can help people recognize when to seek a professional assessment. If you or someone you know is struggling with these patterns, consider speaking with a licensed mental health professional for support.
The Nine Diagnostic Symptoms of BPD
1) Frantic efforts to avoid real or imagined abandonment
Many people with BPD experience a profound fear of being left alone. This fear can trigger intense anxiety and proactive (often drastic) attempts to prevent perceived abandonment, even when no real threat exists. The distress is not just about a breakup; it can surface in everyday interactions where you worry about a friend canceling plans or a partner spending time with someone else.
- Calling or texting someone repeatedly after they don’t respond right away, even when their schedule is busy.
- Arriving unexpectedly at a friend’s or partner’s home to avoid being rejected.
- Clinging to relationships in an effort to keep someone close, sometimes before a minor disagreement.
2) A pattern of unstable and intense interpersonal relationships, characterized by alternating between extremes of idealization and devaluation
Relationships can feel like a roller coaster. People with BPD might momentarily see someone as perfect and life-saving, then flip to perceiving them as uncaring or dangerous after a small conflict. This shifting view can lead to cycles of closeness and distance that are hard for others to navigate and for the person with BPD to sustain.
- Loving a friend or partner one moment and blaming them for all problems the next after a minor disagreement.
- Relying heavily on another person for emotional support, then perceiving them as a threat or disappointment without clear reason.
- Jumping between “you’re my savior” and “you’re the reason I’m failing,” sometimes within the same week.
3) Identity disturbance: markedly and persistently unstable self-image or sense of self
A person with BPD may struggle to know who they are or what they want. This can show up as sudden shifts in values, goals, careers, sexual orientation, or hobbies. Feeling like you don’t have a steady sense of self can be confusing and exhausting, making it hard to maintain consistent life choices.
- Trying out different styles, careers, or social circles to see which fits best.
- Feeling like you are “encasing” yourself in a role (e.g., the confident person, the serious student, the partygoer) that changes with the situation.
- Experiencing a persistent sense of emptiness or confusion about personal beliefs and priorities.
4) Impulsivity in at least two areas that are potentially self-damaging
Impulsivity is common in BPD and can show up in ways that risk physical or financial harm. The important factor is that these actions happen in a pattern and are driven by the intensity of emotion rather than careful planning.
- Spending sprees, risky online shopping, or sudden large purchases to cope with mood shifts.
- Unsafe sexual behaviors or promiscuity, sometimes driven by a need for closeness or validation.
- Substance use, binge eating, reckless driving, or other risky activities during periods of emotional distress.
5) Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
Thoughts of self-harm or actual self-injury may occur as a way to cope with overwhelming emotions or fear of abandonment. This symptom is a serious signal that warrants immediate professional attention and support from trusted people in the person’s life.
- Threats of self-harm or statements like “I can’t go on” during a crisis.
- Self-injury such as cutting or burning as a way to soothe emotional pain.
- Recurring thoughts about death or taking steps toward ending one’s life during stressful periods.
6) Affective instability due to a marked reactivity of mood
Emotional responses in BPD can swing rapidly and intensely. A person may feel euphoric one moment, then suddenly overwhelmed with sadness or irritability for hours or days. These mood shifts are often in reaction to external events but can also occur without a clear trigger.
- Mood that shifts quickly from happiness to tearfulness or anger in response to everyday stress.
- Episodes of irritability or anxiety that last a few hours and feel out of proportion to the situation.
- Feeling overwhelmed by emotions that seem to surge and fade unpredictably.
7) Chronic feelings of emptiness
Many people with BPD describe a persistent sense of emptiness or hollowness, as if something essential is missing inside. This feeling can contribute to craving connection or stimulation and may drive other symptoms like impulsive behaviors or intense relationship dynamics.
- Regularly feeling “not good enough” or like you are a blank slate without a stable sense of self.
- Seeking out activities, people, or situations to fill the emptiness, sometimes leading to risky choices.
- Difficulty enjoying or finding meaning in things that would otherwise be satisfying.
8) Inappropriate, intense anger or difficulty controlling anger
Anger in BPD is often intense, frequent, and hard to regulate. It might show up as sarcasm, sarcasm, or explosive outbursts. This anger can damage relationships and lead to further conflict or withdrawal.
- Sudden outbursts of rage after small provocations or perceived slights.
- Persistent bitterness or harsh criticism toward others, sometimes including loved ones.
- Physical expressions of anger such as slamming doors or throwing objects during a fight.
9) Transient, stress-related paranoid ideation or severe dissociative symptoms
Under significant stress, some individuals with BPD may experience brief paranoid thoughts or dissociation—feeling detached from themselves or reality. These symptoms are usually short-lived but can be very distressing and frightening in the moment.
- Feeling “checked out” or like you’re not fully present during a tense situation.
- Suspicion or fear that others are talking about you, even without evidence.
- Momentary experiences of depersonalization or derealization yes, during high stress, such as a confrontation or major life change.
