Borderline Personality Disorder

Diagnosing BPD

The term borderline personality disorder (BPD) is a terrible name because it does not describe what it represents. What is the personality on the border of? What is the personality between or next to? A good way of thinking about borderline personality disorder is that it is a disorder of emotional regulation. 

People with BPD have very strong and intense emotions, often in reaction to how they perceive and believe others are treating them and these emotions are difficult to control. Not surprisingly, individuals who have strong emotional reactions that are difficult to control have problems with interpersonal relationships and self-image. Because the primary problem of people with BPD seems to be regulating their intense emotions, it has been suggested that the name be changed to emotional intensity disorder.

BPD is diagnosed when five or more of the following nine features are present.

1. strong fears of being abandoned, and going to extremes to keep someone from leaving
2. a recurring pattern of intense, stormy relationships with strong positive feelings towards someone alternating with strong negative feelings
3. uncertainty about one's identity or sense of self
4. impulsive behavior that can cause problems (e.g., gambling, spending money, sex, drug and alcohol use, stealing, eating binges, reckless driving)
5. recurrent suicide attempts, suicide threats, or self-damaging behavior such as cutting, burning, or hitting oneself
6. frequently changing, intense moods
7. feeling empty much of the time
8. problems with anger
9. when under stress, feeling paranoid or suspicious of people who are usually trusted, or feeling like you are losing touch with reality

It is important that a thorough diagnostic evaluation of patients with BPD be done to determine if other psychiatric disorders are present such as major depression, substance abuse, posttraumatic stress disorder or other anxiety disorders.

Treatment

Back   |   Borderline personality disorder