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Symptoms and Definition of Borderline Personality Disorder

As with all Personality Disorders, Borderline Personality Disorder is a type of character style that becomes apparent by early adulthood and thereafter continues to be a pervasive and maladaptive pattern of behaving and of perceiving oneself and the world. This pattern consists of unstable relationships, intense and unpredictable mood swings, difficulty maintaining a stable self-image, and a tendency to be very impulsive.

At least five of the following nine symptoms, occurring in a variety of contexts, need to be present in order to make the diagnosis:

Interpersonal problems:

1) Constant worries of being abandoned by others, especially in romantic relationships, with a tendency to make frantic efforts to prevent this. (Note that the suicidal or self-mutilating behaviors described in item 4 below should not be counted among these efforts.)

2) A tendency for one's close relationships to be intense and unstable. This is often characterized by oscillating back and forth between seeing one's relationship partners as being either all good (idealization) or all bad (devaluation).

Impulsivity symptoms:

3) A tendency to act very impulsively in ways that can be dangerous, including at least two of the following areas: spending money; sex; substance abuse; reckless driving; and binge-eating. (Note that the suicidal or self-mutilating behaviors described in item 4 below should not be counted here.)

4) Recurrent suicidal behaviors, gestures or threats, or self-mutilating behaviors, which can include cutting or burning oneself or any other action designed to inflict pain on oneself.

Affective/ emotional instability:

5) Unstable moods, with swings to anger, sadness or anxiety in reaction to life situations. These moods states usually do not last more than a few hours, and rarely more than a few days.

6) Longstanding feelings of emotional emptiness.

7) Difficulty controlling one's anger, which can lead to intense and inappropriate displays of anger and aggression, including physical fights.

Cognitive disturbances:

8) Significant trouble maintaining a stable self-image or sense of self. The individual will tend to see him or herself differently in different situations, often in response to how they feel others are relating to them. The individual will also have trouble feeling consistent and will have interests, goals or values that are often changing.

9) Transient, stress-related paranoid thoughts or dissociative symptoms.