Symptoms

There are nine specific diagnostic criteria (symptoms) for borderline personality disorder defined in the
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (referred to as DSM-IV-TR, or just DSM-IV) published in 2000 by the American Psychiatric Association.1  In order to be diagnosed with borderline disorder, you must have five of the nine criteria.

It is now common to list the symptoms of the disorder in four groups or dimensions:

1. Excessive, unstable and poorly regulated emotional responses.
The most commonly affected emotions are anger, anxiety and depression. Of the nine DSM-IV criteria for borderline disorder, three fall into this group:

  • Affective (emotional) instability including intense, episodic emotional anguish, irritability, and anxiety/ panic attacks
  • Anger that is inappropriate, intense and difficult to control, and
  • Chronic feelings of emptiness

In addition, if you suffer from borderline disorder, you may also experience

  • Emotional over reactivity (“emotional storms”)
  • Emotional responses that are occasionally under reactive, and
  • Chronic boredom

2. Impulsive behaviors that are harmful to you or to others.
Two of the DSM-IV criteria for borderline disorder are in this group:

  • Self-damaging acts such as excessive spending, unsafe and inappropriate sexual conduct, substance abuse, reckless driving, and binge eating, and
  • Recurrent suicidal behavior, gestures, threats, or self-injurious behavior

Also, you may engage in other impulsive behaviors such as actions that are harmful and destructive to yourself, others or to property.

3. You may have an inaccurate view of yourself and others, and experience a high level of suspiciousness and other misperceptions.

Two of the DSM-IV criteria for borderline disorder are included in this group:

  • A markedly and persistently unstable self-image or sense of your self (your identity), and
  • Paranoid ideation or severe dissociative episodes (transient and stress related)

In addition, you may consistently experience

  • Expectations of negative and harmful attitudes and behaviors from most people
  • Impaired social reasoning under stress
  • Impaired memory under stress

4. Finally, you may experience tumultuous and very unstable relationships. 

The final two DSM-IV criteria fall in this group:

  • You may engage in frantic efforts to avoid real or imagined abandonment, and
  • Your relationships may be very intense, unstable, and alternate between the extremes of over idealizing and undervaluing people who are important to you

You may also recognize that you have overly dependent and clinging behavior in important relationships.


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