Unveiling Borderline Personality Disorder: 9 Common Signs You Should Know

Human minds are complex and understanding them isn’t always easy. Unfortunately, the stigma surrounding mental health disorders still prevents people from accessing the support they need.

A common misconception surrounding mental health challenges is that they only affect “weak” people, which can stop people from seeking help. The truth is that mental health conditions do not discriminate—they can affect anyone.

Although all mental health disorders are stigmatized, borderline personality disorder (BPD) is an especially stigmatized type of personality disorder. As it is characteristic of extreme symptoms and volatility, alongside relatively little research, misconceptions are commonplace even in the medical world.

BPD is often misdiagnosed, as its symptoms can overlap with other mental health conditions like Bipolar Disorder, Anxiety Disorders, and Depressive Disorder. For example, BPD and Bipolar Disorder can share similarities in terms of mood instability, impulsivity, and emotional dysregulation. The key distinction is that Bipolar Disorder involves distinct episodes of manic or hypomanic highs and depressive lows, whereas BPD is characterized by more rapid and short-term mood fluctuations.

The intense emotions, self-harm behaviors, and feelings of emptiness in BPD can sometimes lead to a misdiagnosis of a Depressive Disorder. However, in BPD, mood instability is a prominent feature, and depressive symptoms may fluctuate rapidly.

BPD can also present with symptoms resembling various anxiety disorders, such as generalized anxiety disorder (GAD), panic disorder, or post-traumatic stress disorder (PTSD). The key difference is that BPD typically involves a broader range of emotional and interpersonal difficulties beyond anxiety alone.

BPD is characterized by a wide range of symptoms and patterns of behavior that may also be present in other mental health conditions, there are several distinct features and behavioral patterns that are commonly associated with BPD.

Here are some clear, unique signs that may be indicative of BPD:

1.   Fear of Being Abandoned, Whether Real or Imagined

Extreme fear of abandonment, both real and imagined, is a common sign of BPD. People may experience anxiety over situations like a partner going on a trip, with a tendency to think the worst. Imagined scenarios, such as suspecting that a friend is upset with you, may also cause great stress. Sometimes, this fear can manifest as frantic efforts to avoid abandonment, including self-destructive behaviors.

2. Unstable and Intense Interpersonal Relationships

People with BPD often have tumultuous relationships that swing from intense love to extreme dislike quickly. It’s not about being difficult—it’s a genuine struggle with emotional regulation, something that’s central to the borderline personality disorder DSM 5 criteria.

3. Identity Disturbance

Identity disturbance, or identity diffusion, refers to difficulties in remaining consistent. A deep lack of self-understanding may lead to over-identification with group identities or the frequent change of interests and goals. This tumultuous internal landscape may leave people feeling confused and empty. Although feelings of uncertainty are common, for people with BPD, they go beyond regular self-doubt. Intense feelings of confusion can be distressing, causing people to feel unmoored in life.

4. Impulsive Behaviors

Impulsive actions, like excessive spending, binge eating, or drug use, can be a coping mechanism for managing overwhelming emotions. People may experience an uncontrollable urge to act on an impulse to relieve internal discomfort in the short term. As a temporary distraction, these impulsive behaviors often lead to undesirable consequences, causing more harm in the long term.

5. Recurring Suicidal Thoughts or Parasuicidal Behaviors

Persistent thoughts of suicide, tendencies toward self-harm, and parasuicidal behaviors are often associated with BPD. It’s crucial to understand that these signs highlight a need for professional assistance, regardless of whether they are symptomatic of BPD or any other mental health issue. Seek help if you find yourself facing these thoughts or actions by calling the 988 suicide and crisis lifeline.

6. Unstable Mood and Irritability

The irritability that accompanies BPD is more than just feeling grumpy after a bad day—it’s about severe mood swings that can last from a few hours to a few days. This distinct feature of BPD is what often leads to confusion in the Borderline Personality Disorder vs. Bipolar Diagnosis.

7. Chronic Feelings of Emptiness

Feeling empty can often feel like a hole inside that nothing can fill, a persistent sensation of loneliness, or a lack of fulfillment. Although we all may have days where we feel lost or empty, for people with BPD, it’s a profound, chronic feeling. People often describe it as a numbness that leads to a disconnect with the world around them and a lack of fulfillment in life.

8. Difficulty Controlling Anger

Struggling to control anger, having frequent outbursts, or experiencing intense annoyance can be indicative of BPD. Intense bouts of anger can occur suddenly and often without any apparent external triggers, leading to difficulties within interpersonal relationships. Anger may be directed outward during arguments or fights, or it might be directed inward, leading to feelings of self-loathing, shame, and in some cases, self-harm.

9. Stress-Induced Paranoia

Under stress, experiences of severe dissociation and paranoia are common for people with BPD. Paranoia refers to intense and irrational suspicions or beliefs that others are intending to harm or deceive you, even when there is no evidence to support such beliefs. This paranoia may extend to suspicions surrounding others’ motives, leading to a loss of touch with reality. Feelings of fogginess, known as dissociation, may accompany high-stress periods.

common signs someone has a borderline personality disorder (BPD)

Seeking Help for BPD

Are you wondering, “Do I have borderline personality disorder?” or do some of these signs resonate deeply with you? Seeking professional guidance will help. Living with untreated BPD can be a scary, isolating experience. When undiagnosed, people with BPD may not understand their own behavior or feel frustrated with difficulty maintaining interpersonal relationships. In the light of a diagnosis, family members and friends can support the individual in more appropriate ways.

People with BPD behaviors may often say hurtful things to people they love, lash out for fear of abandonment, or act in irresponsible ways, but these actions do not reflect the person themselves. These actions are symptoms of a complex and serious mental health condition that requires treatment and support. A mixture of therapy and medication for borderline personality disorder can help people manage their symptoms and maintain interpersonal relationships. Take the first steps to develop healthy coping strategies by finding a licensed mental health care provider who is specializing in treating Personality Disorders.

For a deeper dive on understanding borderline personality disorder, check out our Convos from the Couch podcast series with LifeStance provider Jami Shanes, LPCC.

Authored By 

LifeStance Health
LifeStance Health

LifeStance is a mental healthcare company focused on providing evidence-based, medically driven treatment services for children, adolescents, and adults suffering from a variety of mental health issues in an outpatient care setting, both in-person and through its digital health telemedicine offering.