Symptoms and Clinical Features
Individuals diagnosed with Borderline Personality Disorder (BPD) often possess a heightened sensitivity, comparable to having a raw nerve exposed. Even minor occurrences can provoke intense emotional responses, and once upset, finding resolution or returning to baseline becomes challenging. This emotional instability and difficulty in self-soothing can result in rocky relationships and impulsive, sometimes even risky, actions.
A symptom is something an individual notices about themselves, while a clinical feature or sign is something a doctor or professional notices. Explore various symptoms and clinical features below that individual's with BPD often resonate commonly with. Keep in mind that not all individual's with BPD experience all the below symptoms and features, as BPD falls on a spectrum similar to many other disorders.
Irritability & Anger
Borderline personality disorder often presents with intense and inappropriate anger, which is commonly known as "borderline rage." This anger can manifest as explosive episodes that are hard to control and can greatly impact a person's relationships.
Splitting
Borderline personality disorder causes individuals to struggle with accurately evaluating others or situations, leading to extreme black-and-white perceptions. Splitting occurs when someone unconsciously views people as either all good or all bad, without recognizing the gray areas.
Self-Mutilation
Self-mutilation is frequently observed in individuals with BPD, yet it does not necessarily indicate a desire to end one's life. Instead, it serves various purposes such as managing negative emotions, conveying distress, expressing feelings, and dealing with dissociative experiences. Several factors, including biological, psychological, and social risks, contribute to the likelihood of engaging in self-harm.
Identity Disturbance
Borderline personality disorder causes confusion about who you are, with conflicting beliefs and behaviors, strong attachment to groups or roles, and struggles with commitment to work, values, and goals.
“You have mastered the art of protecting your conscience while completely masking your sooul.”
― Angel Foxx, Poetic Turbulence
Chronic Emptiness
People diagnosed with BPD frequently go through intense and changing emotions. After these emotions calm down, they might be left feeling empty or numb. The persistent sense of emptiness in BPD could be connected to emotional instability
Intense Mood Shifts
Individuals diagnosed with borderline personality disorder often encounter drastic shifts in their emotions and struggle with a sense of self-uncertainty. Their feelings towards others can rapidly fluctuate, ranging from intense closeness to strong aversion. These ever-changing emotions can result in unstable relationships and emotional distress.
Intense & Unstable Relationships
People with BPD often struggle with intense and unstable relationship patterns, oscillating between idealization and devaluation, and experiencing both a desire for closeness and a fear of rejection due to interpersonal hypersensitivity
Paranoia
When individuals with BPD are stressed, they may have paranoid thoughts. Paranoia involves strong feelings of distrust towards others or believing that others have harmful intentions.
Extreme Fear of Abandonment
Individuals diagnosed with BPD experience a profound dread of being abandoned. They constantly seek validation from others, constantly fearing rejection and often feeling isolated even within close relationships. Consequently, they struggle to navigate the typical highs and lows of a romantic partnership. Engaging in impulsive and self-destructive actions may serve as a coping mechanism to alleviate the mounting anxiety associated with the fear of being abandoned.
Disturbed Patterns of Thinking
Various thoughts can impact individuals with BPD, like distressing thoughts about being a bad person or feeling like you don't exist. It's common to doubt these thoughts and seek confirmation that they're inaccurate.
Panic
Many individuals with borderline disorder often experience symptoms of anxiety and panic attacks. Around 90% of people with this disorder have anxiety symptoms. Stressful situations can trigger heightened levels of anxiety and panic attacks in those with borderline disorder.
Emotional Instability
Emotion dysregulation refers to the difficulty in effectively handling and adapting to emotions. Individuals with BPD often experience frequent and abrupt changes in their emotional states, often characterized by negative emotions like anxiety, depression, or anger.
Masochistic Characteristics
More commonly among BPD women, those with masochistic traits reported more child sexual abuse, more hostile/dismissing attachments, higher sensation seeking, and more frequently exploratory/impersonal sexual fantasies than BPD without masochistic traits.
Demandingness and Control
People with petulant borderline personality disorder may develop excessively high expectations of others, which are often unrealistic and detrimental to their well-being. Consequently, they may exhibit unreasonable anger and make excessive demands when these expectations are not fulfilled.
Hypersexuality
Hypersexuality in BPD can be viewed as an ineffective way of dealing with overwhelming emotional distress or a sense of emptiness commonly linked to the disorder. Engaging in sexual activities temporarily alleviates these unpleasant emotions, offering a brief respite.
Dysphoria
Individuals with Borderline Personality Disorder may feel intense emotions, which can worsen feelings of dysphoria. These strong feelings of dysphoria may lead to risky impulses. Relationships evolve during a gender transition, and the 'coming out' process can be distressing.
Euphoria
People with BPD may experience moments of intense happiness called euphoria, but they usually struggle more with dysphoria, which is a deep sense of unease or dissatisfaction, as well as depression and overall distress.
Impulsivity & Risky Behavior
Acting without thought when making decisions. Struggling to see consequences and danger of specific situations and decisions. Can include running away, substance use, self-harm, violent outburts, increase of risky sexual behaviors, body modifications, legal trouble, spending sprees, reckless driving, disordered eating, etc.
Suicidal Ideation
Suicidality is frequent among individuals with BPD. Studies indicate that approximately 75% of those with BPD will try to commit suicide at least once, with many making multiple attempts. Around 10% of BPD patients will end their lives by suicide.
Shame
Studies suggest that individuals diagnosed with borderline personality disorder tend to have higher levels of shame, while surprisingly experiencing less guilt, in comparison to the general population. Shame is associated with feelings of inadequacy, diminished self-worth, and a negative self-perception. During intense episodes of shame, we may temporarily lose access to positive self-regard and struggle to maintain a coherent sense of our own existence or worthiness.