Borderline personality disorder (BPD) is a mental health condition that is characterized by instability in moods, behavior, self-image, and functioning. It is also known as emotionally unstable personality disorder (EUPD). People with BPD may have difficulties controlling their emotions and impulses, leading to impulsive and self-destructive behaviors. Therapists can identify BPD by assessing an individual’s symptoms and behavior.
Signs and Symptoms of BPD
People with BPD often experience intense emotions, such as anger, anxiety, and depression. They often have difficulty controlling their emotions, leading to impulsive and self-destructive behaviors. Common signs and symptoms of BPD include:
• Intense mood swings and difficulty managing emotions
• Unstable relationships with friends, family, and significant others
• Impulsive and risky behaviors, including drug and alcohol abuse, self-harm, and unprotected sex
• Intense feelings of emptiness and loneliness
• Difficulty controlling anger and intense outbursts of rage
• Fear of abandonment and intense need for attention
• Inappropriate and extreme reactions to perceived criticism or rejection
• Extremely low self-esteem and feelings of worthlessness
Diagnostic Criteria
In order to diagnose BPD, therapists typically use criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to the DSM-5, a person must display at least five of the nine criteria to receive a diagnosis of BPD. The nine criteria are:
• Frantic efforts to avoid real or imagined abandonment
• Unstable and intense interpersonal relationships characterized by alternating between idealization and devaluation
• Identity disturbance, such as a significant and persistent unstable self-image or sense of self
• Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
• Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
• Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
• Chronic feelings of emptiness
• Inappropriate, intense anger or difficulty controlling anger
• Transient, stress-related paranoid ideation or severe dissociative symptoms
Assessment and Diagnosis
When assessing and diagnosing BPD, therapists typically use a combination of clinical interviews, psychological tests, and questionnaires. During the clinical interview, therapists ask questions about the individual’s symptoms, behaviors, and feelings. They also ask about the person’s family and social relationships, work or school history, and medical history.
Psychological tests and questionnaires can also be used to assess the individual’s mental health. For example, a therapist may use the Minnesota Multiphasic Personality Inventory (MMPI-2) to assess the individual’s personality and mental health. The results of these tests and questionnaires can help the therapist determine if an individual meets the criteria for BPD.
Treatment
Once BPD is diagnosed, a therapist or mental health provider can develop a treatment plan that is tailored to the individual’s needs. Treatment typically includes individual therapy, group therapy, and medications. Individual therapy is often used to help the person learn coping skills and better manage their emotions and behaviors. Group therapy can also be beneficial, as it can provide support and a safe space for the person to share their experiences. Medications may also be used to help manage symptoms.
In conclusion, therapists can spot BPD by assessing an individual’s symptoms and behavior. They typically use a combination of clinical interviews, psychological tests, and questionnaires to diagnose BPD. Once diagnosed, a therapist can develop a treatment plan that is tailored to the individual’s needs.
