Symptoms & Signs of Borderline Personality Disorder (BPD)

What Is Borderline Personality Disorder (BPD)?

Borderline personality disorder (BPD)–also known as emotionally unstable personality disorder (EUPD)–is characterized by abnormal patterns of thinking about self and others, emotional instability, behavioral problems, and unhealthy relationships.⁴ People with BPD are often complex trauma survivors who struggle with an intense fear of abandonment, low self-esteem, intense mood swings, and impulsive decision-making.³

BPD & Stigma

The public, loved ones, and the healthcare community often have negative assumptions about BPD. People with BPD may be labeled immature, unstable, manipulative, and untreatable. This stigma stems from a lack of knowledge, misinformation, and outdated data. Because of this, many individuals with BPD do not receive appropriate care.⁹

However, due to scientific research, BPD can now be better understood and given medical attention. New developments indicate that appropriate evidence-based interventions can result in favorable outcomes, including BPD symptom reduction, improvement in functioning, and a better quality of life.⁹

9 Borderline Personality Disorder Symptoms & Signs

Borderline personality disorder symptoms include pervasive instability of interpersonal relationships, self-image, and mood. Those with BPD commonly struggle with impulsivity by early adulthood, which can present in various contexts. Some individuals internalize BPD symptoms (as seen in quiet BPD or high-functioning BPD), whereas others exhibit these more externally. Because symptoms of borderline personality disorder can mimic those of other mood, impulse-control, and trauma conditions, BPD is often missed or misdiagnosed.⁵

Below are nine common signs and symptoms of borderline personality disorder:

1. Frantic Efforts to Avoid Abandonment

Deep-seated fears of abandonment and trust issues can drive the negative thoughts, emotions, and actions of someone with BPD.^1,3 Individuals with this condition frequently feel insecure and worry that people will betray, leave, or hurt them. Even in secure relationships, BPD symptoms and worries can be triggered.

To avoid abandonment, those with BPD may become clingy, manipulative, overly reactive to conflict, or oscillate between “hot and cold” affection. In turn, they commonly remain in toxic relationships, become easily jealous or controlling, and engage in negative attention-seeking behaviors.

2. Unstable Relationships

Borderline personality disorder relationships tend to exhibit toxic, unhealthy, or codependent patterns. These same patterns can result in conflict or cause loved ones to cut ties altogether. In romantic relationships, BPD individuals may damage the partnership or break up with their partners despite deep fears of abandonment.^1,4 bpd unstable relationships

Signs of BPD unstable relationships may include:⁶

• Relationships are “on/off” again
• Several burned bridges with long-standing friends
• Alternating between describing relationships as wonderful or terrible
• High levels of conflict
• Patterns of codependent romantic relationships
• Moving quickly from one serious relationship to another
• Having few close friendships or long-lasting friendships
• Being highly sensitive to rejection cues (i.e., rejection sensitive dysphoria)

3. Unstable Sense of Self

Characteristics of borderline personality disorder typically include a lack of a healthy, stable sense of self. Individuals with BPD may seemingly “switch” personalities, moods, or interests based on emotions or those around them. At the core, these behaviors may result from personal insecurities, lack of self-worth, and fear of rejection or abandonment.

Signs of an unstable sense of self in those with BPD may include:^6,7

• Adopting personas and personality traits of others to be liked or accepted
• Going through “phases” of having different interests, styles, or hobbies
• Alternating between states of pride and shame
• Feeling unsure of self or feeling like they have no ‘true self’
• Internalizing expectations, criticisms, and praise given by others or taking things too personally

4. Impulsive Decision Making

People with BPD have a tendency to make poor, impulsive, or destructive decisions based on their emotions or urges.^1,4,7 These behaviors may lead to problems and consequences, often triggering shame, guilt, and regret. Strong, intense, and uncontrollable emotions may contribute to these rash decisions.

Borderline personality disorder impuslivity may include:

• Drinking alcohol or abusing prescribed or illicit substances
• Sexual promiscuity or high-risk sexual behaviors
• Self-sabotaging behaviors that damage the person’s relationships, work, or life
• Unhealthy patterns of behavior (i.e., binge eating)
• Risky behaviors (i.e., reckless driving or driving under the influence)
• Overspending or poor financial decisions
• Saying or doing things out of anger

5. Self-harming Behaviors

Some people with BPD engage in self-harming behaviors, such as cutting themselves, in order to feel alive. Suicidal behaviors and attempts are also common in people with BPD.^1,4,7 Less observable self-harm may include substance misuse, risky decisions, self-sabotaging relationships, restricting food intake, or threats of self-harm.

6. Mood Swings & Intense Emotions

People with BPD have trouble regulating their emotions and tend to experience their feelings intensely. Emotions often display as moodiness, irritability, anxiety, or frequent and intense mood swings and can be easily triggered.^1,4 BPD mood swings can result in anger issues or rage, sometimes resulting in destructive actions or arguments.

Often, the core issue in BPD is not the intensity of one’s emotions but the fact that the individual does not know how to cope with their feelings. Because of this, they often respond to strong emotions in unhelpful ways, such as amplifying or ruminating on negative emotions.

7. Feelings of Emptiness

Another common borderline personality symptom is the feeling of emptiness. Individuals may experience this as emotional numbness or dissociation.^1,4,6,7 Sometimes, these feelings can intensify to hopelessness, helplessness, or worthlessness, and a person may even consider ending their life.

Feelings of emptiness associated with BPD may include:

• Feeling unsure or unclear about who they are
• Feeling numb or apathetic
• Having no interest or enjoyment in activities
• Feeling like something inside of them is broken or missing
• Feeling as though they have no life purpose

8. Intense Anger & Outbursts

People with BPD struggle with emotional regulation, often contributing to anger issues and an inability to control themselves when upset.^1,4,7 When a person with PBD is angry or emotional, they usually have extreme “all or nothing” thoughts about themselves, others, their lives, and their future (also called BPD splitting), which feeds their BPD anger.

Examples of anger issues and outbursts common in people with BPD include:

• Being quick to jealousy, anger, or irritability
• Borderline rage attacks
• Anger outbursts (i.e., yelling, making threats, or becoming aggressive)
• Being quick to lash out, attack someone, or threaten to end a relationship

9. Paranoia & Dissociative Episodes

The signs of BPD may include paranoid thoughts or dissociation. BPD paranoia can range from slight distrust to strong beliefs that others have bad intentions.¹ These thoughts can cause severe anxiety or social avoidance.⁶

Dissociation occurs when a person becomes disconnected from their body, thoughts, or emotions. This experience often stems from stress, trauma, or intense emotional or physical pain. Some studies suggest that as many as 75-80% of people with BPD experience dissociative episodes, which may include.⁸

What Causes BPD?

Researchers believe that genetics and environmental factors contribute to borderline personality disorder. Those with a family history of mental illness may be more likely to develop the condition, as are individuals with certain neurological or psychological predispositions.

Possible causes of BPD include:

• Brain abnormalities: Some studies suggest that people with BPD have abnormalities in the areas of their brain responsible for emotion regulation and impulse control.¹
• Childhood trauma: Many experts believe that BPD develops in response to childhood trauma and is the direct result of lasting psychological and emotional wounds related to these experiences.³ Many symptoms of BPD may have developed as defense mechanisms to protect themselves.
• Genetic factors: Evidence suggests that BPD may be a genetic condition as those with a family member with the condition are more likely to develop it themselves.¹

Borderline Personality Disorder Treatments

When possible, those struggling with borderline personality disorder symptoms should seek treatment early. For example, studies claim early intervention for borderline personality disorder (BPD) in teens or young adults shows favorable results.

Many may wonder, “Is BPD curable?” While “curing” BPD is not possible, individuals with the condition report an overall improvement in their ability to function, maintain healthy relationships, and manage difficult emotions when engaged in treatment. Typical treatment for BPD includes therapy, lifestyle changes, and sometimes medication.

How to Cope With BPD

Dealing with BPD symptoms can be challenging. However, there are healthy methods and tools you can use to manage emotions, improve how you relate to others, and address unhealthy traits of borderline personality disorder. This strategy includes practicing mindfulness, engaging in relaxation techniques, using grounding exercises, developing distress tolerance, and self-care.

Below are some ways to cope with symptoms of borderline personality disorder:¹¹

• Practice mindfulness: Mindfulness for BPD is beneficial because it creates space between emotions, urges, and behavior. If you are aware of your feelings, you can pause before acting. Rather than ruminating about the past or worrying about the future, focus on what is happening now.
• Use relaxation techniques: When our levels of distress are high, thoughts and emotions are especially hard to work with. Relaxation techniques can help us lower distress levels meaning we are less likely to get stuck in maladaptive thinking or difficult emotions. Relaxation techniques might include paced breathing or progressive muscle relaxation.
• Find distractions: Mindfully distracting can be an effective way to get through difficult emotions. Rather than pushing sadness down or attaching to it, engage in an activity that will distract your mind momentarily. A distraction might be watching your favorite TV show episode or taking a walk.
• Use grounding exercises: Mental or physical grounding exercises bring us into the present moment. These are helpful for BPD symptoms because you can use them anytime you have drifted into rumination or worry. Examples include focusing on your senses as you eat or observing nature.
• Develop distress tolerance: When we experience intense emotions, we often have urges to act in ways we regret later. Because of this, people with BPD may feel powerless and ruled by emotional instability. Practice tolerating the moment without making it worse–stop before acting, observe and describe your emotion, and ride the wave of your emotion as it passes.
• Improve social skills: Effectively interacting with others can improve our sense of connection and self-worth, boosting our resilience when negative emotions come our way. Working with a therapist can be a helpful way to look objectively at how you interact with others, allowing you to improve relationships and create a social life that aligns with your values.
• Learn how to process your emotions: We often hear that we need to “process emotions,” but many of us have never learned how to do that. In fact, this seemingly simple idea involves many steps. If you are learning to process emotions, start observing emotions as they happen and writing them down in a journal each day.
• Try volunteering:  Having BPD can lead to feelings of isolation. Volunteering or other activities that connect you to the community can help you feel less alone. For some individuals with BPD, contributing can also build emotional resilience.
• Focus on maintaining self-care: We all need to practice self-care, and those struggling with BPD can especially benefit from moments of being kind to themselves. Self-care might include going to yoga, meditating, or getting a massage. It can also include activities like setting boundaries with difficult people, taking a break from social media, or speaking more kindly to ourselves.

Final Thoughts

The symptoms of borderline personality disorder can be challenging to cope with. While debilitating, negative BPD traits can be treated and often improve with therapies like CBT and DBT.^1,2