Borderline Personality Disorder Symptoms

Nobody knows for sure what causes borderline personality disorder, but there are some theories. Most researchers and professionals believe that BPD is caused by a variety of factors, including biological, genetic and environmental factors, that work together to increase a person’s risk for developing BPD. Many people with BPD report having distressing childhood experiences that typically involve caregivers, such as childhood abuse, neglect, emotional abuse and early separation from caregivers. This plays a large role in the symptoms of BPD, which are outlined below.

BPD Symptom #1: Extreme fear of abandonment.

People with BPD frequently fear being left or abandoned by loved ones and will often believe they are being abandoned, even when they’re not. This leads to intense abandonment fears and inappropriate anger, even when the abandonment is imagined (such as if an appointment is cancelled or someone is a few minutes late). This often leads to frantic efforts to avoid real or imagined abandonment, such as self-mutilation, suicidal gestures, or even physically clinging to a person.

BPD Symptom #2: Emotional instability.

BPD causes frequent and intense mood swings that are caused by reactions to stress. These mood swings typically involve feelings of intense anger, sadness, panic, despair, anxiety or irritability that can last for only a few minute up to a few hours, but usually never more than a few days.

BPD Symptom #3: Unstable relationships.

BPD patients have a pattern of unstable and intense relationships that are marked by lots of conflict, arguments and repeated breakups. This is usually caused by an unrealistic “idealization” of lovers or potential caregivers. BPD patients typically share intimate details early in the relationship and demand a lot of time spent together, but then quickly switch to feelings of disappointment or even hatred of loved ones because they feel the person doesn’t care enough or isn’t there for them enough. A person with BPD can fluctuate between feeling as if they can’t live without someone to feeling as if they can’t get far enough away from the same person within a short period of time.

BPD Symptom #4: Unstable identity.

People with BPD will experience dramatic and persistent shifts in self-image, such as feeling okay about themself one minute and feeling like they’re a bad person the next minute. They often feel unsure about who they really are or what they believe in, and may suddenly change their mind about their career, sexual identity, goals, values, and who they hang out with. These experiences are usually triggered when these individuals are in an environment where they feel alone or unsupported.

BPD Symptom #5: Impulsive, self-damaging behavior.

People with BPD will exhibit impulsive behaviors in at least two areas, including sex, substance abuse, reckless driving, binge eating, self injury, gambling, spending, etc.

BPD Symptom #6: Chronic emptiness.

BPD patients often have a history of constantly feeling empty or emotionally dead. They become easily bored and may constantly seek something to do to fill their emptiness.

BPD Symptom #7: Intense, inappropriate anger.

People with BPD will experience intense anger that is usually inappropriate or unwarranted. They also have difficulty controlling their anger and may act out by getting into physical fights, having verbal outbursts, breaking things or displaying extreme sarcasm. This behavior is often exhibited when they think a caregiver is being neglectful, uncaring, withholding, or abandoning them, and is often followed by feelings of shame and guilt that only reinforce their belief that they are inherently bad or evil.

BPD Symptom #8: Suicidal behaviors or self-harm.

BPD patients sometimes have recurrent suicidal thoughts, attempts and gestures, and will threaten suicide to test their loved ones. Self-injury or mutilation such as cutting or burning is also common in BPD patients. These behaviors are usually preceded by real or imagined threats of separation or rejection.

BPD Symptom #9: Self-induced paranoia or dissociation.

BPD can cause patients to respond to stress by having paranoid thoughts (like feeling as if someone is trying to harm them) or dissociating from reality so that people or things seem unreal or they feel like they’ve “zoned out” or are numb. These periods are usually rare and tend to last for only a few minutes or hours.

Treating Borderline Personality Disorder Symptoms

Treatment of BPD symptoms typically involves long-term psychotherapy (“talk” therapy) with a therapist who is experienced at treating this kind of disorder. Dialectal behavior therapy is often the most effective form of psychotherapy treatment for patients with BPD. Sometimes medications such as antidepressants and mood stabilizers may also be prescribed to help with very specific and debilitating symptoms, such as depression and anxiety.

There are so many stigmas and shame attached to mental illness that people often don’t want to come forward with their symptoms and seek help. If you think that you suffer from BPD or know someone who may be, it’s important to seek help and support right away, especially if substance abuse is present. The symptoms of BPD are dangerous enough without the added stress and health risk of alcohol or drug abuse.


This blog is for informational purposes only and should not be a substitute for medical advice. We understand that everyone’s situation is unique, and this content is to provide an overall understanding of substance use disorders. These disorders are very complex, and this post does not take into account the unique circumstances for every individual. For specific questions about your health needs or that of a loved one, seek the help of a healthcare professional.