The Truth About Borderline Personality Disorder

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Most of us have heard of borderline personality disorder (BPD) and much of what we hear seems to be negative. Patients with this disorder have gotten a bad reputation, thanks - in part - to the movie Fatal Attraction. BPD tends to be poorly misunderstood as it is, so to say that the main female character in Fatal Attraction represents a typical BPD sufferer is unfair and unrealistic. 

Criteria for the Diagnosis of Borderline Personality Disorder 

A diagnosis of borderline personality disorder is made by a mental health professional using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) criteria established by the American Psychiatric Association.

In order to be diagnosed with BPD, you must meet five or more of these nine symptoms:

  1. Frantic efforts to avoid abandonment, whether real or imagined and experiencing extreme emotions when any abandonment is perceived. 
  2. Having had unstable and intense interpersonal relationships that involved both extremes of idealizing the relationship ("He's perfect for me!") and not valuing the relationship ("I can't stand him!").
  3. Not having a stable self-image or identity.
  4. Engaging in impulsive and risk-taking behavior such as spending money, having unsafe sex, substance abuse, reckless driving, binge eating, and the like.
  5. Having extreme and intense moods, such as irritability, anxiety, or depression that last from a few hours to a few days.
  6. Continual feelings of being empty.
  7. Having anger issues, including intense anger that is inappropriate for the situation, inability to control temper, being angry all the time and/or engaging in physical fights.
  8. Feeling disconnected from your mind or body and having paranoid thoughts when you're under stress, leading to potential psychotic episodes.
  9. Repeated suicidal behavior or threats or self-mutilation.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Who Develops Borderline Personality Disorder?

Recent research has shown that many people diagnosed with BPD are trauma survivors. Genetics may also play an important role in developing BPD. Studies show that if you have a parent, sibling, or child with BPD, your chances of developing it yourself are five times greater. There also appears to be neurological impairment in people with BPD, meaning that certain areas of the brain do not communicate well with other areas.

Borderline personality disorder usually starts in adolescence or young adulthood. An estimated 1.6 percent of adults deal with BPD though that number could be significantly higher. Females are typically the population that is diagnosed, but studies have shown that males have tended to be misdiagnosed with post-traumatic stress disorder (PTSD) or depression instead of BPD.


There are several psychotherapy approaches that have been proven to be helpful in borderline personality disorder. One of these, dialectical behavior therapy (DBT), is an approach that combines techniques from several approaches and takes advantage of a combination of group and individual therapy.

Though the Food and Drug Administration (FDA) has not approved the use of any medications to treat BPD, some physicians prescribe them to BPD patients to help reduce certain symptoms like depression or anxiety. 

Living With Borderline Personality Disorder

Being diagnosed with borderline personality disorder means you have taken your first step to getting your symptoms under control.

Your physician will work with you to develop a personalized treatment plan that maximizes your quality of life while reducing your symptoms as much as possible. This can take time and multiple adjustments, so be patient and keep communication open with your doctor about how you are doing.

Surround yourself with supportive people and learn everything you can about BPD so you can take steps to increase your mental well-being.

2 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.

  2. National Institute of Mental Health (NIMH). Borderline Personality Disorder.

By Leonard Holmes, PhD
Leonard Holmes, PhD, is a pioneer of the online therapy field and a clinical psychologist specializing in chronic pain and anxiety.