BPD Diagnosis Diagnosing and Treating Borderline Personality Disorder Is There a Borderline Personality Disorder Test? By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. Learn about our editorial process Updated on August 27, 2019 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Tom Merton / Caiaimage / Getty Images Borderline personality disorder (BPD) is a mental health condition that causes people to have difficulty regulating their emotions. The primary symptoms of the condition are dramatic mood swings, impulsive behaviors, poor self-esteem, and persistent difficulties in personal and professional relationships. While mental health professionals may use screening tools to help diagnose BPD, a single, definitive diagnostic test for borderline personality disorder doesn't exist. Instead, a licensed mental health provider will diagnose BPD through a thorough assessment. Diagnosis If you suspect that you or a loved one has BPD, look for a mental health professional with experience diagnosing and treating personality disorders. Only a qualified mental health professional like a psychiatrist, psychologist, or clinical social worker can diagnose BPD. Usually, a diagnosis is made after a comprehensive assessment, which entails much more than a single test. The process may include consultations and conversations with previous caregivers, family members, and friends. A medical exam is often part of the assessment because it can help rule out other causes for the reported symptoms. The Assessment Process When you arrive for your first session with your new therapist, you may feel nervous or uncomfortable. Your therapist should share their diagnostic approach with you, but don't hesitate to ask questions about what their assessment might entail. The assessment may carry over into a few sessions. That's OK. Your therapist will ask you questions about your symptoms, health history, and life. You may be asked to complete a questionnaire or screening test. If you are diagnosed with BPD, your therapist will discuss recommended treatment options to help you manage your symptoms and feel better. As part of their assessment, mental health professionals may use screening tools to assist with diagnosis, including: The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), which is a 10-item, paper-and-pencil test based on DSM-5 diagnostic criteria The Personality Diagnostic Questionnaire (PDQ-4), which offers another approach with 99 true or false questions that screen for several different personality disorders, including BPD Professionals may also use resources like the APA's Structured Clinical Interview for DSM-5 Personality Disorders to help screen for BPD. What to Know About the BPD Assessment Process Diagnostic Criteria Ultimately, an official diagnosis requires at least five of the nine primary symptoms of BPD to be present: Fear of abandonment Unstable and intense interpersonal relationships Uncertainty about self-image or identity Impulsive behavior Self-injurious behavior Emotional reactivity or instability Feelings of emptiness Difficulty controlling intense anger Transient suspiciousness or "disconnectedness" Often, ordinary activities and events can precipitate symptoms in a person with BPD. For example, when a close friend or relative takes a vacation or has to cancel plans due to a work conflict, a person with BPD may become disproportionately upset and angry, fearing abandonment. A Closer Look at the Criteria for BPD Diagnosis Causes It is not yet known exactly what causes borderline personality disorder, but a combination of genetics, neurological, and social factors are most likely at play. For example, people with a first-degree relative who has the condition are about five times more likely to also have BPD. Additionally, many people with BPD experienced a past trauma that may have influenced the development of the disorder. Imaging studies have shown that people with BPD demonstrate structural and functional differences in their brains compared to those who don't have BPD. Here's What May Cause Borderline Personality Disorder Treatment BPD treatment typically involves some combination of therapy, medication, and social support. Psychotherapy Therapy for BPD may include the following: Cognitive behavioral therapy Dialectical behavioral therapy Psychodynamic psychotherapy The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. Medication Medications may be adjusted over time based on trial and error and may include: Antidepressants Antipsychotics Mood stabilizers Patients treated with any anti-seizure medications, like Neurontin (gabapentin), should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Lifestyle Modifications In addition, adhering to some of the following lifestyle modifications may be useful in recovering from BPD: Maintain a regular eating and sleeping scheduleExercise regularlySpend time with friends and family and build trusting relationships with people you can confide inInform friends, family, and co-workers about what may trigger symptomsBe patient with your progressLearn about your condition and stay informed about treatment optionsAvoid alcohol and drugs It's important to note that BDP frequently co-occurs with other mental illnesses like depression, anxiety disorders, bipolar disorder, eating disorders, or substance use disorder. A study published in the Journal of Affective Disorders found that BPD is a risk factor for bipolar disorder, and one-fifth of people with BPD also have a diagnosis of bipolar disorder. This comorbidity can make a diagnosis and effective treatment of BPD more difficult but not impossible. A Word From Verywell Borderline personality disorder is associated with a high risk of self-harm or suicide. If you or someone you know is exhibiting symptoms of BPD or any other mental illness, it's important to talk to a doctor and get help. While there is no single test you can take to diagnose BPD, a licensed mental health professional can help determine whether your symptoms indicate BPD or another personality disorder and most importantly, recommend treatment that can improve your quality of life. Could You Have BPD? 4 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. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. National Institutes of Health. National Institute of Mental Health. Borderline personality disorder Frías Á, Baltasar I, Birmaher B. Comorbidity between bipolar disorder and borderline personality disorder: Prevalence, explanatory theories, and clinical impact. Journal of Affective Disorders. 2016;202:210-219. doi:10.1016/j.jad.2016.05.048 Frías Á, Baltasar I, Birmaher B. Comorbidity between bipolar disorder and borderline personality disorder: Prevalence, explanatory theories, and clinical impact. Journal of Affective Disorders. 2016;202:210-219. doi:10.1016/j.jad.2016.05.048 By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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