Borderline Personality Disorder (BPD)

Borderline Personality Disorder (BPD) is a complex and chronic mental health condition characterized by pervasive patterns of instability in emotions, self-image, interpersonal relationships, and behavior. These symptoms often lead to significant distress and impairment in personal, social, and occupational functioning. BPD is classified as a Cluster B personality disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Diagnostic Criteria (DSM-5)

A diagnosis of BPD requires the presence of at least five or more of the following criteria, which are stable over time and across situations:

1. Fear of Abandonment: Intense fear of real or imagined abandonment and frantic efforts to avoid it.
2. Unstable Relationships: Intense and unstable interpersonal relationships characterized by alternating extremes of idealization and devaluation (often referred to as “splitting”).
3. Identity Disturbance: Markedly unstable self-image or sense of self.
4. Impulsivity: Impulsive behaviors in at least two areas that are potentially self-damaging (e.g., spending, substance abuse, reckless driving, binge eating).
5. Recurrent Suicidal Behavior or Self-Harm: Recurrent suicidal gestures, threats, or self-mutilating behavior.
6. Emotional Instability: Marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety lasting a few hours to days).
7. Chronic Feelings of Emptiness: Persistent sense of emptiness or lack of fulfillment.
8. Inappropriate Anger: Intense and inappropriate anger or difficulty controlling anger (e.g., frequent outbursts, constant anger, recurrent physical fights).
9. Paranoid Ideation or Dissociation: Transient, stress-related paranoid thoughts or severe dissociative symptoms.

Core Features

1. Emotional Dysregulation: BPD is often characterized by difficulty managing intense emotions, leading to rapid mood swings.
2. Interpersonal Challenges: Relationships are often unstable, intense, and conflict-ridden.
3. Impulsivity: Reckless actions can lead to physical, financial, or relational harm.
4. Self-Image Instability: Individuals may struggle with a fragmented or fluctuating sense of identity.

Causes and Risk Factors:

BPD results from a combination of genetic, environmental, and social factors:

• Biological: Dysregulation in brain regions involved in emotional regulation (e.g., amygdala, prefrontal cortex) and neurotransmitter imbalances.
• Psychological: A history of childhood trauma, neglect, or abuse is common among individuals with BPD.
• Environmental: Unstable family environments, invalidation of emotions, or chronic stress may contribute.