Borderline personality disorder is a mental health condition with a pattern of consistently changing mood, self-image, and behavior. People who have borderline personality disorder often have difficulty in maintaining relationships and are prone to impulsive action.
The mood swings seen in people with borderline personality disorder leads to quick changes in interests, values, and most things are viewed in extremes of being all good or all bad. They are sometimes misdiagnosed with other mood disorders because some of the patterns are similar, like impulsive behavior and intense episodes of anger, depression, and anxiety.
One distinguishing factor between it and other mood disorders, like bipolar disorder, is that the difficulties in maintaining relationships, changes in moods, thoughts or threats of self-harm, and feelings of dissociation have often been a pattern for at least one year. Sudden changes in functioning or if all of the symptoms are new it is less likely to be borderline personality disorder.
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If you or someone you know is in crisis and threatening self-harm or suicide, contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). This is a national toll-free number that is available 24/7 that will provide confidential support and connect you to local crisis centers.
Criteria for Borderline Personality Disorder
The criteria for diagnosing borderline personality disorder is based on the prevalence of common symptoms. These are outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DMS-5). For someone to be diagnosed with borderline personality disorder there must be five of the nine signs and symptoms present.
According to the DSM-5 the nine criteria for borderline personality disorder are:
- Fear of abandonment
- Unstable and intensive relationships with rapid changes between idealization and derogation
- Identity disorder
- Impulsivity (spending money, unsafe sexual behavior, substance abuse, and other risk-taking behavior)
- Recurrent suicidal behavior, threats of committing suicide, or behaviors causing self-harm
- Emotional instability
- Feelings of emptiness
- Inappropriate anger and uncontrolled aggression
- Stress dependent paranoid ideations or dissociative symptoms
How Is Borderline Personality Disorder Diagnosed?
There are no clinical imaging or laboratory tests that can diagnose borderline personality disorder. It is diagnosed through an assessment by a clinician trained in mental health disorders.
It’s not possible to diagnose yourself with borderline personality disorder because the symptoms overlap with multiple other mental health conditions, like:
Seeing a trained health care provider can not only make sure you receive an accurate diagnosis but also help with developing a treatment plan to help manage and reduce the symptoms you experience.
Types of Tests
The Diagnostic Interview for Borderlines—Revised
The revised diagnostic interview for borderlines is a semi-structured interview that assesses the symptoms and signs of borderline personality disorder. It is based on reported behaviors and feelings by the individuals for the last past two years. This interview for this test takes about 30 to 60 minutes to complete.
Structured Clinical Interview
The structured clinical interview follows the official interview guide from the American Psychiatric Association. It’s done by a clinical directly asking you questions that are related to the DSM-5 criteria for borderline personality disorder.
The Mclean Screening Instrument
The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) is a questionnaire sometimes used during assessments that consists of 10 questions. This is commonly used to screen for borderline personality disorder.
Borderline Personality Questionnaire
The borderline personality questionnaire is a longer form questionnaire to assess the symptoms, including 80 true/false questions.
The International Personality Disorder Examination Screening Questionnaire
This tool is a 77-item questionnaire completed by the patient for personality disorders. There is a subsection of the questionnaire that is designed specifically to assess the criteria for diagnosing borderline personality disorder.
The Mood Disorder Questionnaire
This is a self-report questionnaire that is used for diagnosing mood disorders. However, this is not the most effective tool for diagnosing borderline personality disorder because it has been found to often misdiagnose the person with bipolar disorder.
Effectiveness of Tests
For an official diagnosis of borderline personality disorder, an assessment by a trained mental health provider—such as a psychiatrist or psychologist—is required. They will do this through an interview, medical exam, and a diagnostic tool. Self-reported questionnaires are less commonly used in clinical settings.
A Word From Verywell
Borderline personality disorder is difficult to diagnose because its symptoms overlap with many other mood disorders. Both interviews and questionnaires can be used to assist a trained professional in making an accurate diagnosis. After diagnosis, consistently following a treatment plan created alongside trained mental health professionals will help to manage the symptoms of borderline personality disorder.
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