Symptoms used to diagnose
The ruleA long-standing pattern beginning by early adulthood, with 5+ of the 9 features below.
Symptoms
- Frantic efforts to avoid abandonment
- Unstable, intense relationships
- Unstable sense of self
- Impulsivity that can be harmful
- Recurrent self-harm or suicidal behaviour
- Intense, quick mood changes
- Chronic emptiness
- Intense or hard-to-control anger
- Stress-related paranoia or dissociation
How diagnosis works
- DSM-5-TR: at least 5 of 9 features, e.g. fear of abandonment, unstable relationships, unstable identity, impulsivity, self-harm, mood swings, emptiness, intense anger, stress-related paranoia or dissociation.
- ICD-11 instead rates personality disorder severity (mild/moderate/severe) with an optional 'borderline pattern' qualifier.
A diagnosis is made by a qualified clinician after a full assessment — this summary is to help you understand it, not to self-diagnose.
Commonly used medications
Medication isn't usually a first-line treatment for this condition.
Therapies & support
- Dialectical behaviour therapy (DBT)
- Mentalisation-based therapy (MBT)
- Schema therapy
Good to know
- No medication is licensed for BPD; NICE advises against routine medication, though co-occurring conditions may be treated.
Sources
- 01Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR)
American Psychiatric Association, 2022
- 02ICD-11 for Mortality and Morbidity Statistics — Chapter 6: Mental, behavioural or neurodevelopmental disorders
World Health Organization, 2022
- 03The Maudsley Deprescribing Guidelines
Horowitz & Taylor, Wiley-Blackwell, 2024