Borderline personality disorder is often difficult for mental health professionals to diagnose. BPD is often misdiagnosed as a more common issue such as post-traumatic stress disorder, depression, anxiety, narcissistic personality disorder, or antisocial personality disorder. What’s more, many people living with the condition are also living with multiple health issues such as eating disorders or substance abuse. At the same time, many doctors and mental health professionals hesitate to diagnose someone with BPD because it can be very difficult to treat or manage BPD.
Treating borderline personality disorder is possible, however early diagnosis is a key factor in successfully managing the disorder. If you believe you or a loved one could be living with BPD, the first step is understanding what BPD is, the different BPD test used by mental health professionals, and what those tests look for.
What is Borderline Personality Disorder?
BPD is a personality disorder expressed as an ongoing cycle of instability. Specifically, borderline personalities experience feelings of instability in their relationships, emotions, behavior, and self-identity. It is difficult for people with BPD to regulate their emotions and they often experience intense fear of being abandoned.
The characteristics of BPD include:
- Extreme difficulties forming or maintaining relationships
- Unstable self-image or concept of oneself
- Impulsive and risky behaviors
- Feeling empty or numb
As with many mental and physical health issues, there is no specific single cause for borderline personality disorder. Instead, the reasons are likely a mixture of genetics (an inherent vulnerability to the disorder) and environmental (long-term exposure to “consistently invalidating” surroundings).
Different Types of BPD Tests
Mental health professionals have created a set of screening tests to help identify patients who may be living with BPD:
- The McLean Screening Instrument for BPD
- The Personality Diagnostic Questionnaire, 4th Edition
- The Structured Clinical Interview for DSM-5 Personality Disorders
- The Zanarini Rating Scale for Borderline Personality Disorder
The four BPD tests listed above do not provide a definitive diagnosis for borderline personality disorder. Instead, they are designed to help professionals know where to investigate further or rate or track symptoms’ severity.
An actual clinical diagnosis requires an evaluation of the patient according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition published by the American Psychiatric Association.
Symptoms and Criteria for Borderline Personality
The DSM-V lists nine possible symptoms of borderline personality disorder. Five of these nine need to be present for a BPD diagnosis. These criteria are:
- Unstable sense of identity
- Unstable emotions with intense emotions that last only a few hours
- Impulse control issues in multiple self-damaging areas such as spending, reckless driving, substance abuse, etc.
- Feeling empty
- Extreme or frantic efforts aimed at avoiding feelings of abandonment
- Intense anger and difficulty managing that anger
- Unstable and intense personal relationships
- Paranoid ideation or dissociative brought on my stress
- Self-harm or repetitive suicidal threats or gestures
Symptoms must be present in different contexts (at home and at work, for example) and significantly impair the patient’s ability to live a healthy life.
Borderline personality disorder is a complex diagnosis and requires long-term treatment to successfully manage. That’s why it’s so important to be able to recognize symptoms early and get an accurate diagnosis from a professional. By informing yourself you’ll be better positioned to experience better outcomes if you think you or a loved one is suffering from BPD.
