Borderline Personality Disorder (BPD) is a mental illness that is surrounded by stigma and considered by professionals to be a severe psychiatric disorder yet, despite the negative connotations and complexity, being given a diagnosis was in some ways a positive as it has made so many things in my life make more sense. There is so much involved in it that it simply wouldn’t be possible to fit into one post, so today we are just going to start at the beginning: the criteria of BPD and what it means to me.
To be diagnosed with BPD you must meet five out of nine diagnostic criteria (symptoms) as defined by DSM-5, and these need to have a significant impact on your life. Below we will look at them in their most basic definitions as the complexity and variety of individual symptoms and manifestations is extensive, and with each one I will include just what it means for my diagnosis and how it started to make everything make sense.
- Frantic efforts to avoid real or imagined abandonment.
- I will do anything to keep people happy, often to my detriment, and take the smallest inconsistencies as a sign that I’m hated and not wanted. I incessantly apologise and constantly need to check and validate that things are okay, people still like me and I haven’t done something wrong. This is due to an intense fear of rejection and not being good enough. All of a sudden this diagnosis made the way I behave make perfect sense.
- A pattern of unstable and intense interpersonal relationship characterized by alternating between extremes of idealization and devaluation.
- Unhealthy previous relationships and the way I go through phases of viewing the validation from certain people in my life as being of upmost importance fits into this criteria perfectly.
- Identity disturbance: markedly and persistently unstable self-image or sense of self.
- There are days I look in the mirror and don’t recognise who I see. I will cling to any opportunities to define myself by an activity or a relationship, just so that I have something solid that I can hang my identity onto. This criteria made me notice just how much my self-image differs depending on my mood or who I’m with, it is never consistent and that is one of the primary reasons I’ve struggled so much with my confidence.
- Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
- Fortunately, this is one of the criteria I meet less but I still haven’t escaped completely. I do things to extremes – I will be compulsively saving and then sporadically become obsessed with a concept so buy everything related or try to cheer myself up by spending money I later regret. Or it will be little things like sending impulsive messages or making sudden decisions on things that ordinarily I would think through and plan. And I become easily obsessive so a substance abuse problem wouldn’t be difficult to imagine.
- Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour
- This criteria made behaviours I’ve had since I was a child make sense – predominantly dermatillomania (compulsive skin picking). As a child they thought I had a skin condition and even tried to treat it. But now it makes sense that it is correlated to stress or low mood – it is rare I don’t have areas of skin that I am picking at especially my fingers or my head. And one of my coping mechanisms for emetophobia has always been digging my nails into my arm. Between the two I meet this criteria without even thinking about it. And, although I’ve never made any concrete plans, I do get suicidal ideation.
- Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
- Mood swings. No doubt about this one – I can wake up in the morning feeling on top of the world and it takes only the tiniest trigger for it to spiral downwards into anxiety or depression or something equally as unpleasant but, on the plus side, it also means it doesn’t take a lot to trigger a good mood and bouncing back. Having a diagnosis gives some hope that, with the right coping mechanisms, I can get these triggers under control and maybe start to find some stability.
- Chronic feelings of emptiness
- Between the mood swings, depression, anxiety and dissociation sometimes the emptiness is a welcome relief but there are without a doubt days that I feel completely numb to the world and with it comes intense feelings of worthlessness and loneliness which certainly isn’t pleasant.
- Inappropriate, intense anger or difficulty controlling anger (e.g. frequent displays of temper, constant anger, recurrent physical fights).
- Of the nine criteria this is the one I identify with the least – only very occasionally do I feel intense anger and, although sometimes I can be extremely childlike in my five minute tantrum of showing it, I don’t think it is any less than anyone else.
- Transient, stress-related paranoid ideation or severe dissociative symptoms
- I get days where I think that everyone is talking about me and looking at me, and days where I feel completely detached from the real world and like I’m in a bubble, add in the seizures which are a dissociative symptom all of their own and I have certainly got this criteria covered. But it’s such a strange feeling that dissociation will have to be covered another time. At least having a diagnosis, alongside the NEAD diagnosis, means more hope of getting it all under control.
So, that’s the basics of BPD – although there is so much more depth to each criteria and so much more that people go through alongside this. And, although I was certainly guilty of googling it prior to my assessments, it is such a complex disorder that no one should take this list as a way to self-diagnose – a diagnosis can only ever come from a medical professional.
Hopefully this has given a bit on insight into BPD and how I got this diagnosis, but please do not hesitate to comment any questions you have.
Bee x




