By: Ann Cain

What is Borderline Personality Disorder?

May is borderline personality disorder awareness month. What is borderline personality disorder, commonly known by its acronym,  BPD? Who does it impact? Why is there such stigma attached to this diagnosis?

The Diagnostic and Statistical Manual (DSM) outlines the criteria for a diagnosis of BPD:

A pervasive pattern of instability of personal relationships, self image and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following. 

  1. Fear of abandonment
  2. Unstable or changing relationships
  3. Unstable self-image; struggles with identity or sense of self
  4. Impulsive or self-damaging behaviors (e.g., excessive spending, unsafe sex,      substance abuse, reckless driving, binge eating).
  5. Suicidal behavior or self-injury
  6. Varied or random mood swings
  7. Constant feelings of worthlessness or sadness
  8. Problems with anger, including frequent loss of temper or physical fights
  9. Stress-related paranoia or loss of contact with reality

You might find yourself relating to at least one or more of the criteria above. Does this mean that you have BPD? Not necessarily. That is why there are multiple criteria necessary to make a diagnosis. Symptoms of BPD also may overlap with other diagnoses in the DSM. 

Controversy and Stigma

BPD is a highly stigmatized diagnosis. Those with the condition are often labeled as manipulative, attention seeking, and/or hard to treat. These generalizations are not only harmful but also paint a picture of those with BPD that often does not fit. 

While many believe that BPD is a valid diagnosis there is a growing number of clinicians and clients who are questioning whether or not BPD really exists as we know it now. Many of those who have been diagnosed with BPD have experienced trauma, especially chronic or repeated trauma. Although not an official diagnosis, complex post traumatic stress disorder (C-PTSD) may explain a series of symptoms that was previously diagnosed as BPD.  

Some may find a diagnosis helpful, others may not. It is important to remember that a diagnosis of BPD does not define a person! We can look at any diagnosis as just a piece of the puzzle. 

How can we help?

One of the most important actions we can take to reduce stigma is to uplift the voices of people with lived experience with BPD. Author and creator of dialectical behavioral therapy (DBT), Marsha Linehan, is not only an expert in the field but lives with BPD. She continues to use her own experience and clinical expertise to educate others about BPD and how we can help those with the diagnosis. There are also a plethora of articles, blogs, videos, and interviews by those with BPD. The National Alliance on Mental Illness websites presents an article that details the struggles of someone with BPD (read here).

Together we can work to reduce the stigma that surrounds BPD. For more information and first-hand accounts of life with BPD check out the resources below.

For clinical resources on BPD:

For stories and perspectives from those with BPD