BPD – Know your symptoms

Today I read that although there are 9 number of BPD symptoms, they can manifest in over 250 possible combinations.

These 9 symptoms are commonly quoted as the symptoms of BPD:

… but they are outdated (and pretty vague tbh).

They were replaced by the DSM-5 criteria in 2011 (sorry, guys…).

Originally I was going to write about some of my experiences with my BPD symptoms, but how can I talk about symptoms if we all start off on a different page?

So, instead, here is the *longest* post I will write (promise). And, if you’re not sure about what BPD actually is, by the end of this, you’ll be a pro!

BPD Diagnostic criteria, as per DSM-5

‘The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose borderline personality disorder, the following criteria must be met:

A. Significant impairments in personality functioning manifest by:

1 Impairments in self functioning (a or b)

a) Identity: markedly impoverished, poorly developed, or unstable self-image, often associated with excessive self-criticism; chronic feelings of emptiness; dissociative states under stress.

b) Self-direction: Instability in goals, aspirations, values, or career plans

AND

2. Impairments in interpersonal functioning (a or b):

a) Empathy: Compromised ability to recognise the feelings and needs of others associated with interpersonal hypersensitivity (i.e. prone to feel slighted or insulted); perceptions of others selectively biased towards negative attributes or vulnerabilities.

b) Intimacy: Intense, unstable, and conflicted close relationships, marked by mistrust, neediness, and anxious preoccupation with real or imagined abandonments; close relationships often viewed in extremes of idealisation and devaluation and alternating between over involvement and withdrawal.

B. Pathological personality traits in the following domains:

1: Negative Affectivity: Characterised by:

a) Emotional liability: Unstable emotional experiences and frequent mood changes; emotions that are easily aroused, intense and/or out of proportion to events and circumstances.

b) Anxiousness: Intense feelings of nervousness, tenseness, or panic, often in reaction to interpersonal stresses; worry about the negative effects of past unpleasant experiences and future negative possibilities; feeling fearful, apprehensive, or threatened by uncertainty; fears of falling apart or losing control.

c) Separation insecurity: Fears of rejection by – and/or separation from – significant others, associated with fears of excessive dependency and complete loss of autonomy..

d) Depressivity: Frequent feelings of being down, miserable, and/or hopeless; difficulty recovering from such moods; pessimism about the future; pervasive shame; feeling of inferior self-worth; thoughts of suicide and suicidal behaviour.

2. Disinhibition, characterised by:

a) Impulsivity: acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of outcomes; difficulty establishing or following plans; a sense of urgency and self-harming behaviour under emotional distress.

b) Risk taking: Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard to consequences; lack of concern for one’s limitations and denial of the reality of personal danger.

3. Antagonism: Characterised by:

a) Hostility: Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults.

C. The impairments in personality functioning and the individual’s personality trait expression are relatively stable across time and consistent across situations.

D. The impairments in personality functioning and the individual’s personality trait expression are not better understood as normative for the individual’s developmental stage or socio-cultural environment.

E. The impairments in personality functioning and the individual’s personality trait expression are not solely due to the direct physiological effects of a substance (e.g. a drug of abuse, medication) or a general medical condition (e.g. severe head trauma).”


phew

Further information:

ICD-10 2019 (a little more vague) and DSM-5 criteria (which I basically just spent 3 years writing out) for Borderline Personality Disorder.

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