How to Diagnose Borderline Personality Disorder (BPD)

The diagnosis of Borderline Personality Disorder (BPD) is a difficult one to make, both because there are so many possible symptoms and because there are psychiatrists who say the term is too broad to actually be an illness by itself. But there are certain definitive symptoms that, together, are present in anyone diagnosed with this illness.

Instructions

Difficulty: Challenging

1. Note the two main signs of those with BPD. They are the lack of psychosis-- differentiating between reality and hallucinations--and the lack of knowledge of who they really are. They have a chameleon-like ability to become like whomever they're with because of their lack of "self." There's also a tendency to project their own feelings onto those they are with.
2. Try to understand the BPD's inability to form a complete understanding of a relationship. They have what is called "emotional amnesia"--an intrinsic inability to recall emotions in relation to any past interaction. Each meeting is a summation of the relationship to them; there is no continuity. They also experience emotions so intensely that when feeling one emotion they cannot remember what other emotions feel like.
3. Watch for odd perceptions and thinking. There is often paranoia accompanied by chaotic and excessive relational attachments and a desperate fear of being deserted, betrayed and being alone. BPD's sometimes think they have almost "magical powers" to sway events and try to manipulate others emotions to keep them from leaving. They tend to see things only in terms of black and white, such as good versus bad and right versus wrong.
4. Look for certain extreme behaviors caused by lack of impulse control, a low tolerance for anxiety and extreme reactions to situations, sexual promiscuity and the inability to gain any satisfaction or enjoyment from work or hobbies. Sadomasochistic behavior, such as burning or cutting themselves is common, along with suicidal tendencies or threats of suicide often used as manipulation of others' actions and emotions.
5. Attempt intervention when someone with a BPD shows signs of drug or alcohol abuse, anorexia or bulimia or other compulsive behavior that's dangerous. They have continual feelings of emptiness and depression, and fill their lives with behaviors that distract them from their feeling of isolation. They're often exciting, fun and intelligent with a carefree attitude masking their inner grief.
6. Attempt to determine whether the person with BPD have a history of neglect or abuse; this is quite common and exacerbates a genetic tendency towards the disease. BPD's are usually so rooted in their problems, they do not realize their perceptions are not normal. They seldom seek help until they have serious trouble in their lives and realize they cannot help themselves.
7. Administer a psychological test. The most helpful and common test used is the Minnesota Multiphasic Personality Inventory (MMPI). The results are interpreted by comparing the patient's scores to others' with a known BPD. Doctors refer patients who show specific behaviors over a long period of time who do not indicate other personality disorders.

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