How to spot someone with Borderline Personality Disorder


Angry Man

For me, spotting someone with Borderline Personality Disorder (BPD) is a gut reaction.  I tend to be triggered in a particular emotional way when I encounter someone struggling with BPD.  This is my first reaction, and then as the interaction continues I can gather the information necessary to fit the person’s reported emotions and behavior into the clinical categories for a possible diagnosis of BPD.  Personality disorders are enduring as the name suggests, it is part of your fixed self, so a responsible clinician would not be quick to diagnose an individual with one.  Change is possible with the right kind of treatment, and, yet, personality disorders are known for being difficult to treat.

For a non-clinical layperson, it may be helpful to know the characteristics of BPD.  It often helps us realize that the problem lies with the other person.  If we know the signs, we can also have a bit more empathy for the person with BPD as well as protect ourselves with appropriate boundary setting.  Here are a few of the signs covered in a recent article by Carol Berman, MD entitled, “9 Tips on How to Recognize Someone With Borderline Personality Disorder.”   Dr. Berman describes two tenets of BPD are the difficulty the individual has processing information (it is often skewed in a negative way) and unstable relationships with others (one minute the person may love you and the next they may be screaming at you).

  • The person puts you on a pedestal.  People with BPD often see the world in black and white with everything (or a whole person) being either all good or all bad.
  • The person doesn’t have a clear sense of their own identity.  This will manifest in rapidly changing physical appearance or constantly changing interests or career pursuits.
  • An inability to handle abandonment, either real or imagined, is another sign of someone with BPD.
  • The person has made attempts to end his or her life or engages in self-harming behaviors.  It is important to note here that people with BPD are 800 times more likely to complete suicide, so these threats must always be taken seriously and reported to 911 or the nearest emergency department.
  • The person reacts to situations with intense emotions, often rage over something that most people would be able to let go.
  • The person may report feelings of constant emptiness and unimportance.
  • The person’s most common emotion that is outwardly expressed is anger.
  • The person has a lot of paranoid thoughts about people talking negatively about them or working against them.
  • The individual tends to act impulsively, and in ways that are potentially harmful to them (i.e. risky sexual behavior, gambling, substance abuse).

Once you understand that these behaviors are part of a disorder, it might be easier to avoid taking the actions of the individual personally.  Encourage the person to seek treatment.  It is often a relief for the individual to receive a diagnosis of BPD in that they can name what they have been suffering from, and, with their therapist, find coping strategies in order to work toward a healthier and happier life.

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