BPD411 - Diagnostic Criteria

Diagnostic Criteria for Borderline Personality Disorder

Annotated

The DSM is the source of these diagnostics. Because the DSM is for mental health professionals, it sometimes uses words that you may not know the definition for. They may also be used in different ways than standard English. This annotated version is designed to help you understand what is meant in a general way.

A pervasive pattern of instability of interpersonal 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:

"Affects" are thinking patterns. If you get lost in the "pervasive" and "variety of contexts" parts... don’t worry about that so much. Understand that if it quacks like a BP, you can use the techniques from our mailing list, and from this web page to build yourself a better life.

(1) frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

These "frantic efforts" can include hoovering as well as threats to yourself, or to him or herself. As an example, one BP got so worked up that she got physically ill when her husband went fishing for a few days.

(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

Idealization means that the BP puts the Non up on a pedastul, like a hero or a god. Devaluation means that the BP puts the Non in the ditch with other "good for nothing"s. It’s all about splitting.

(3) identity disturbance: markedly and persistently unstable self-image of sense of self

BPs don’t have a stable internal sense of self. BPs understand theirselves only through how others reflect them back. If they are currently feeling abandoned, then the black and white thinking leads them to thinking that they are, themselves, all bad. When someone is building them up, then they feel good about themselves, but only in a superficial and temporary way.

(4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

Many BPs having no clear sense of self, will attempt to fill up the emptiness they find with an activity that lets them refocus on something else. It is too painful to be me, so I’ll drug myself, or distract myself with spending, eating, etc. so that I don’t have to think about it too much.

(5) recurrent suicidal behaviors, gestures, or threats, or self-mutilating behavior

Suicidal threats in high functioning borderlines are most often associated with threats of abandonment.

(6) 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)

Unstable thought patterns that are emotionally driven. They will often rage, go silent, or just be anxious for a time. These episodes are what the Non attempts to avoid (fruitlessly) by walking on eggshells.

(7) chronic feelings of emptiness

This is related to the lack of self image. It is hard to know much about this one, except through watching actions that may indicate this underlying feeling.

(8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

Raging is a classic BP symptom. Most rage verbally, some however rage silently, and some spill over into physical abuse.

(9) transient, stress-related paranoid ideation or severe dissociative symptoms

When BPs are experiencing periods of stress, they often have paranoid thoughts. Dissociation is "going away" from yourself... kind of like "highway hypnosis", but more powerful. Some lower functioning BPs actually experience loss of time. Paranoid thoughts can lead to distortion campaigns.

Provided by the

Diagnostic and Statistical Manual of Mental Disorders DSM-IV

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Disclaimer: The information on this site (http://www.bpd411.org) is based on personal experiences of the authors and members of our e-mail mailing list. It is NOT meant to replace professional advice or take the place of counseling, therapy or additional personal research.