Borderline personality disorder - Diagnosis

Diagnosis-Borderline personality disorder

See your GP if you're concerned that you have borderline personality disorder (BPD). They may ask about your symptoms and how they're affecting your quality of life.
Your GP will also want to rule out other more common mental health conditions, such as depression, and make sure there's no immediate risk to your health and wellbeing.
If your GP suspects BPD, you'll probably be referred to your local community mental health team for a more in-depth assessment. Ask if the service you're being referred to has experience of working with personality disorders.
You may also find the Mind and Emergence websites useful.

Community mental health team

Community mental health teams help people with complex mental health conditions such as BPD. However, some teams may focus only on people with psychotic disorders. In other areas, there are complex needs services that may be better placed to help you.
Your assessment will probably be carried out by a specialist in personality disorders, usually a psychologist or psychiatrist.

Assessment

Internationally recognised criteria are used to diagnose BPD. A diagnosis can usually be made if you answer "yes" to five or more of the following questions:
  • Do you have an intense fear of being left alone, which causes you to act in ways that, on reflection, seem out of the ordinary or extreme, such as constantly phoning somebody (but not including self-harming or suicidalbehaviour)?
  • Do you have a pattern of intense and unstable relationships with other people that switch between thinking you love that person and they're wonderful to hating that person and thinking they're terrible?
  • Do you ever feel you don't have a strong sense of your own self and are unclear about your self-image?
  • Do you engage in impulsive activities in two areas that are potentially damaging, such as unsafe sex, drug abuse or reckless spending (but not including self-harming or suicidal behaviour)?
  • Have you made repeated suicide threats or attempts in your past and engaged in self-harming?
  • Do you have severe mood swings, such as feeling intensely depressed, anxious or irritable, which last from a few hours to a few days?
  • Do you have long-term feelings of emptiness and loneliness?
  • Do you have sudden and intense feelings of anger and aggression, and often find it difficult to control your anger?
  • When you find yourself in stressful situations, do you have feelings of paranoia, or do you feel like you're disconnected from the world or from your own body, thoughts and behaviour?

Involving your family

Once a diagnosis of BPD has been confirmed, it's recommended that you tell close family, friends and people you trust about the diagnosis.
There are several reasons for this.
Many of the symptoms of BPD affect your relationships with people close to you, so involving them in your treatment may make them aware of your condition and make your treatment more effective.
Your family and friends can then remain alert for any behaviour that may indicate you're having a crisis.
They may also benefit from local support groups and other services for people in a relationship with a person with BPD.
However, the decision to talk about your condition is entirely your own, and your confidentiality will be respected at all times.