Borderline personality disorder (BPD) is a personality disorder characterized by a long-term pattern of unstable emotions and internal experience. Interpersonal relationships, distorted sense of self, and strong emotional reactions are key symptoms. Those affected often engage in self-harm and other dangerous behaviors. This is due to their difficulty with returning their emotional level to a healthy or normal baseline. They may also struggle with a feeling of emptiness, fear of abandonment, and detachment from reality. These are the 10 worst symptoms of borderline personality disorder.
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Symptoms of BPD may be triggered by events considered normal to others. BPD typically begins by early adulthood and occurs across a variety of situations. Substance use disorders, depression, and eating disorders are commonly associated with BPD. Approximately 10% of people affected with the disorder die by suicide. The disorder is often stigmatized in both the media and the psychiatric field. It’s quite rare, as it affects less than 1 percent of the general population. It’s said that the disorder is underdiagnosed, but there has been proof that overdiagnosis is more likely.
Worst Symptoms of Borderline Personality Disorder
1. Abandonment Issues
Emotional abandonment is a subjective emotional state in which people feel undesired, left behind, insecure, or discarded. Feeling emotionally abandoned is a key feature of borderline personality disorder, and it leaves a person feeling lost and alone. People experiencing emotional abandonment may feel lost as to why they feel this way or why others disregard them. They may feel like they have been cut off from a crucial source of sustenance or feel withdrawn. Since BPD is often associated with attachment issues and other mental disorders, it’s no doubt why it’s the case. This does have a positive side though, as those with BPD often show affection far more than others.
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They feel this either suddenly or through a process of erosion, but the feeling skews what the actual reality is. Emotional abandonment can manifest through loss or separation from a loved one. Feeling rejected — which is a significant component of emotional abandonment — has a biological impact in that it activates the physical pain centers of the brain. It can leave an emotional imprint in the brain’s warning system, hardwiring the brain to react differently. Emotional abandonment has been a staple of poetry and literature since ancient times.
2. Splitting and Relationships
Splitting (also called black-and-white thinking or all-or-nothing thinking) is a key feature of borderline personality disorder. It is the failure in a person’s thinking to bring together the dichotomy of both positive and negative qualities. This applies to the self and others, where a person cannot properly associate things into a cohesive, realistic whole. It is a common defense mechanism, and it is most commonly seen in BPD. The individual tends to think in extremes, i.e., an individual’s actions and motivations are all good or all bad with no middle ground. The good news is that when finally free from borderline tendencies, these people can adjust and mature better than others.
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Splitting begins as the inability of the infant to combine the fulfilling aspects of the parents (the good object) and their unresponsive aspects (the unsatisfying object) into the same individuals, instead seeing the good and bad as separate. In psychoanalytic theory this functions as a defense mechanism. This also goes hand in hand with a distorted self-image. A person with this disorder will have a hard time seeing themselves for who they truly are. They will typically see themselves in a negative slant, which furthers their anxiety and emotional responses. The good in all of this is that when a person is seeing all white, they will have euphoria and extreme passion.
3. Identity Problems and Mirroring
An identity disturbance is a deficiency or inability to maintain one or more major components of identity. Having a problem with identity is a key component of borderline personality disorder. These components include a sense of continuity over time and emotional commitment to representations of self and role relationships. Other features include disturbances in core values and self-standards. Those with this problem will have issue with the development of a meaningful world view. This all makes it hard to have recognition of one’s place in the world. It can lead to a mental process called mirroring, that enables a person to mimic the personality of others. This helps them gain a sense of self and is possible because a person lacks a sense of self.
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It appears to be linked to emotional dysregulation, which has been shown to be a significant predictor of identity disturbance. in psychiatric patients even when controlling for borderline personality disorder diagnosis, depression, and anxiety. Although some researchers posit that it is the lack of consistent goals, values, world views, and relationships that lead to a sense of emptiness, it is not entirely clear whether the link between emotional dysregulation and identity disturbance is because a disturbed identity creates a negative affect that is hard to regulate, because emotional dysregulation disturbs identity, because a third variable causes both (confounding), or some combination of the above. The good side of this is that BPD sufferers can gain good characteristics while experimenting with their personality.
4. Impulsivity
In psychology, impulsivity (or impulsiveness) is a tendency to act on a whim and is a key feature of borderline personality disorder. An impulsive person will display behavior characterized by little or no forethought, reflection, or consideration of the consequences. Impulsivity can be classified as a multifactorial construct, and can later lead to guilt and regret. This tends to become part of a cycle a person becomes used to as they continue to make mistakes. It is caused by all or nothing thinking and is worsened by extreme emotions. Impulsivity is both a facet of personality and a major component of various other disorders. This includes FASD, ADHD, substance use disorders, bipolar disorder, and antisocial personality disorder.
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A functional variety of impulsivity has also been suggested, which involves action without much forethought in appropriate situations. A sufferer of BPD can react with courage and does result in desirable consequences. When such actions have positive outcomes, they tend not to be seen as signs of impulsivity in most cases. They can be seen as indicators of boldness, quickness, spontaneity, courageousness, or unconventionality. Thus, the construct of impulsivity includes at least two independent components. First, acting without an appropriate amount of deliberation, which may or may not be functional. Secondly, choosing short-term gains over long-term ones.
Worst Symptoms of Borderline Personality Disorder
5. Depression and Anxiety
It is common among those with borderline personality disorder to struggle with depression and anxiety. The anxiety one feels from their emotions is more easily felt and the same goes for depression. A person struggling with BPD will often go between bouts of anxiety to depression and anxiety to anger. The sufferer may also have a comorbid anxiety or depressive disorder, i.e., generalized anxiety and major depression. This can lead to mostly negative outcomes, but positive ones are also possible.
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Anxiety is the prevailing symptom of this disorder, as it is a cause and side effect of negative emotions. The negative reactions a person with BPD has will further exacerbate the anxiety, anger, and depression. It then becomes a negative cycle a person must break by avoiding the negative reactions they are used to. This kind of reconditioning becomes nearly impossible the farther in a person is during the disorder. This is where cognitive behavioral therapy comes in handy for those struggling to keep themselves together.
6. Suicidal Ideation/Attempts and Self-Harm
Suicidal thoughts and actions are very common among those dealing with BPD. It’s an unfortunate truth that suicide rates among BPD patients is the highest of any mental disorder. There is an compulsive need to hurt oneself when feeling betrayed during a fit of rage or depression. It may only be a desire to make another person pay or a grab for attention, but it does not always end well. A person who was not intending on killing themself can end up dead because of rash decision-making.
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Those with BPD do not want to hurt themselves, but they often feel like there is no other choice. They may start by cutting or burning themselves, as a form of self-harm. This is because they know no other way to release their negative emotions. In response to feelings of rejection or being betrayed, they will respond by hurting themselves. It’s not to say that the depression and overwhelming desire to die cannot be there, but it’s temporary. A person with these kinds of emotions will find it hard to see other methods as an option.
Worst Symptoms of Borderline Personality Disorder
7. Severe Emotional Reactions
Having extreme emotional reactions is one of the key features of borderline personality disorder. A person can go from zero to ten in a matter of seconds over what others consider harmless. It’s typically in response to things you would least expect a reaction from. A person may spin what you said to them into an insult and end up overreacting. If they sense a lack of control, extreme reactions from others may help them feel relief, akin to a narcissist. It’s not the same as a narcissist, as the underlying motivation is entirely different. A narcissist seeks to feel better by controlling others, while a borderline seeks reassurance. This is why borderline sufferers can also feel extreme joy, gratitude, and other positive feelings. These feelings can cause a sufferer to feel euphoria, and it can lead to them being some of the nicest people.
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Because they feel neglected, it’s their way of seeing that you care over all else. If you do not show this level of subservience, they may end up lashing out. This usually shows as anger, but it can be displayed as anxiety and depression as well. Any emotion is volatile, including crying and sadness, anger, guilt, shame, and so on. This very much leads to a sense that one lacks control over their emotions and overall mental state. It does not matter how much you try to please someone feeling this way, as it will always turn into another problem. Because a person with borderline never properly learned how to seek help and share frustration, they lash out this way. This constant self-doubt is the key ingredient to their endless negativity and low self-esteem.
8. Feelings of Emptiness
Emptiness as an emotional condition is a sense of generalized boredom, social alienation and apathy. Feelings of emptiness often accompany dysthymia, depression, loneliness, anhedonia, despair, or other mental/emotional disorders. These include schizoid personality disorder, post trauma, attention deficit hyperactivity disorder, schizotypal personality disorder and borderline personality disorder. A sense of emptiness is also part of a natural process of grief, as resulting death of a loved one, or other significant changes. However, the particular meanings of “emptiness” vary within the particular context.
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Feelings of emptiness are common among BPD sufferers because of their inability to trust their own emotions. It can also come from the invalidation — abuse/neglect — they were affected by during their childhood. Borderline personality traits almost lend themselves to a person being hard on themselves. This leads the person with BPD feeling as if they have no where to go and deserve feeling hopeless. This, and the feeling that they have committed some great harm can lead to compensating through enduring pain. They may even expose themselves to situations they would overall rather avoid out of guilt and depression.
Worst Symptoms of Borderline Personality Disorder
9. Extreme Anger and Pain
Having extreme anger and mood swings is a key feature of borderline personality disorder. A person going through these kinds of mental states can lead to acute and long-term pain. The combination of this with the other symptoms of depression and anxiety makes this the most painful mental disorder. The feelings of confusion and lack of total control create a recipe for disaster. All it takes is the flip of a small switch and a person with BPD will lose all control. Extreme jealousy is another symptom of this anger, as one emotion leads to the next. The level of pain a person with BPD feels can cause others to suffer along with them. In a relationship, a sufferer can even cause themselves and their lover PTSD and other mental problems.
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The anger and jealously they often feel becomes a habit and addicting, being caused by the incessant pressure of their expectations. The more a person falls for these feelings, the more difficult it will be to condition out of them. The extremes almost become a drug to the person with borderline personality disorder, and they can experience withdrawal. This emotional withdrawal can create even further struggle and cause someone to revert back to their extremes to feel a sense of control. This anger is a also a response to feeling exposed, confused, and vulnerable; it is a malicious feeling in BPD they do not like. This vulnerability causes them to question the every move of other people around them. To control this anger, it is often recommended a person seek anger management or CBT.
10. Paranoid Delusions and Dissociation
Transient paranoia and delusions are fairly common among those dealing with BPD. It can lead to sufferers thinking that others are out to get them or talking smack about them. In turn, this can lead to obsessive thinking and rumination that does little to help their overall mindset. This negative thinking will also lead to severe dissociation, where derealization and depersonalization are present. The paranoia is not as bad as it is in schizophrenia, as it’s duration in shorter and less intense. If someone is in a relationship with a BPD sufferer, jealously and envy are very much at play. A person with this personality disorder will often assume the worst from their partner. It takes nothing but the slightest clue, and their paranoia will kick in.
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Accusations of cheating will be thrown around, leading to the partner reacting with equal amazement. This creates a dichotomic relationship, causing the partner to react equally to the person with the disorder. In response to this pain, dissociation is often used to avoid negative thinking. A person may zone out to disconnect from what they feel is too overwhelming. This is not good, as it blocks out a person’s understanding of their own emotions. It will also hinder others from knowing exactly what the person is struggling with. This is dangerous, as it leads to a cycle where the struggler will think others do not care. This feeling of vulnerability is exacerbated by their lack of control and leads to further paranoia. The more they make these mistakes, the more they will question people. This is because they think others will betray them for it out of spite or disappointment.
Worst Symptoms of Borderline Personality Disorder
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