BPD: Breaking Down the 9 Criteria

  • A young woman with blonde hair in a messy bun sitting on the floor of a dressing room, wearing a black tank top, looking at her phone with a distressed expression. She is barefoot, with a laptop open in front of her, and clothes hanging on a rack above her.

    1) Frantic efforts to avoid real or imagined abandonment

    What does this look like?

    When folx with BPD feel as though they are being abandoned - or are abandoned (such as the end of a relationship - they may exhibit extreme behaviors.

    These are usually in response to real or perceived abandonment because of the intensity of the emotional pain that those with BPD experience.

    Most behaviors often derive from wanting to escape emotional pain.

    Some examples include:

    - Begging for someone to stay in their life

    - Showering them with gifts

    - Frequent messaging or calling

    (Note: Does not include suicidal or self-mutilating behavior covered in Criterion 5.)

  • A man and woman standing in front of a large striped wall, holding hands and facing opposite directions. The woman is holding a coffee cup and camera, wearing a beanie, jacket, and boots. The man is dressed in a two-tone jacket, gray pants, and brown boots, with his other hand in his pocket.

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

    What does this look like?

    One of the cornerstones of BPD is seeing things in “black & white” or “all or nothing” thinking.

    This can translate to relationships of any nature. A person with BPD might idolize the other person at times, and then shift to disliking them, or hating them.

    This can cause a lot of confusion and push and pull in relationships.

    It is also very difficult for those with BPD to fully understand the shifts between idolizing someone, to disliking them, which can happen in cycles. This creates a lot of emotional distress.

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    3) Identity disturbance: markedly and persistently unstable self-image or sense of self

    What does this look like?

    People with BPD have a difficult time knowing who they are, what they are passionate about, and often experience very low self-esteem.

    Some instances of identity disturbance include:

    - Rapidly shifting interests/passions

    - Changing careers or course of study often

    - Frequent change in values

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    4) Impulsivity in at least two areas that are potentially self-damaging

    What does this look like?

    Examples of impulsivity can include:

    - Excessive spending

    - Sex

    - Substance Abuse

    - Gambling

    - Reckless Driving

    (Note: Does not include suicidal or self-mutilating behavior covered in Criterion 5.)

  • A man with brown hair is seated on a bench with his head bowed and hands clasped together. Several hands are on his shoulders and back, suggesting support or comfort.

    5) Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

    What does this look like?

    Due to the extreme emotions that those with BPD experience, many exhibit self-harming behaviors, as well as frequent suicidal ideation.

    This often includes a history of attempts.

    Sometimes those with BPD may also make “threats” about self-harm or suicide.

    This is NOT a manipulation tactic.

    Usually, it is an extreme cry for a cry to be heard and cared for.

    (It is important to note that not everybody with BPD experiences suicidal ideation, but it is common.)

  • Black and white image of a woman in distress, with multiple overlapping exposures showing her with hands on her head, eyes closed, and mouth open as if crying or screaming.

    6) Affective instability due to a marked reactivity of mood

    What does this look like?

    Criteria 6 refers to the extreme emotions and moods that those with BPD experience - and how these emotions shift rapidly.

    For example, one with BPD might experience extreme irritability for a few hours, followed by a heightened sense of despair, then intense anxiety.

    Unfortunately, those with BPD experience “dysphoria,” or a lowered sense of well-being and satisfaction. If feelings of wellbeing arise, they are often interrupted by anger, panic, or despair.

    Due to the rapid shift of emotions, they rarely last more than a few days.

    More often than not, extreme moods can last a few hours at most before changing.

    Sometimes causes for different emotions can be identified. But a lot of the time, people with BPD have a hard time identifying the causes, which can cause further distress, guilt, and shame.

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    7) Chronic feelings of emptiness

    What does this look like?

    Feeling of emptiness in BPD often show up as feeling as though one has no purpose, nothing fulfills them, and they don’t know what makes them happy.

    These feelings of emptiness are often associated with the unstable sense of self that many people with BPD experience.

  • A young man with glasses and dark hair is holding his head with both hands and screaming or yelling with an intense expression.

    8) Inappropriate, intense anger or difficulty controlling anger

    What does this look like?

    For those with BPD who experience intense anger and display anger outwardly, they may display behaviors such as physical fights, throwing things, yelling, etc.

    For those with the discouraged or “quiet” type of BPD - they often act “in” rather than “out”.

    In this case, feelings of anger can manifest inward, such as self-harming behaviors or substance abuse. They are often an attempt to manage or escape the emotion.

  • A person with long dark hair using a stylus on a graphics tablet while working on a laptop.

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

    What does this look like?

    Paranoia can show up in BPD if a person is experiencing intense stress or other heightened emotions.

    It can also be connected to stress within interpersonal relationships, which can manifest in paranoia.

    Dissociation is also common. It generally shows up in two types:

    - Depersonalization: feeing disconnected from oneself and body

    - Derealization: feeling disconnected from one’s surroundings

    Dissociation is often a response to stress, trauma, any current situation, or emotional overwhelm.