Is BPD a lifelong diagnosis?

Psychiatry, Psychosomatics & Psychotherapy

Diagnosis of borderline personality disorder

Borderline disorder is a complex clinical picture that can be diagnosed on the basis of various behaviors and characteristic personality traits. For the diagnosis to be particularly strong impulsive behavior and a profound pattern of instability in the affects, in self-image and in interpersonal relationships. In most cases, the behaviors show up over a longer period of time and have already emerged in puberty.

In addition, at least five of the following criteria must be met for a borderline disorder to be present (according to DSM-IV):

  1. Desperate effort to prevent real or imaginary solitude.
  2. A pattern of unstable and intense interpersonal relationships.
  3. Identity disorders: A pronounced instability of self-image or feeling for oneself.
  4. Impulsiveness in at least two potentially self-harming areas (e.g. spending money, sex, substance abuse, reckless driving, binge eating).
  5. Recurring suicide threats, allegations or attempts or self-harming behavior.
  6. Affective instability, which is characterized by a pronounced orientation towards the current mood (e.g. severe episodic depression, irritability or fear).
  7. Chronic feeling of emptiness.
  8. Inappropriately strong anger or difficulty controlling anger or anger (e.g., frequent outbursts of anger, persistent anger, repeated fights).
  9. Temporary stress-related paranoid ideas or severe dissociative symptoms.

Not all those affected inflict injuries to themselves and not all are addicts. Usually, however, the borderline disorder occurs together with other diseases and disorders.

The further steps and the type of therapy are determined depending on the composition of the criteria and the severity of the individual case.

Technical support: Prof. Dr. med. Sabine C. Herpertz, Heidelberg (DGPPN)