The symptoms associated with BPD are seen in a variety of cultures across the world (APA, 2013). About 75% of those diagnosed are females (APA, 2013). The core features of BPD are (APA, 2013):
- Fear of abandonment
- Intense interpersonal relationships
- Unstable self-image
- Self-damaging impulsivity
- Affective instability
Those with BPD tend to avoid both real and imagined abandonment uncontrollably. They exhibit intense and inappropriate anger when faced with realistic separation from someone who is important to them. For example, someone with BPD might panic when a clinician announces the end of their hour appointment. They have a deep intolerance for being alone, and their impulsivity can lead to self-mutilation and suicidal behaviors (APA, 2013).
Those with BPD display unstable and intense interpersonal relationships. They frequently idealize potential caregivers or romantic partners at first; however, this infatuation rapidly shifts to hatred, believing that the other person does not love them enough. Those with BPD are prone to dramatic and quick changes in their views of others, which in turn often leaves them isolated and abandoned (APA, 2013).
Individuals suffering from BPD display a persistent, unstable self-image. Their goals, values, and career choices may change day to day. They alter between playing the role of a needy victim to that of a righteous avenger. Those with BPD tend to view themselves as either all good or all evil, and when undergoing severe stress, they may feel as though they do not exist at all (APA, 2013).
Furthermore, people with BPD exhibit marked impulsivity that is potentially self-damaging. For example, they may gamble, irresponsibly spend money, binge eat, abuse harmful substances, engage in unsafe sex, or drive recklessly. Furthermore, these individuals may repeatedly self-mutilate or make suicidal threats or gestures. Around 8%-10% of those with BPD complete suicide (APA, 2013).
Finally, individuals with BPD present with marked reactivity of mood that usually manifests as intense episodic dysphoria, irritability, and anxiety. They also tend to report chronic feelings of emptiness, panic, anger, and despair. When they feel as though they are being abandoned, they may exhibit extreme sarcasm or verbal outbursts that then leave them feeling guilty. During times of extreme stress, those with BPD tend to report paranoid ideation or dissociative symptoms (APA, 2013).