The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, 2013) is the official classification and diagnostic tool for psychiatric disorders in the United States. Fifth Edition, abbrev. DSM-5, 2013) is the official classification and diagnostic tool for psychiatric disorders of the American Psychiatric Association (APA) and is internationally recognized.
According to the DSM-5, borderline personality disorder is described as “a pervasive pattern of instability in interpersonal relationships, self-image, and emotions, characterized by intense impulsivity, beginning in early adulthood and occurring across a variety of contexts.” (American Psychiatric Association, 2013). Patients with borderline personality disorder usually fear abandonment, whether real or imagined. Desperate attempts to avoid abandonment are a dominant feature of borderline disorder.
Intense fears of abandonment may exist even when the patient fears that he or she may be separated from someone in a relationship. For example, a patient may panic or become angry when their therapist is out of town, even if the vacation was previously announced or even if alternative means of communication were provided to the patient. The borderline personality disorder sufferer perceives such situations as abandonment, resulting in feelings of sadness and/or anger.
Another symptom of borderline personality disorder is frequent and intense changes in the individual’s relationships with others. Often, the patient loves or hates their partners, relatives, doctors, and other people with whom they are closely associated. Their emotions can often be extreme, ranging from intense love and sympathy to hatred and aversion.
Borderline personality disorder is also characterized by identity problems, such as a weak or distorted sense of self (Luyten et al., 2020). This can manifest itself through dramatic changes in interests, goals, or values. Similarly, individuals with borderline personality disorder may undermine their own efforts. They may destroy healthy relationships or drop out of school just before graduation.
Impulsivity is another common symptom of borderline personality disorder (McDonald 2019), as it is of all disorders in Custer B. Impulsivity is self-destructive and can be associated with substance abuse, reckless driving, gambling, overeating, unsafe sex, or reckless spending. In other words, due to their impulsive nature, individuals may often engage in the above behaviors without giving much thought to their consequences. Patients with borderline personality disorder often feel a strong sense of emptiness (McDonald 2019). Self-harming behaviors, such as cutting or burning, as well as suicidal thoughts, threats, and behaviors are also common. Although self-harm and suicidal behaviors can be genuine and should be taken seriously, they can also be used as desperate attempts to avoid abandonment and may also be impulsive because the person is experiencing feelings of abandonment or rejection (American Psychiatric Association, 2013).
Individuals with borderline personality disorder have difficulty controlling their emotions. The DSM-5 explains that patients may express disproportionate or inappropriate anger. This can lead to problems in interpersonal relationships or even physical altercations. Finally, patients with borderline personality disorder may experience dissociative symptoms or paranoia when under stress (American Psychiatric Association, 2013).