Borderline Personality Disorder DSM-5 Criteria And How It’s Treated

Published 10/26/2020

Borderline personality disorder (BPD) is a severe mental health issue that involves difficulties regulating mood and emotions. BPD's signs and symptoms are difficult to manage and keep under control, but it is possible, and effective treatments are available. This article will learn what borderline personality disorder is and how it’s described in the DSM-5 and what can be done to help those who have the disorder.


What Is Borderline Personality Disorder?

Borderline personality disorder belongs to a class of mental health conditions known as personality disorders, which can significantly impair and distress.

In fact, that’s exactly what makes it a disorder. Your personality varies from those around you;. At the same time, they might be similar to some; you have different thoughts, feelings, and behaviors as individuals shaped by the environment around you. Still, sometimes it can go against cultural values and beliefs too.

However, according to the American Psychiatric Association, with personality disorders, the personality traits not only go against the cultural norms, but they also cause difficulties with functioning and lead to distress. [1]

Currently, the DSM identifies ten unique personality disorders, and perhaps you have heard of them some in your lifetime.

These different personality disorders can be grouped into clusters shown below: [2]

Cluster A: Odd Or Eccentric Thoughts & Behaviors

  • Paranoid Personality Disorder
  • Schizoid Personality Disorder
  • Schizotypal personality disorder

Cluster B: Overdramatic, Overly-Emotional, Or Unpredictable Thoughts & Behaviors

  • Antisocial Personality Disorder
  • Borderline Personality Disorder
  • Histrionic Personality Disorder
  • Narcissistic Personality Disorder

Cluster C: Fearful Or Anxious Thoughts & Behaviors

  • Avoidant Personality Disorder
  • Dependent Personality Disorder
  • Obsessive-Compulsive Personality Disorder

It’s estimated that around 1.4 percent of the United States population has borderline personality disorder, and as you can see, BPD is just one of the many personality disorders people can be diagnosed with. Altogether, personality disorders are more common than most people think. [3]

Nonetheless, in the next section, you will learn the characteristics of this particular personality disorder and what goes into diagnosing it.

Borderline Personality Disorder DSM-5 Criteria


Mental health professionals use the most current Diagnostic and Statistical Manual by the American Psychiatric Association to diagnose individuals with mental health issues. It contains the most up-to-date information for them, including all personality disorders.

Below, you will find the most current DSM borderline personality disorder criteria that can lead to a diagnosis for BPD: [4]

A pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) or the following:

  1. Frantic efforts to avoid real or imagined abandonment (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5)
  2. A pattern of unstable and intense interpersonal relationships characterized by alternating

between extremes of idealization and devaluation

  1. Identity disturbance: markedly and persistently unstable self-image or sense of self
  2. Impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating) (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5)
  3. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
  4. Affective instability due to a marked reactivity of mood (e.g. intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
  5. Chronic feelings of emptiness
  6. Inappropriate, intense anger or difficulty controlling anger (e.g. frequent displays of temper, constant anger, recurrent physical fights)
  7. Transient, stress-related paranoid ideation or severe dissociative symptoms

What Causes Borderline Personality Disorder?

Like most mental health disorders, there is no exact cause that is known to cause BPD; rather it’s a combination of different factors that can contribute to it.

Just like the most common concerns like major depression, anxiety disorders, and obsessive-compulsive disorder, personality disorders like BPD are believed to have a biological component to them, especially in regards to genetics as well as brain structure and chemistry.

Although there isn’t a specific gene that has been identified that is connected with BPD, people who have family members with BPD or other mental health issues may be at increased risk for having it.

There are also some studies that show that there may be differences in the structure of the brain and how it operates, which can lead to the emotional behaviors seen in borderline personality disorder. However, it isn’t yet clear if this is responsible for the disorder or its effect. [5]

Lastly, a person’s environment may also be influential in the development of the disorder.


For instance, people who have experienced trauma, toxic and abusive social relationships, including with parents, and been involved in instances of severe conflict or neglect at a very young age can contribute to BPD appearing later on.

Because of these kinds of situations, these individuals who have been exposed to them may display some of the symptoms that are characteristic of the disorder, such as a fear of abandonment and an inability to control or cope with their emotions, and this can present many issues for the individual with BPD.

What Are The Consequences Of Borderline Personality Disorder?

Like all of the other personality disorders, borderline can cause significant challenges in virtually every aspect of life.

Forming and maintaining social relationships due to emotional instability can be one of the biggest problems for many individuals and this can lead to additional issues such as low self-esteem, an extreme fear of being abandoned, or even suicidal ideation.

People with borderline personality disorder may also become very impulsive. Many of these behaviors, such as gambling, unsafe sex, and binge eating, can have a profoundly negative effect on their financial well-being and overall health. [2]

It’s also very common for people with BPD to resort to substance abuse and self-harm to cope with the extreme ups and downs that come with the condition.

Therefore, because of all of these factors, borderline personality disorder should be urgently treated so that they can start building more productive lives in all aspects.

How To Get Help For Borderline Personality Disorder

While it’s important for an individual who suspects they have BPD to have an understanding of the signs and symptoms of the condition, this personality disorder, like the others, has a specific set of guidelines laid out by the DSM-5, and treating it will require a formal assessment and diagnosis from a mental health professional.

Following a diagnosis using the DSM-5 borderline personality disorder criteria, a person can receive treatment, and this typically consists of a combination of medication and psychotherapy.

Medications like mood stabilizers, which are commonly used to treat bipolar disorder can help keep a person’s emotions more stable and can aid in controlling some of the symptoms, like anger outbursts, impulsiveness, and other aggressive behaviors.

Additionally, antidepressants can also help address the depressive-like symptoms seen in borderline personality disorder, and antipsychotics may also be prescribed to deal with other disorganized thought patterns, delusions, paranoia, and possibly disassociation.

Psychotherapy is also highly recommended because it can help give patients with borderline personality disorder the skills to cope with the different feelings and emotions that they can experience.

Therapy offers excellent strategies that can be used lifelong, and in conjunction with medication and the support of those around them, individuals with BPD can live normal lives.

Do You Have Borderline Personality Disorder?


Knowing if you truly have borderline personality disorder will require a diagnosis from a mental health professional, and you should contact one and schedule an appointment as soon as possible if you believe you or a loved one has this condition

However, it’s still possible to have a better understanding of the likelihood of this diagnosis beforehand.

In addition to going over the DSM-5 BPD criteria listed above, you can also take this BPD test and find out where you stand in regards to it.

The test is brief and completely free and can give people the motivation to seek out a professional as soon as possible so that they can begin a treatment plan.


Borderline personality disorder isn’t always easy to catch since many of its symptoms can match with other mental health issues, but hopefully, the DSM-V borderline personality disorder criteria listed here have helped you understand better what it entails and how it differs from other personality disorders that people can struggle with. Without education and awareness, people may be unaware that they or someone else that they care about has a personality disorder, and many don’t get the help they need, despite the effective resources available to them.


  1. American Psychiatric Association. (2018, November). What are Personality Disorders? Retrieved from
  2. Mayo Clinic Staff. (2016, September 23). Personality disorders. Retrieved from
  3. National Alliance on Mental Illness. (2017, December). Borderline Personality Disorder. Retrieved from
  4. Australian BPD Foundation. (2020, October 12). Diagnostic Criteria. Retrieved from
  5. National Institute of Mental Health. (2017, December). Borderline Personality Disorder. Retrieved from