People with BPD experience wide mood swings and can display a great sense of instability and insecurity. According to the Diagnostic and Statistical Manual diagnostic framework, some key signs and symptoms include:
- Frantic efforts to avoid real or imagined abandonment by friends and family
- Intense and unstable personal relationships that alternate between idealization (“I’m so in love!”) and devaluation (“I hate him”). Also known as “splitting” people are viewed in extremes – all good or all bad. An individual who is seen as a friend one day may be considered an enemy or traitor the next.
- Distorted and unstable self-image, which affects/changes moods, values, opinions, goals and relationships. Mood swings increase uncertainty about how they see themselves and their role in the world.
- Impulsive behaviors that can have dangerous outcomes – excessive spending, unsafe sex, substance abuse and reckless driving.
- Self-harming behavior including suicidal threats or attempts
- Periods of intense depressed mood, irritability or anxiety lasting a few hours to a few days
- Chronic feelings of boredom or emptiness
- Inappropriate, intense or uncontrollable anger—often followed by shame and guilt
- Dissociative feelings—disconnecting from your thoughts or sense of identity or “out of body” type of feelings—and stress-related paranoid thoughts. Severe cases of stress can also lead to brief psychotic episodes.