BPD was officially recognized and diagnosed by psychiatrists in 1980, although the understanding and diagnostic criteria have evolved over time.

People diagnosed with a personality disorder are usually young adults aged 18 and older. Often, BPD develops to a full disorder by early teenage years, but BPD is not generally diagnosed in people under 18 unless the symptoms are present for more than 1 year.

The BPD diagnosis is typically made by a physician or psychiatrist based on a set of criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (“DSM-5”).

The DSM-5 criteria for BPD include a pervasive pattern over at least one year of instability of interpersonal relationships, self-image, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five or more of the following:

  1. Fear of abandonment & desperate efforts to avoid abandonment (actual or imagined),
  2. Unstable, intense relationships that alternate between idealizing and devaluing the other person (known as “splitting”),
  3. Unclear or unstable self-image, including struggles with sense of self and identity,
  4. Temporary paranoid thoughts or severe dissociative symptoms triggered by stress,
  5. Inappropriately intense anger or anger regulation problems, including frequent loss of temper or physical fights,
  6. Consistent and constant feelings of emptiness, sadness or worthlessness (“dysphoria”),
  7. Recurrent self-injury, self-mutilation, suicidal ideation, suicidal gestures, or suicidal thoughts or behavior,
  8. Emotional dysregulation – Frequent, rapid, drastic changes in mood, lasting usually only a few hours and rarely more than a few days. Emotional instability in reaction to day-to-day events (ex. intense episodic sadness, irritability, anger, or anxiety),
  9. Two or more impulsive behaviors such as unsafe sex, reckless driving, binge eating, substance abuse, or excessive spending.