301.83 Borderline Personality Disorder
DSM-IV diagnostic criteria:
A pervasive pattern of instability of interpersonal relationships,
self-image and affects, as well as marked impulsivity, beginning by
early adulthood and present in a variety of contexts, as indicated by
five (or more) of the following:
1. frantic efforts to avoid real or imagined abandonment. Note: Do
not include suicidal or self-injuring behavior covered in Criterion
2. a pattern of unstable and intense interpersonal relationships
characterized by alternating between extremes of idealization and
3. identity disturbance: markedly and persistently unstable
self-image or sense of self
4. 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-injuring behavior
covered in Criterion 5
5. recurrent suicidal behavior, gestures, or threats, or self-injuring
6. 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).
7. chronic feelings of emptiness
8. inappropriate anger or difficulty controlling anger (e.g.,
frequent displays of temper, constant anger, recurrent physical
9. transient, stress-related paranoid ideation, delusions or severe
As far as I know, I have never received a diagnosis of borderline
personality disorder. Because I have (some) history of self-harm
(e.g., cutting), I think some people may have assumed this was one of
However, there are some of the criteria that are so wrong for me that
I think it's unlikely I would receive, or agree with such a
diagnosis. Aside from that, diagnosis of borderline personality
disorder can be stigmatizing, and associated with a poor prognosis.
It originally got its name due to symptoms that seemed to be
borderline schizophrenic. I don't think that 'emotionally unstable
personality disorder', a suggested replacement name, is
1. I never actually try to avoid abandonment - in fact, I am more
likely to suggest the endings of relationships, to make things
easy for the person if they wish an ending, and I do know how to take
no for an answer. I have absolutely no wish to hold on to illusions
regarding relationships, and if they have been based upon false
pretenses, I have to let go. The idea of 'clinging' is abhorrent to
2. I suppose that it might seem like I have a pattern of having
unstable and intense interpersonal relationships, but I
think my two long-term relationships (both at least 7 years in
length) could hardly be counted as unstable.
3. It is difficult to hold on to a strong sense of identity when
messages from society say that someone in my position is lazy,
a quitter, manipulative, avoidant, needy, high maintenance,
embarrassingly excessive, out of touch with reality, negative, etc.
4. Impulsivity in binge eating or drinking: check.
5. I have an ongoing wish to die, but I don't like the wording of 5.,
and don't think of myself as emotionally manipulative in my
expression of that wish. As for self-harm, it has been many years
since my cutting phase, and in total it only happened a certain
number of times through the years. It turned out to be a
coping mechanism that didn't 'stick'.
6. My moods are usually stable (depressed).
7. I suppose that a chronic feeling of emptiness is similar to a
chronic wish to die - except I am not actually all that sure that I
emptier than most people.
8. I had an anger phase in my mid-to-late 30s or so as I was starting
to get in touch with my repressed rage, but things have been a lot
calmer for some time, and for most of my life, I have probably been
far less irritable and angry than most people.
9. I suppose my delusions from 2005-2008 might fit this category.
Maybe I have fit enough of the criteria at certain times in my life?
Certainly not in early adulthood, though. I think my attempt at self-diagnosis
gives a more
comprehensive or helpful perspective.