1. Criteria

A pervasive pattern of instability in interpersonal relationships, self-image, and affects, with marked impulsivity, begins by early adulthood and is present across contexts.

At least 5 of the following features are present.

Frantic efforts to avoid real or imagined abandonment.
A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
Identity disturbance, including markedly and persistently unstable self-image or sense of self.
Impulsivity in at least 2 areas that are potentially self-damaging, such as spending, sex, substance use, reckless driving, or binge eating.
Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
Affective instability due to marked reactivity of mood.
Chronic feelings of emptiness.
Inappropriate, intense anger or difficulty controlling anger.
Transient stress-related paranoid ideation or severe dissociative symptoms.

2. Context

Borderline personality disorder is usually experienced as instability that touches nearly everything: relationships, identity, mood, anger, impulsivity, and the ability to feel steady from one moment to the next. The pattern is broad, longstanding, and often most visible under interpersonal stress.
Pattern across settings: The diagnosis is about a pervasive pattern, not a single crisis, breakup, or emotionally intense week.
Risk assessment: Self-harm, suicidality, dissociation, substance use, and impulsive behavior need repeated and careful assessment over time.
Medication limits: Medication may help with pieces of the picture, but psychotherapy remains the center of treatment for the disorder itself.
Clinical focus: Brief screening instrument for borderline personality features.

3. Validated scales

MSI-BPD

Brief screening instrument for borderline personality features.

ZAN-BPD

Clinician-rated severity measure for borderline symptom domains.

4. FDA approved treatments

Diagnosis-specific FDA indications

This prototype does not list a core borderline-personality-disorder-specific FDA medication indication; medication use is generally symptom- or comorbidity-targeted. Verify current labeling for any off-label strategy.

No diagnosis-specific FDA medication entry is listed in this prototype section.

Common treatment side effects

Check drugs.com/sfx for common side effects. Direct side-effect links for the medications in this section are below when available.

Common off-label medications

Interventional psychiatry modalities

Interventional psychiatry is not standard for borderline personality disorder itself.
ECT may be used for severe comorbid mood syndromes, not for core BPD.
TMS and ketamine are being explored mainly for comorbid affective symptoms.

Related Guides

5. Top management articles

Management review for Borderline Personality Disorder PubMed search
Borderline Personality Disorder treatment guideline PubMed search
Borderline Personality Disorder pharmacotherapy or psychotherapy review PubMed search

When to seek professional help

Seek urgent help if there are thoughts of suicide, self-harm, or feeling unable to stay safe.³
Seek urgent help if there are thoughts of harming someone else, escalating violent urges, or loss of behavioral control.³
Take hopelessness seriously, especially if the person feels trapped, cannot imagine staying safe, or is withdrawing from support.⁴
Use emergency services if there is immediate danger, severe agitation, psychosis, intoxication, or inability to care for basic needs. In the United States, call or text 988 for crisis support and call 911 for immediate danger. Use emergency services in your region if you are outside the U.S.³

Simple Psych

Borderline Personality Disorder