How to Diagnose Borderline Personality Disorder

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Written by:Dr. Karmen Smith, LCSW, DD

Published On: June 23, 2022

Medically reviewed by: Reshawna Chapple, PhD, LCSW

Reviewed On: June 23, 2022

Updated On: July 5, 2023


Borderline personality disorder (BPD) is a complex, often difficult-to-diagnose mental health condition. It affects an estimated 1.6% of the population in the United States and results in difficulty regulating emotions and maintaining healthy relationships.

BPD causes abrupt mood swings, risky behaviors, a poor sense of self, disruptions to work and family life, and sometimes, the desire for self-harm. If you think you might have BPD, it’s important to get an accurate diagnosis so you can begin an effective treatment program.

Continue reading to learn how to get a BPD diagnosis and better understand this serious mental health condition. You’ll discover healthy, promising ways to improve your BPD symptoms — starting today.

How Is BPD Diagnosed?

If you’re looking for information on how to get a BPD diagnosis, it’s important to understand there’s no quick, simple answer. There isn’t a single test or examination that accurately diagnoses mental health conditions like borderline personality disorder.

If you believe you have BPD, educating yourself is key. Arming yourself with knowledge can give you important coping skills to manage your condition. While you should never self-diagnose, learning about the diagnostic process will help make the entire experience less stressful and easier to get through.

DSM-5 BPD diagnosis criteria

There’s no specific test that can be done, and the process of getting a BPD diagnosis is multifaceted. It can involve a thorough assessment, interviews, psychological exams, personal screenings — and most importantly, meeting the BPD diagnosis criteria set forth by the American Psychiatric Association’s (APA’s) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

The current DSM-5 criteria for a borderline personality disorder diagnosis states that someone must routinely experience at least 5 of the following symptoms:

  • Consistent feelings of emptiness
  • Persistent and unstable self-image
  • Intensely unstable relationships
  • Repetitive suicidal thoughts, threats, gestures, or behaviors
  • Energetic effort to avoid abandonment (imaginary or real)
  • Inappropriate, intense anger or difficulty controlling temperament
  • Sudden mood swings and emotional instability that can last hours or days
  • Severe dissociative symptoms and paranoid delusions related to temporary stressors
  • At least 2 impulsive behaviors (for example: reckless driving, overeating, overspending, substance use, or sex)

Getting a borderline personality disorder diagnosis involves several steps, including a general psych evaluation and going through the BDP assessment process as described below.

Psychiatric evaluation

It’s essential to find a doctor or therapist who understands the nuances of borderline personality disorder. You want to work with someone who’s experienced and skilled at treating BPD. You can expect to fill out evaluations and questionnaires and go through interviews during your evaluation.

“Written assessments are used to assist with the diagnosis of personality disorders, but the primary tool is having sessions with a therapist who can ask questions and understand patterns that are consistent with the diagnosis.”

Licensed Clinical Social Worker (LCSW), DD Karmen Smith

BPD Assessment Process

If you’re wondering how to diagnose borderline personality disorder accurately, understanding the BPD assessment process can help. You can start with your primary physician to find a mental health professional you trust and would like to work with. Then, you’ll schedule an assessment and begin the process as follows:

  1. Attend your initial consultation.
  2. Schedule any follow-up sessions needed for a full assessment.
  3. Provide detailed information about your symptoms, family life, living situation, and work history.
  4. You may need to complete a short questionnaire or a lengthier psychological assessment.
  5. A therapist may refer you to a specialist for a more thorough assessment.

Once your full BPD assessment is complete, you’ll receive a diagnosis. It may be for BPD, another mental health condition, multiple conditions, or no discernible condition whatsoever.

Let us reassure you: it’s normal to feel a little nervous at your first session, especially if you’ve never been in therapy before. Good therapists realize it’s not easy to open up about the details of your life. Even though it can be a difficult process, in order to get a borderline personality disorder diagnosis, try to be as honest and direct as possible during the assessment.

Remember how important it is to get help, collaborate with an experienced mental health professional, and find a therapist who uses evidence-based treatment options. BPD may not be entirely curable, but it is very treatable.

What to Do if You Get Diagnosed with BPD

If you do receive a BPD diagnosis after your assessment, your therapist will explain in detail the symptoms you’re experiencing and offer effective treatment options you should consider.

Learning how to treat borderline personality disorder is a critical step in working toward a happier, healthier, stable life in the future.

Seek therapy for BPD

Some highly effective types of therapy for BPD you can turn to after receiving a borderline personality disorder diagnosis include:

In some cases, BPD medication might also be recommended for short-term symptom management.

Discuss medication for symptoms with a doctor

There are no known medications that work (or that are FDA-approved) specifically to treat personality disorders like BPD. However, some mood stabilizers or antipsychotic medications might be recommended to relieve or address some of the symptoms you experience.

Medication can be useful in treating some of the severe symptoms of BPD and some comorbid mental health conditions.

“Borderline personality disorder symptoms include emotional dysregulation and erratic interpersonal relationships. This could be the reason people seek treatment. Therapy and medication management can help effectively treat symptoms of BPD.”

Licensed Clinical Social Worker (LCSW), DD Karmen Smith

Do your research and ask relevant questions before beginning a new prescription. Doing deep, intense work in therapy can be necessary to diminish your BPD symptoms, and it will most often be more helpful than relying on medication alone.

The process of getting an accurate BPD diagnosis might seem daunting, but it’s worth it. Once you’re diagnosed, you can get the tools you need to live a rewarding and full life. Treatment will release you from the tumultuous instability this condition often causes. You can learn to live with BPD, and having a diagnosis in hand is the first step.

If you believe you are showing signs of BPD, consider starting with our BPD test to learn more.

See References

Dr. Karmen Smith, LCSW, DD

Dr. Karmen Smith is a board-certified Clinical Social Worker in the state of Nevada. She has worked over 20 years for Clark County Family Services with abused and neglected children in the shelter, adolescents in juvenile detention, and adults who have suffered severe trauma. Dr. Smith is a shamanic teacher and minister of metaphysics and her doctorate is in Pastoral Counseling.

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