What are the signs of borderline personality disorder?
Since these patients will make frantic efforts to avoid a sense of feeling abandoned, you know, they will be very needy and dependent. Now, as I say that, while they're very needy, and don't want to feel abandoned, it should be mentioned that that dependency on others while they feel it's absolutely necessary to their continued existence, they also find it rather terrifying and intimidating. So, the clinical presentation of a patient with borderline personality disorder is very variable. It's incredibly variable between patients, it's incredibly variable within a single patient depending on what time of day you catch them and what kind of mood they're in. However, I would tell you that invariably, most of them will report a chronic dysphoria: an unhappiness. They often have feelings of emptiness, their relationships with other people tend to be very stormy and ungratifying, they often will fluctuate between totally idealizing you and completely devaluing you. So one moment you're like the most wonderful guy they've ever met in their entire lives, and the next second, you know, if you disappoint them or do something to upset them, they hate your guts and never want to see you again. Which can explain some of the interpersonal dysfunction in these people. As I mentioned before, one of the more dramatic hallmarks of the disorder for which a lot of people know them for is the self-mutilation. Now this is distinctively different than suicide attempts, although these patients will make suicide attempts. However the self-mutilation is described as in a whole different vein. What patients often describe as a rising tension that they're unable to tolerate, and one of the ways they get rid of that tension is if they cut on themselves. So you'll see what people often refer to as 'hesitation marks,' but it's like superficial cuts, you know, all over. And once they feel the pain or see the blood, they'll describe as the release of tension. I'm pointing to my arms here but you know, often patients will make the cuts on their legs where some of it can't be readily seen.
