How Borderline Personality Disorder Is Diagnosed

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If you suspect you or someone you love might have borderline personality disorder (BPD), a helpful first step is to learn about the process of receiving a borderline personality disorder diagnosis.

Borderline personality disorder is a serious mental health condition that makes it difficult to regulate emotions, resulting in unstable moods, behaviors, and relationships, per the American Psychiatric Association (APA).

While overviews of BPD symptoms are widely available online, the only person who can diagnose borderline personality disorder is a licensed mental health professional.

There’s no specific test for BPD, but a healthcare provider can determine a diagnosis with a comprehensive psychiatric interview and medical exam. After that, you can get appropriate treatment and begin to manage your symptoms better and move forward in your life.

In the meantime, here’s what you need to know about what a screening for BPD typically entails, the criteria for a borderline personality disorder diagnosis, and more.

Mental health professional meets with client

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Professional Screenings

Borderline personality disorder can be diagnosed by a trained mental health professional such as a psychiatrist, therapist, or clinical social worker. Screenings for BPD should be done face-to-face in person or virtually rather than via an online test.

A complete assessment for BPD includes:

  • A thorough interview including a discussion of your symptoms and past and present life
  • A review of your personal and family medical history
  • A medical exam to rule out other potential causes of symptoms
  • In some cases, additional interviews with family and friends

The "Diagnostic and Statistical Manual of Mental Disorders" (DSM), published by the APA, provides the official diagnostic criteria for BPD and other mental health conditions.

To receive a borderline personality disorder diagnosis, you must experience five or more of the following symptoms in a variety of contexts:

  • Feelings of emptiness
  • Emotional instability (such as intense sadness, irritability, or anxiety lasting a few hours or, rarely, more than a few days)
  • Efforts to avoid real or imagined abandonment
  • Identity disturbances with unstable self-image or sense of self
  • Impulsive behavior (such as reckless driving, binge-eating, substance abuse, or unsafe sex)
  • Inappropriate, intense anger or difficulty controlling anger
  • Pattern of unstable and intense interpersonal relationships
  • Recurrent suicidal behavior, gestures, or threats, or self-harming behavior
  • Transient, stress-related changes in thoughts such as paranoid ideation (like beliefs that others may be trying to hurt or harm you) or dissociation (feeling as if you’re outside of your body or numb)

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Many people living with borderline personality disorder also have co-occurring health conditions such as a mood disorder, eating disorder, substance abuse, or other personality disorders. Due to overlapping clusters of symptoms, it can be difficult to diagnose and treat borderline personality disorder and sometimes requires multiple appointments to receive a definitive diagnosis.

Labs and Tests

Currently, there are no laboratory tests to determine whether a person has borderline personality disorder. However, your healthcare provider may perform a physical exam along with bloodwork or additional tests to rule out other possible causes of your symptoms. In turn, this can increase your confidence in a borderline personality disorder diagnosis.

Self/At-Home Testing

While it’s possible to identify recurring moods, behaviors, or patterns in your relationships on your own, you cannot diagnose yourself or someone else with borderline personality disorder without the proper training.

What’s more, many people experience the symptoms that characterize BPD from time to time—but may not fully meet the criteria for an official borderline personality disorder diagnosis. As is true for any mental health condition, the only way to receive an official diagnosis of BPD is to meet with a qualified mental health professional.

If you’re wondering whether or not you have BPD, contact a mental health professional to schedule an appointment for an assessment. While it can take time to connect with a clinician who specializes in treating BPD, it's the best way to find an effective treatment for your needs.

If you or a loved one are struggling with borderline personality disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

A Word From Verywell 

Borderline personality disorder can make those living with it and their loved ones feel out of control, off-kilter, and exhausted. Although BPD can be hard to diagnose due to a cluster of symptoms that often overlap with other mental health conditions, it is possible to find a mental health professional you trust to receive a proper diagnosis and get the help you need. Reach out to a healthcare provider to get started.

Seeking help and sticking with treatment can be challenging, especially if you feel embarrassed or ashamed about a potential BPD diagnosis. But know that there are many effective treatment options available specifically targeted to BPD, such as dialectical behavior therapy (DBT) and mentalization-based treatment (MBT) as well as medication.

There are also plenty of ways friends and family can provide and receive support. With help, you can learn how to add structure to your day, process stormy emotions, improve your communication skills, and lead a fulfilling life with fewer symptoms.

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4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th edition. 2013. doi:10.1176/appi.books.9780890425596

  2. Cleveland Clinic. Borderline personality disorder (BPD): Diagnosis and tests. Updated October 14, 2020. 

  3. National Alliance on Mental Illness (NAMI). Borderline personality disorder. Updated December 2017.

  4. Psychopharmacologic treatment of borderline personality disorder. Dialogues Clin Neurosci. 2013;15(2):213–224.