Borderline Personality Disorder (BPD) is often misunderstood, even though it affects millions of people. If you experience intense emotions, unstable relationships, or a shaky sense of who you are, you might be wondering if BPD could explain your experiences. This evidence-based screening tool can help you recognize patterns that warrant professional evaluation.
Key Takeaways
BPD is a treatable condition: Despite its reputation, Borderline Personality Disorder responds well to specialized therapies like Dialectical Behavior Therapy (DBT), with many people achieving significant improvement.
It's more common than you think: BPD affects about 1.4% of the adult population, though rates may be higher due to underdiagnosis—particularly in men, who are often misdiagnosed with depression or PTSD.
Early intervention helps: Getting accurate diagnosis and appropriate treatment can dramatically improve quality of life and reduce the risk of self-harm or suicide attempts associated with untreated BPD.
About This BPD Screening Quiz
This self-assessment is based on elements from the McLean Screening Instrument for BPD (MSI-BPD) and criteria from the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders).
The quiz explores core features of BPD, including emotional instability, relationship difficulties, identity disturbance, and impulsive behaviors.
Understanding Borderline Personality Disorder
BPD is a mental health condition characterized by pervasive patterns of instability in emotions, self-image, and relationships. People with BPD often experience the world in intense, extreme ways—emotions feel overwhelming, relationships feel all-or-nothing, and self-perception fluctuates dramatically.
The term "borderline" is historical and somewhat misleading. It doesn't mean you're "on the border" of anything—it's simply the clinical name for this specific pattern of symptoms.
The BPD Self-Assessment
For each statement, consider whether it describes your typical patterns over the past several years (not just recent months). Answer yes or no:
Questions:
My relationships are very intense, unstable, and involve a lot of conflict
I have done things impulsively that could hurt me (like spending sprees, risky sex, substance abuse, reckless driving, binge eating)
I have made suicide attempts or threatened suicide, or hurt myself on purpose
I have had a lot of mood swings—feeling extremely anxious, irritable, or sad that usually last a few hours
I often feel empty inside
I have had intense anger or difficulty controlling my anger
I get very suspicious of other people or feel "out of it" when I'm stressed
I am terrified of being abandoned by the people I'm close to
My sense of who I am often changes dramatically
I have trouble controlling my emotions when they're triggered
How to Score Your Responses
This quiz is an educational screening tool inspired by the MSI-BPD and DSM-5 criteria. It is not the validated scoring method used in clinical settings, but it can help you understand whether your experiences are consistent with BPD traits.
Count the number of “yes” responses:
0–2 yes
These responses suggest you are not describing a pattern typically associated with BPD. Occasional emotional intensity or relationship stress is normal.3–4 yes
This may indicate some traits associated with BPD, but people can have a few traits without having the disorder. Consider whether these patterns affect your daily functioning.5–6 yes
These responses suggest moderate BPD-like patterns that may be impacting relationships, work, or emotional wellbeing. A professional evaluation is recommended.7 or more yes
This range is closest to the validated MSI-BPD cutoff used in research to identify people who may benefit from a comprehensive BPD evaluation. A clinical assessment is strongly recommended.
Important Note
Only a trained mental health professional can diagnose BPD. This quiz helps you recognize patterns, not determine whether you have the disorder.
What Your Score Means
Low Likelihood (0-2)
Your responses suggest you're not currently experiencing significant BPD symptoms. Everyone has occasional emotional intensity or relationship challenges, and your experiences appear to be within a normal range.
If you're concerned about specific patterns in your life, discussing them with a mental health professional can provide clarity and support.
Some BPD Traits (3-4)
Your responses indicate some traits associated with BPD. Many people have a few BPD characteristics without having the full disorder. However, even subthreshold symptoms can cause distress and may benefit from therapeutic support.
Consider whether these patterns are causing significant problems in your life. If they are, professional consultation can help determine whether treatment would be beneficial.
Moderate Likelihood (5-6)
Your responses suggest moderate BPD symptoms that likely affect your relationships, work, and overall wellbeing. At this level, symptoms typically interfere with multiple areas of life.
Professional evaluation is recommended. A mental health provider can conduct a comprehensive assessment and discuss treatment options, particularly Dialectical Behavior Therapy (DBT), which is specifically designed for BPD.
High Likelihood (7+)
Your responses indicate patterns strongly consistent with BPD. These symptoms are likely significantly impacting your quality of life, relationships, and daily functioning.
Professional evaluation is strongly recommended. The good news is that BPD is one of the few personality disorders with clear evidence-based treatments that work. Many people with BPD see substantial improvement with proper care.
How Common Is BPD?
Borderline Personality Disorder affects approximately 1.4% of adults in the United States, according to the National Institute of Mental Health. This means about 4 million Americans live with BPD.
Historically, BPD was diagnosed more frequently in women, but recent research suggests it affects men and women equally. Men may be underdiagnosed because their symptoms sometimes manifest differently or get misdiagnosed as depression, PTSD, or other conditions.
BPD typically emerges in adolescence or early adulthood, though symptoms often begin in childhood. Early traumatic experiences are common in people who later develop BPD, though not everyone with BPD has a trauma history.
What Causes BPD?
Research suggests BPD develops from a combination of biological vulnerability and environmental factors, particularly early life experiences.
Biological Factors
Studies using brain imaging have found differences in how people with BPD process emotions and regulate behavior. Research published in The American Journal of Psychiatry shows that areas of the brain involved in emotional regulation—including the amygdala, hippocampus, and prefrontal cortex—function differently in people with BPD.
Neurotransmitters like serotonin, which help regulate mood and impulse control, may also play a role. This is why medications affecting serotonin can sometimes help with specific BPD symptoms.
Genetic Factors
BPD has a genetic component, with studies showing that having a first-degree relative with BPD increases your risk. Research published in JAMA Psychiatry suggests that genetic factors account for approximately 40% of the risk for developing BPD.
Environmental Factors
Early life experiences significantly influence BPD development, particularly:
Childhood trauma: Many people with BPD experienced physical, emotional, or sexual abuse during childhood. Studies show that trauma rates among people with BPD are substantially higher than in the general population.
Invalidating environments: Growing up in an environment where your emotions were dismissed, criticized, or punished can contribute to difficulties with emotional regulation later in life.
Neglect: Emotional neglect or inconsistent caregiving during critical developmental periods may increase vulnerability to BPD.
Early losses: Separation from caregivers, death of a parent, or other significant losses in childhood can be risk factors.
Common BPD Symptoms in Detail
Understanding the full range of BPD symptoms can help you recognize patterns in your own experiences.
Fear of Abandonment
This is often one of the most prominent BPD symptoms. The fear isn't just about being alone—it's an intense terror of being abandoned or rejected. This fear can lead to:
Frantically trying to avoid real or imagined abandonment
Clinging to relationships even when they're unhealthy
Preemptively ending relationships to avoid being abandoned
Constantly seeking reassurance from others
Misinterpreting neutral situations as signs of abandonment
Unstable Relationships
Relationships in BPD tend to follow intense patterns, often called "splitting" or black-and-white thinking. Someone might be idealized as perfect one moment, then devalued as terrible the next. This isn't intentional manipulation—it reflects genuine shifts in perception driven by emotional intensity.
Identity Disturbance
Many people with BPD describe feeling like they don't know who they are. This might involve:
Frequently changing goals, values, or career plans
Shifting self-image based on who you're with
Feeling like a "chameleon" who adapts to others
Uncertainty about sexual orientation or gender identity
Feeling like you have no core sense of self
Impulsive Behaviors
Impulsivity in BPD is often driven by intense emotions and difficulty tolerating distress. Common impulsive behaviors include:
Reckless spending or shopping sprees
Substance abuse
Risky sexual behavior
Dangerous driving
Binge eating
Sudden, major life changes (quitting jobs, ending relationships)
Emotional Instability
Emotions in BPD are intense, rapid, and reactive. Mood shifts can happen within hours or even minutes, triggered by interpersonal events or sometimes without clear triggers. Common emotions include:
Intense anxiety or panic
Profound sadness or emptiness
Overwhelming anger or rage
Brief periods of euphoria or excitement
Chronic Emptiness
Many people with BPD describe feeling chronically empty inside—like there's a void that nothing can fill. This isn't the same as sadness; it's more like numbness or hollowness that persists even when things are going well.
Anger Problems
Anger in BPD can be intense and difficult to control. This might involve:
Frequent displays of temper
Constant anger or bitterness
Physical fights
Sarcasm or cutting remarks
Anger that feels disproportionate to the situation
Stress-Related Paranoia or Dissociation
During high stress, people with BPD may experience:
Paranoid thoughts about others' intentions
Feeling suspicious or distrustful
Dissociation (feeling disconnected from yourself or reality)
Feeling like you're watching yourself from outside your body
Memory gaps during stressful periods
Self-Harm and Suicidal Behavior
This is one of the most serious symptoms of BPD. Self-harming behaviors might include:
Cutting, burning, or otherwise injuring yourself
Suicidal thoughts or threats
Suicide attempts
Engaging in behaviors you know are self-destructive
If you're experiencing suicidal thoughts, please reach out for help immediately by calling 988 (Suicide and Crisis Lifeline).
Treatment Options for BPD
The good news is that BPD has some of the strongest evidence-based treatments of any personality disorder. Research shows that many people with BPD improve substantially with proper treatment.
Dialectical Behavior Therapy (DBT)
DBT (Dialectical Behavior Therapy), developed by Marsha Linehan, is the best-supported psychotherapy for BPD and specifically targets core symptoms such as self-harm, emotional dysregulation, and interpersonal instability.
DBT includes four main components:
Mindfulness: Learning to be present in the moment without judgment, which helps manage intense emotions.
Distress Tolerance: Developing skills to tolerate difficult situations without making them worse through impulsive behaviors.
Emotion Regulation: Understanding and managing intense emotions more effectively.
Interpersonal Effectiveness: Improving relationship skills, setting boundaries, and communicating needs.
Research published in JAMA Psychiatry shows that DBT significantly reduces self-harm, suicide attempts, and hospitalizations while improving overall functioning.
Mentalization-Based Treatment (MBT)
MBT helps people with BPD develop the capacity to understand their own and others' mental states. This treatment focuses on improving the ability to "mentalize"—to reflect on thoughts, feelings, and motivations.
Studies show that MBT reduces symptoms and improves social functioning in people with BPD.
Transference-Focused Psychotherapy (TFP)
TFP is a psychodynamic therapy that examines how patterns from past relationships show up in current relationships, including the therapeutic relationship.
Schema Therapy
This integrative approach combines elements of cognitive-behavioral, attachment, and psychodynamic theories. It focuses on identifying and changing deeply held patterns (schemas) that drive BPD behaviors.
Medication
While no medication is specifically approved for BPD, medications can help with specific symptoms:
Mood stabilizers may help with emotional instability and impulsivity.
Antidepressants (particularly SSRIs) can help with depression, anxiety, and emotional sensitivity.
Antipsychotics (at low doses) may help with dissociation, paranoia, or severe emotional dysregulation.
Medication is typically most effective when combined with psychotherapy rather than used alone.
General Psychiatric Management (GPM)
GPM is a less intensive but still effective approach that general mental health clinicians can deliver. It focuses on psychoeducation, case management, and principles drawn from various therapeutic approaches.
When to Seek Professional Help
You should seek professional evaluation if:
You have intense, unstable relationships that cause significant distress
You engage in self-harm or have suicidal thoughts
Your emotions feel out of control or overwhelming
You struggle with a consistent sense of who you are
Impulsive behaviors are causing problems in your life
You feel chronically empty or experience intense anger
People close to you have expressed concern about your behavior
How Online Psychiatry Can Help with BPD
Virtual psychiatric care through platforms like Blossom Health offers several advantages for BPD treatment:
Accessibility: Connect with providers experienced in treating BPD, which can be difficult to find in some areas.
Consistency: Maintain regular appointments even when you're struggling or want to avoid treatment—the lower barrier of virtual care can improve attendance.
Crisis support: Some platforms offer more frequent check-ins during difficult periods.
Medication management: Psychiatric providers can prescribe and monitor medications that help with specific BPD symptoms.
The Bottom Line
If your screening results suggest BPD, know that you're not alone and that effective, evidence-based treatments exist. BPD is not a character flaw or life sentence—it's a treatable mental health condition.
The most important step is seeking comprehensive evaluation from a mental health professional experienced in treating BPD. With proper treatment, most people with BPD experience significant improvement in symptoms and quality of life. Many people who complete BPD treatment go on to build stable relationships, pursue meaningful careers, and live fulfilling lives.
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. If you're experiencing suicidal thoughts or a mental health emergency, call 988 (Suicide and Crisis Lifeline) or go to your nearest emergency room.
Sources
National Institute of Mental Health - Borderline Personality Disorder
American Psychiatric Association - What is Borderline Personality Disorder?
Distel MA, et al. Heritability of borderline personality disorder features. JAMA Psychiatry. 2008
Zanarini MC, et al. The course of borderline personality disorder. JAMA Psychiatry. 2012
National Education Alliance for Borderline Personality Disorder
